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Date: 04-11-2024
Case Style:
Case Number: 23-cr-60237
Judge: Rodney Smith
Court: The United States District Court for the Southern District of Florida (Miami-Dade County)
Plaintiff's Attorney: The United States Attorney’s Office in Miami
Defendant's Attorney: Louis V. Martinez
Description:
Sober homeowner sentenced to four years in prison for defrauding over $4 million from Federal Employee Health Benefits Program to fund lavish lifestyle
A substance abuse facility owner was sentenced to four years in federal prison, followed by three years of supervised release, and ordered to pay $4,444,417.65 in restitution, for defrauding the Federal Employees Health Benefits Program (FEHBP) of over $4 million. The sentence comes after the defendant entered a guilty plea in February.
Joseph Toro, 39, of Jupiter, Florida, owned and operated Reawakenings Wellness Center (RWC), a substance abuse facility that treated patients, including FEHBP beneficiaries, from 2013 until January 2018, when RWC was evicted from their location in Miramar, Florida. After the RWC eviction, Toro continued to submit FEHBP insurance claims, using personal identifying information of former RWC patients, for substance abuse treatment that was never provided. To do so, he called the FEHBP hotline, impersonated former patients, and changed their mailing addresses to addresses that he controlled so he could obtain the fraudulent insurance reimbursement checks. For over a year, Toro submitted fraudulent claims on behalf of 29 former RWC patients for over $6.7 million in substance abuse treatment that he knew RWC never provided. As a result of Toro’s fraudulent claims, he obtained nearly $4.2 million in proceeds from the FEHBP. Toro also applied for and obtained a $150,000 Economic Injury Disaster Loan (EIDL) from the U.S. Small Business Administration (SBA) during the COVID-19 pandemic. That application misrepresented that RWC had five employees and grossed over $1.4 million in 2019, when in truth RWC had shut down years prior.
With the fraudulently obtained proceeds, Toro purchased a waterfront mansion in Jupiter, a Lamborghini Aventador, a Mercedes G Wagon, two Cadillac Escalades, an Audemars Piguet watch, and various other properties and luxury goods.
U.S. Attorney Markenzy Lapointe for the Southern District of Florida and Special Agent in Charge Derek M. Holt of the U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), announced the sentence imposed by U.S. District Judge Rodney Smith.
OPM OIG investigated the case. Assistant U.S. Attorney Joseph Egozi prosecuted it. Assistant U.S. Attorney Joshua Paster handled asset forfeiture.
Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov, under case number 23-cr-60237.
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Defendant's Experts:
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