By james art Federal authorities in the US say that a Cuban immigrant Joel Regino Diaz Martin fled to Cuba with a fortune after orchestrating a massive Medicaid fraud scheme in Miami. Diaz pretended to own a mental health clinic, illegally securing about $4 million from the state’s low-income insurance program.
Report of Miami Herald revealed that Diaz amassed his wealth by falsely claiming ownership of the New Behavior Health Direction clinic in Hialeah Gardens, Florida. However, the real owner was a Cuban American Jose Davila Nunez. Significant portions of the fraudulent profits obtained through false Medicaid invoices went to Dávila, who compensated Diaz for serving as the clinic’s “designated owner,” according to court records.
Diaz, who arrived in Florida in 2018, reportedly fled to Cuba in the fall of 2020, as detailed by the Miami Post. Before fleeing, he transferred millions from the clinic’s accounts to his boss, keeping some of the funds for himself, according to court documents.
The wider scheme and its players
The Miami Herald noted that Diaz’s case is part of a larger trend in which “hundreds of Cuban immigrants” have come to South Florida to engage in health care billing fraud, only to flee back to the island or to other Latin American countries when pursued by federal agents. This pattern was previously documented by the paper in a 2018 article titled “Medicare Crooks.”
On Oct. 11, Davila, 51, of Miami, was sentenced to more than five years in federal prison, followed by three years of supervised release, after pleading guilty to conspiracy to commit health care fraud. He was also ordered to pay $3,869,703 in restitution to Medicaid.
Two of Dávila’s associates, Jesus Rojas, 44, and Luis Rivero, 50, also admitted to conspiring to pay bribes to patients from November 2018 to December 2022. They did so in exchange for patients visiting alleged mental health sessions at three other Miami clinics: Davila Medical Center, Incorporated, Advanced Community Wellness Center, and Larkin Behavior Health, Incorporated. These clinics collectively defrauded Medicaid of about $12 million. Rojas and Rivero received sentences of two to three years in prison.
Revelations and consequences
From April 2019 to September 2020, New Behavior Health Direction submitted fraudulent Medicaid claims totaling $3,869,703 purported to provide psychosocial rehabilitation (PSR) services. PSR is a form of therapy aimed at helping people with disorders such as depression and anxiety.
In September 2020, Diaz, acting as the “designated owner,” made several cash withdrawals from the fraud proceeds, turned over some of the money to Davila, and then fled to Cuba, as reported by the Miami Herald based on a factual statement related to the Settlement for Dávila’s guilty plea. However, the statement did not specify how much taxpayer-funded Medicaid money Diaz took to Cuba.
The US government was able to seize approximately $1.7 million in cash related to A new direction for behavior and healthbank accounts of. According to the newspaper report, federal prosecutors in Miami declined to comment on whether Diaz faces charges related to Medicaid fraud, and no criminal cases have been filed under his name in the South Florida federal court system.
The plea agreement accompanying Davila’s lawsuit reveals that in June 2018, he “instructed” Diaz to register as the sole owner of New Behavior and enroll the clinic in Medicaid.
During the investigation, federal agents discovered that Dávila had stolen the identity of a Miami-Dade physician to list him as a supervising physician for New Behavior, facilitating the clinic’s Medicaid billing scheme. In 2020, investigators confirmed through an interview with the doctor that he neither ran New Behavior nor knew Dávila.
Dávila also impersonated a therapist who allegedly accounted for nearly half of the $3.8 million billed to Medicaid by New Behavior. The investigation revealed that the therapist never provided mental health treatment to anyone at the clinic.
To channel the fraudulent funds, Dávila instructed Diaz to open six corporate bank accounts in TD Bank, Regional Bankand Truist Bankwhere Dávila deposited $1.7 million in ill-gotten gains, which were later confiscated by federal authorities.
In September 2020, federal agents visited Diaz’s last known address at 1116 Palm Ave., Hialeah, but the owner informed them that he had already moved out. Authorities have been unable to find him since. A government witness reportedly told federal agents that Diaz had “returned to Cuba,” as the Miami Herald report mentioned.