Two Fresno County men are headed to prison for committing healthcare fraud.
U.S. District Judge Jennifer Thurston sentenced Felipe Ruiz, 52, of Fresno, and Jose Gabriel Aguirre, 53, of Clovis, to 63 months in prison for conspiracy to commit healthcare fraud.
Driving the news: Ruiz was a podiatrist and the owner of West Coast Podiatry Inc., which had offices in Fresno, Madera and Stanislaus counties. Aguirre was a pharmaceutical sales representative who sold skin grafts to Ruiz. He was not licensed to practice medicine.
Ruiz purchased skin grafts from Aguirre from June 2021 to January 2024 and allowed Aguirre to apply the grafts and perform other medical procedures on patients suffering from severe wounds, including foot amputations.
Aguirre performed the medical procedures alone without supervision, with some patients believing he was a physician and calling him Dr. Gabe.
Ruiz and Aguirre submitted fraudulent claims to Medicare, Medicaid and Medi-Cal that claimed Ruiz and other physicians had performed the procedures, when Aguirre was actually the one who performed them.
Court documents showed one example where West Coast Podiatry submitted $150,000 claims to Medicare in 2023 claiming a physician performed the procedures. The physician was actually out of the country at that time. Ruiz knew about Aguirre’s conduct but dismissed concerns from his staff.
Staff and third-party auditors raised concerns about their billing practices, but Ruiz and Aguirre ignored the warnings and continued to bill Medicare and Medicaid.
By the numbers: Overall, Ruiz submitted around $3.2 million in false claims to Medicare, Medicaid and Medi-Cal.
What they’re saying: “We trust licensed medical professionals to safeguard their patients and not hand them over to unqualified individuals,” said U.S. Attorney Eric Grant. “This podiatrist put profit over patient safety by allowing a salesman to perform medical procedures on vulnerable Medicare beneficiaries. Today’s outcome underscores our commitment to holding providers accountable when they abuse that trust and bill federal health care programs for services that violate the most basic standards of care.”
FBI Sacramento Special Agent in Charge Sid Patel added, “Health care fraud schemes don’t just drain taxpayer-funded programs, they also put patients directly at risk. The FBI will continue working alongside HHS-OIG and our law enforcement partners to identify and prosecute those who treat public trust as an opportunity for personal profit.”