A North Miami man’s company, the fake owner who left for Cuba and a $1.6 million fraud – InsuranceNewsNet

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September 15, 2022 Newswires No comments
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A North Miami man’s company, the fake owner who left for Cuba and a $1.6 million fraud

Miami Herald (FL)

North Miami resident Daniel Cazola successfully hid his ownership of a Fort Myers company on paper. But when he ran his mouth to a federal confidential informant, Cazola revealed his ownership in the company and how he was using it for a $1.6 million Medicare fraud.

Cazola was sentenced to seven years and three months in federal prison Thursday after pleading guilty to conspiracy to commit healthcare fraud, wire fraud, and mail fraud, and one count of aggravated identity theft.

READ MORE: A South Florida mother, daughter and their $8 million Medicare fraud

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In his guilty plea, Cazola admits he owned Myers Professional Services, housed in a single-floor, beveled-ceiling professional building in Fort Myers. When Myers Professional was registered with the state in March 2021, Jose Antonio Fonseca Gutierrez was listed as president of Myers, which remains an active Florida corporation.

“On ... Dec. 9, 2021, co-conspirator J.F.G. traveled to Cuba and has not returned to the United States through any port of entry,” Cazola’s guilty plea says.

A DME and Myers mix

Myers Professional’s purported raison d’etre was supplying durable medical equipment (DMEs) to Medicare and Medicaid patients. In a recorded conversation in May 2021, Cazola explained how he used fraudulent DME companies for his scams. He didn’t know the person he was talking to had already been arrested, charged and now was working with prosecutors. He used as an example an unnamed company based near Miami International Airport.

“[Cazola] explained that he buys the “patients” (referring to lists of Medicare beneficiaries) from someone he knows for $100 per patient,” Cazola’s guilty plea said. He said he “buys $5,000 worth of “patients” and that the investment generates approximately $100,000 per week” in Medicare payments received from fraudulent claims.

Cazola said he “provides the patient lists to a “biller” who bills Medicare non-stop, including weekends. [Cazola] estimated that the clinics ‘easily yielded $1 million to $1.5 million’ per clinic.’”

The defendant working with investigators told them Cazola was going to U.S. Post Office to do send in some paperwork concerning the next DME company through which the fraud would run. Cazola had a blank check for “Myers Professional Services.”

But from Nov. 8, 2021 and Feb. 10, 2022, Myers Professional submitted $2,339,520 in fraudulent claims to Medicare and Medicaid and got $1,608,759 from those claims.

Investigators interviewed three doctors listed on the claims data as prescribing DMEs. All three denied they had done so. Medicare and Medicaid patients listed as receiving the DMEs denied receiving them or that they’d even been treated by the listed doctors.

The U.S. Department of Health and Human Services’ Office of the Inspector General investigated this case.

©2022 Miami Herald. Visit miamiherald.com. Distributed by Tribune Content Agency, LLC.

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