Man charged in UnitedHealth, BCBS false claims scheme

A man in Miami has been charged with submitting an estimated $38 million in false and fraudulent healthcare claims, federal prosecutors announced Friday.

The 63-year-old man, Armando Valdes, has been charged with 10 counts of healthcare fraud. He was arrested Friday morning by federal law enforcement agents, according to a news release from the Justice Department.

Valdes allegedly submitted false claims to UnitedHealthcare and Blue Cross Blue Shield through a Miami clinic called Gasiel Medical Services, according to a federal grand jury indictment. Valdes allegedly owned and operated the clinic from February 2015 through July 2021.

The allegedly fraudulent claims related to infusions of infliximab that were allegedly not medically necessary and not provided to patients as billed, according to the indictment.

Infliximab, also known by the brand name Remicade, is a prescription immunosuppressive drug approved to use as a treatment for Crohn’s disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and plaque psoriasis, according to the U.S. Attorney’s Office for the Southern District of Florida.

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Valdes allegedly used proceeds from the fraudulent claims to purchase four real estate properties, including a beachfront condo in Pompano Beach, Florida.

He also allegedly used proceeds to purchase luxury vehicles including a Cadillac Escalade and a Tesla Model S, according to the indictment.

If convicted, Valdes could face up to 100 years in prison, according to the U.S. Attorney’s Office for the Southern District of Florida.