GAINESVILLE, FLORIDA – Anthony Hernandez, 43, of Gainesville, Florida, was sentenced yesterday to six months in federal prison after having pled guilty to making false statements relating to health care matters and conspiracy to commit money laundering. Lawrence Keefe, United States Attorney for the Northern District of Florida, announced the sentence.
“The financial losses to healthcare insurance companies resulting from these schemes are staggering,” said U.S. Attorney Keefe. “What’s more, mutual trust between patients and healthcare providers is a critical component of quality care. The actions of Hernandez, and criminals like him, erode that trust. We will continue working in lockstep with our law enforcement partners to see that the perpetrators of these crimes are held accountable.”
Between June 2013 and October 2015, Hernandez defrauded multiple healthcare insurers by submitting false reimbursement claims for allergen immunotherapy treatments, or allergy shots, which were never provided. Hernandez, who holds no medical or chiropractic license, operated Gainesville Medical Centers, LLC, (GMC) in Gainesville, Florida. He recruited individuals, including students from various University of Florida (UF) organizations, to become patients of GMC in order to receive allergy testing. In some cases, Hernandez offered financial compensation to charities, UF sports teams, and UF fraternities and sororities in exchange for its members to receive free allergy testing at GMC. In conjunction with the allergy testing that was actually provided, Hernandez directed his staff to submit false insurance claims for allergy shots which were never administered to GMC’s patients. Through these false claims, Hernandez personally received $810,292.47 from Cigna, Blue Cross Blue Shield, Aetna, and United Health Care healthcare insurance companies. Hernandez also conspired to launder the proceeds received from these false claims by transferring the money from the business bank accounts to personal bank accounts.
“The FBI views health care fraud as a major crime problem,” said FBI Special Agent in Charge Rachel L. Rojas. “Abuse within the health care system reduces the availability of critical resources, and contributes to the rising cost of healthcare for all. The FBI and our law enforcement partners will continue to allocate expert resources to investigate these crimes and prosecute all those who defraud the American public for their own personal gain.”
“We take great pride in our role to protect our nation’s economy by rooting out fraud,” said Special Agent in Charge Brian Payne of IRS Criminal Investigation. “Mr. Hernandez’s actions did not simply affect the insurance companies he ripped off, but also the University of Florida students and other victims he took advantage of. Moreover, his actions tipped the playing field against all consumers. Working alongside FBI, we are keenly dedicated to maintaining a level field for all Americans.”
As part of his sentence, Hernandez was ordered to pay $810,292.47 in restitution to the victims in this case and a $75,000 fine. In addition, after serving his term of imprisonment, Hernandez will begin a two-year term of federal supervised release.
This case was investigated by the Internal Revenue Service Criminal Investigations and the Federal Bureau of Investigations. Assistant United States Attorney Justin Keen prosecuted the case.
