Mother-Son Duo Arrested for Defrauding Medicaid
Release Date
Mar 28, 2023
Contact
Whitney Ray
Phone
850-245-0150
TALLAHASSEE, Fla.—Attorney General Ashley Moody’s Medicaid Fraud Control Unit today announced the arrest of two Miami-Dade County healthcare workers for paying illegal kickbacks to Medicaid recipients. According to an investigation by MFCU, a mother-son duo, Gladys Aracely Gomez and Edward Exequiel Garcia-Gomez, paid illegal kickbacks to patients to receive psychosocial rehabilitation services to defraud the state Medicaid program of more than $300,000.
Attorney General Ashley Moody said, “This mother-son duo used a cunning kickback scheme to steal hundreds of thousands of dollars from a taxpayer-funded health care program. My investigators uncovered this massive Medicaid fraud and will help ensure this criminal team faces justice for exploiting taxpayers.”
According to an investigation by MFCU, Gladys Gomez and Edward Garcia-Gomez illegally paid Medicaid recipients kickbacks to attend psychosocial rehabilitation services. Psychosocial rehabilitation is a therapy service that provides daily medication use, independent living and social-skills training, support to clients and families, housing, pre-vocational and transitional employment, structured activities to diminish tendencies toward isolation and withdrawal, education for the recipient and family about symptom management, medication and treatment options—all billable to the Medicaid program. One witness claimed that the defendants paid clients to sign progress sheets for the whole week. The investigation uncovered that the defendants gave some patients $250 biweekly or $500 monthly in return for attending the rehabilitation sessions.
Both defendants are charged with Medicaid-provider fraud, a first-degree felony. The case will be prosecuted by the Miami-Dade State Attorney’s Office, 11th Judicial Circuit.
# # #
The Florida Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program. From January 2019 to present, Attorney General Moody's MFCU has obtained more than $138 million in settlements and judgments.
The Florida MFCU is funded through a grant totaling $30,219,404 for Federal Fiscal Year 2023, from the U.S. Department of Health and Human Services-Office of Inspector General. The Federal Share of these funds is 75% totaling $22,664,556. The State Matching Share of these funds is 25% totaling $7,554,848, and is funded by Florida.
The Florida Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program. From January 2019 to present, Attorney General Moody's MFCU has obtained more than $138 million in settlements and judgments.
The Florida MFCU is funded through a grant totaling $30,219,404 for Federal Fiscal Year 2023, from the U.S. Department of Health and Human Services-Office of Inspector General. The Federal Share of these funds is 75% totaling $22,664,556. The State Matching Share of these funds is 25% totaling $7,554,848, and is funded by Florida.