A federal jury found a woman from North Carolina guilty of participating in a scheme to defraud various private health insurers by filing more than $34 million in fictitious and fraudulent claims for physical therapy services that were never actually rendered.
Jaroslava Ruiz, 50, of Chapel Hill, is accused of paying bribes and kickbacks to patients with private insurance and patient recruiters in exchange for allowing four Miami physical therapy clinics to bill for medical services that weren’t actually rendered to those patients, according to court documents and evidence presented at trial. Ruiz and her accomplices fabricated medical papers to make it appear as though the physical therapy services were truly provided, were medically required, and had been ordered by a physician. In actuality, none or almost none of the claimed services had been given. To multiple private insurers for those fictitious physical therapy services, Ruiz and her accomplices submitted around $34.6 million in false and fraudulent claims, of which the insurers paid about $7.7 million.
Nine charges of health care fraud and one count of wire fraud conspiracy were found to have been committed by Ruiz. She could spend up to 20 years in jail on the conspiracy charge and 10 years in jail for each count of health care fraud. The U.S. Sentencing Guidelines and other statutory considerations will be taken into account by a federal district court judge when determining any punishment. On October 26, 2022, a sentence will be given.
