A West Palm Beach telemarketer was handed a 15-year prison sentence for his involvement in a $67 million Medicare fraud scheme that capitalized on unnecessary genetic testing. According to the U.S. Attorney's Office for the Southern District of Florida release, Jose Goyos, 38, was convicted of conspiracy to commit wire fraud and money laundering after misleading both patients and physicians to facilitate the exorbitant billing to Medicare.
Goyos used deceptive tactics through a call center's "doctor chase" division, tricking physicians into ordering unnecessary genetic tests for patients. He falsely claimed that these patients had requested and needed the tests. From May 2020 to July 2021, Goyos and his accomplices submitted fraudulent claims, stealing over $53 million from Medicare, with total claims exceeding $67 million, as per the same release.
The investigation, which was led by the FBI and HHS-OIG and resulted in convictions for nine other Florida residents involved in the scheme—sentences ranging from two years to nearly 17 years were handed down to the co-conspirators. Notably, Daniel M. Carver received almost 17 years, while Thomas Dougherty and John Paul Gosney Jr. both were sentenced to 14 and nearly eight years, respectively.
U.S. Attorney Markenzy Lapointe, along with officials from the Justice Department, the FBI’s Miami Field Office, and the HHS-OIG Miami Regional Office, commended the successful prosecution and sentence. Over 5,400 individuals have been charged since the launch of the Health Care Fraud Strike Force Program in March 2007.
