A federal jury convicted a North Carolina woman last Thursday for her role in a scheme to defraud several private health insurers by submitting over $34 million in false and fraudulent claims for physical therapy services that were never actually provided, officials announced Monday.
According to court documents and evidence presented at trial, Jaroslava Ruiz, 50, of Chapel Hill, paid kickbacks and bribes to patient recruiters and patients with private insurance.
In exchange, she allowed four Miami physical therapy clinics to bill for medical services that were never actually provided to those patients.
Ruiz and her co-conspirators falsified medical records to give the impression that the physical therapy services were medically necessary, prescribed by a doctor, officials stated.
In truth and fact, none or virtually none of the purported services had been provided. Ruiz and her co-conspirators submitted approximately $34.6 million in false and fraudulent claims to several private insurers for those nonexistent physical therapy services, of which the insurers paid approximately $7.7 million.
Ruiz was convicted of one count of conspiracy to commit health care fraud and wire fraud and nine counts of health care fraud.
She faces up to 20 years in prison on the conspiracy count and up to 10 years in prison on each health care fraud count.
Sentencing is scheduled for Oct. 26, 2022, according to authorities.
The FBI is investigating the case.
Trial Attorneys Emily Gurskis and Patrick Queenan of the Criminal Division’s Fraud Section are prosecuting the case.