Florida Nursing Assistant Convicted in $11.4M Health Care Fraud Scheme Targeting Medicare Beneficiaries

A federal jury in Fort Lauderdale, Florida, convicted a nursing assistant today for his role in an $11.4 million health care fraud and wire fraud conspiracy in which hundreds of Medicare beneficiaries were sent thousands of orthotic braces they did not need.

“Defendant Chris Cruz blatantly lied to Medicare in order to steal over $11 million from hard-working taxpayers,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s Criminal Division. “Today’s guilty verdict demonstrates that the Criminal Division remains committed to holding criminals accountable who steal from their fellow citizens to fuel their own greed.”

“Nursing Assistant Chris Cruz devised a scheme to enrich himself by defrauding Medicare to the tune of millions of dollars,” said Assistant Special Agent in Charge Chris Caldwell of the FBI Miami Field Office. “The FBI and our partners will not relent in the pursuit of Medicare fraudsters - including greedy nurses.”

“This brazen scheme stole $11.4 million from Medicare and betrayed taxpayer trust,” said Acting Deputy Inspector General for Investigations Scott J. Lampert of HHS-OIG. “HHS-OIG is steadfastly committed to ensuring that medical decisions are driven by patient need rather than financial gain.  We will relentlessly pursue those who put greed over patient care and hold them accountable.”

According to court documents and evidence presented at trial, Christian “Chris” Cruz, 45, of Pompano Beach, Florida, owned and operated a durable medical equipment (DME) supplier based in Florida through which he submitted millions of dollars in false claims to Medicare for medically unnecessary orthotic braces.

Cruz and his co-conspirator paid illegal kickbacks and bribes to obtain signed doctors’ orders. They used these orders to ship orthotic braces to Medicare beneficiaries nationwide and then claim payment from Medicare, including to beneficiaries who neither requested nor required the braces. Cruz lied to Medicare, claiming that he was the sole owner and operator of the company when in fact he shared ownership in the company with his co-conspirator, a convicted felon. Medicare would not have allowed the company to enroll with Medicare if it had known about Cruz’s co-conspirator. The co-conspirator has been charged but remains at large.

Cruz received several hundred thousand dollars to his personal bank account from the fraudulent scheme that he frequently withdrew in cash on consecutive days at different bank branches in South Florida, often in amounts just under the bank reporting threshold of $10,000.

Cruz was convicted of one count of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud, one count of conspiracy to defraud the United States and to make false statements relating to health care matters and three counts of structuring. He is scheduled to be sentenced on April 13 and faces a maximum penalty of 125 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

The FBI and HHS-OIG investigated the case.

Trial Attorney Owen Dunn of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Sterling Paulson of the Southern District of Florida prosecuted the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,800 defendants who collectively have billed federal health care programs and private insurers more than $30 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.