TAMPA, Fla. (February 3, 2022)—U.S. District Judge Virginia Hernandez Covington sentenced Patsy Truglia (54, Parkland, Florida) to 15 years in federal prison for his role in two consecutive conspiracies to commit health care fraud and for making a false statement in a matter involving a health care benefit program. As part of his sentence, the court ordered Truglia to pay $18.3 million to the affected government health programs and an insurance company. The court also entered a money judgment against Truglia in the amount of $10,117,738 and ordered him to forfeit numerous assets, including $9,308,235.86 seized from various financial accounts, high-end automobiles (Rolls Royce, Lamborghini and Mercedes), jewelry and Truglia’s lakefront home, all of which were traceable to the charged criminal conduct. Truglia had pleaded guilty on Oct. 5, 2021.
According to court documents, beginning in January 2018 and continuing into April 2019, Truglia and other conspirators, including co-defendant Ruth Bianca Fernandez (who worked under Truglia’s supervision), generated medically unnecessary physicians’ orders via their telemarketing operation for certain orthotic devices—knee braces, back braces, wrist braces, and other braces—referred to as durable medical equipment (DME). Through the telemarketing operation, federal health care program beneficiaries’ (i.e., Medicare beneficiaries’) personal and medical information was harvested to create the unnecessary DME brace orders.
The brace orders were then forwarded to purported “telemedicine” vendors that, in exchange for a fee, paid illegal bribes to physicians to sign the orders, often without ever contacting the beneficiaries to conduct the required telehealth consultations. The fraudulent, illegal brace orders were then returned to Truglia’s telemarketing operation, which used the orders as support for millions of dollars in false and fraudulent claims submitted to the Medicare program. To avoid Medicare scrutiny, Truglia and Fernandez spread the fraudulent claims across five DME storefronts operated under Truglia’s ownership and control and Fernandez’s day-to-day management. In all, through their five storefronts, Truglia, Fernandez, and other conspirators caused approximately $25 million in fraudulent DME claims to be submitted to Medicare, resulting in approximately $12 million in payments.
On April 9, 2019, multiple federal law enforcement agencies participated in a nationwide action referred to as “Operation Brace Yourself.” The operation targeted ongoing schemes, such as Truglia’s, in which companies were paying illegal bribes to secure signed physicians’ DME brace orders for use as support for fraudulent claims submitted to the federal programs. In the Middle District of Florida, the April 2019 operation included, among other efforts, the execution of search warrants at several of Truglia’s DME storefronts and a civil action under which, among other ramifications, enjoined Truglia and (by extension) his five storefronts from engaging in any further health care fraud conduct.
Undeterred, beginning in or around April 2019 and continuing into July 2020, Truglia and other conspirators—some of whom had worked with Truglia in the earlier conspiracy and some of whom were new conspirators—carried out a similar conspiracy using three new DME storefronts and different “telemedicine” vendors. Through this conspiracy, Truglia and his conspirators caused an additional approximately $12 million in fraudulent DME claims to be submitted to Medicare, resulting in approximately $6.3 million in payments.
“Every defendant in this case shared a common trait—greed,” said IRS-CI Special Agent in Charge Brian Payne. “The desire for money fueled them to commit crimes against our healthcare system and prey upon those in our society who deserve our highest respect, the elderly and military veterans. Thanks to the financial expertise and diligence of IRS-CI special agents, as well as our partner federal, state, and local law enforcement officers, these criminals are off the street and are facing the consequences of their actions.”
“The significant sentence and financial restitution imposed today reflects the serious nature of Mr. Truglia’s criminal conduct and underscores that the Government will continue to vigorously prosecute health care fraud cases and seek the recovery of all illicitly obtained assets of these greed-fueled fraud schemes,” said Special Agent in Charge Omar Pérez Aybar of HHS-OIG. “Collaborating closely with our law enforcement partners, we will continue to thoroughly investigate fraudsters who seek to enrich themselves at the expense of vulnerable members of the public.”
“We have dedicated agents and analysts focused on uncovering the deceitful tactics used to cheat our federal healthcare system,” said FBI Tampa Division Special Agent in Charge Michael McPherson. “The cost of healthcare fraud impacts all of us. The FBI will continue to engage with our partners to protect taxpayers from fraudsters like Mr. Truglia and those identified in Operation Brace Yourself.”
“The sentence imposed today holds this defendant accountable for his prominent role in a reprehensible healthcare fraud scheme involving CHAMPVA and Medicare,” said Special Agent in Charge David Spilker, Department of Veterans Affairs Office of Inspector General, Southeast Field Office. “The VA OIG is committed to ensuring healthcare spending is directed only to deserving veterans and those who serve them. We thank and commend our outstanding law enforcement partners in this important joint investigation.”
This case was investigated by U.S. Department of Health and Human Services – Office of Inspector General, the Federal Bureau of Investigation, the Department of Veterans Affairs – Office of Inspector General, and the Internal Revenue Service –Criminal Investigation, Tampa Field Office. The criminal case was prosecuted by Assistant United States Attorneys Jay G. Trezevant, Tiffany E. Fields, and James A. Muench. The civil action is being handled by Assistant United States Attorney Carolyn B. Tapie.
