In December 2024, Jose Goyos, (38, from West Palm Beach, Florida) was sentenced to 15 years in prison for defrauding Medicare by falsely billing over $67 million for medically unnecessary genetic tests. Goyos and his co-conspirators worked at a telemarketing call center that roped thousands of unsuspecting Medicare beneficiaries and their doctors into their scheme.

According to the government, Goyos managed the call center’s “doctor chase” division that contacted the targeted Medicare beneficiaries’ primary care physicians to con them into ordering medically unnecessary genetic tests from phony paperwork created by the call center. Goyos, for example, told call center employees to falsely represent to health care providers that Medicare beneficiaries were “mutual patients” who had requested genetic testing. They falsely claimed the beneficiaries had medical conditions that qualified for the testing.

Goyos and his accomplices used the doctors’ orders to submit claims to Medicare for expensive and medically unnecessary genetic tests. The test results were often not sent to the Medicare beneficiaries’ primary care physicians and were not used to treat the beneficiaries.

From May 2020 to July 2021, Goyos and his co-conspirators submitted over $67 million in false and fraudulent claims to Medicare. Of these claims, Medicare paid over $53 million.

In October 2023, a jury convicted Goyos of conspiracy to commit wire fraud and conspiracy to commit money laundering. Nine other Florida residents were previously sentenced for their roles in the scheme.

If you believe you have a case or would like to learn more about health care fraud, Medicare fraud, or what it means to be a whistleblower, please contact us. We will connect you with an experienced member of our whistleblower team.

Read Hold the Phone: Telemarketer Sent to Prison for $67M Health Care Fraud and Money Laundering Scheme at constantinecannon.com