Call center manager convicted in scam

A West Palm Beach man has been convicted by a federal jury in a $67 million Medicare fraud scheme after the call center he managed tricked doctors of Medicare patients into approving thousands of expensive and medically unnecessary cardio genetic tests that weren’t used in the treatment of those who took them.

Jose Goyos, 37, was found guilty Oct. 6 of conspiracy to commit wire fraud and conspiracy to commit money laundering at a jury trial in Fort Pierce and now faces maximum penalties of 20 years in prison for the first charge and 10 for the second. He is scheduled to be sentenced Dec. 21.

According to the court documents, Goyos managed a Boca Raton call center, which employed 50 to 70 people, to lead a deceptive telemarketing campaign targeting thousands of Medicare beneficiaries and their doctors between

June 2020 and July 2021.

The scheme was carried out at the outset of the COVID-19 pandemic, when federal authorities made it easier for patients in urban, not just rural, areas to receive telemedicine evaluations.

Goyos directed his employees to tell the physicians that the beneficiaries requested these genetic tests and had medical conditions justifying them, when neither statement was true, the U.S. Department of Justice said Monday in a news release.

“Goyos and his co-conspirators then used those doctors’ authorizations to submit claims to Medicare for the expensive and unnecessary genetic tests,” the Justice Department said. “In reality, the labs were shells; they had no equipment, did not conduct a single test, and had no lab personnel.”

The defendant and his co-conspirators then referred all the genetic tests to other labs, which charged considerably less than the $7,000 per test billed to the tax-payer funded Medicare insurance program, according to the Justice Department and court documents.