A Multimillion Healthcare Fraud Scheme Unearthed In The United States.

Washington DC; February 2026: The owner of two telemedicine companies was sentenced today to 07 years of imprisonment, and ordered to pay $27.9 million in restitution for his role in a scheme to fraudulently bill Medicare for unnecessary durable medical equipment.

“One, Reinaldo Wilson used his telemedicine companies to exploit Medicare and line his own pockets, instead of connecting patients with legitimate care”, said Assistant Attorney General A. Tysen Duva of the Justice Department’s Criminal Division. “He stole over $27.9 million by submitting false and fraudulent claims, robbing a program designed to provide medical care to America’s seniors. The Criminal Division will aggressively prosecute those who defraud Medicare and exploit taxpayer-funded programs meant to serve the people who have paid into the system”.

“Over a timeframe of just two years, Wilson amassed over $56 million in fraudulent Medicare claims, through a cadre of crooked medical providers and co-conspirators, leveraging durable medical equipment for personal financial gain”, said Special Agent in Charge Stefanie Roddy of the FBI’s Newark Field Office. “When criminals defraud Medicare, they undermine the U.S government. The FBI will always work to apprehend theses fraudsters and put an end to their schemes”.

“Today’s sentence underscores the serious consequences for those who exploit Medicare for personal gain”, said Acting Deputy Inspector General for Investigations Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS‑OIG). “This sentence reflects our commitment to holding individuals accountable when they manipulate providers, target vulnerable patients, and attempt to conceal fraud behind complex schemes. We will continue working with our law enforcement partners to ensure anyone who abuses federal health care programs is exposed and brought to justice”.

According to court documents and statements made in court, Reinaldo Wilson, 57, formerly of Richmond Hill, Georgia, owned and operated 02 telemedicine companies located in Bayonne, New Jersey between 2017 and 2019. Through these companies, Wilson and others paid illegal kickbacks to medical providers to sign orders for orthotic braces for Medicare beneficiaries, even though the beneficiaries did not need the braces.

Furthermore, Wilson and others illegally sold the signed orders to purported marketing companies that often re-sold the orders to brace companies, which in turn submitted claims for the unnecessary braces to Medicare. Wilson and his co-conspirators at marketing companies cajoled beneficiaries into accepting as many braces as possible. Providers working for Wilson’s telemedicine companies signed orders for four or more orthotics a piece for over 3,000 beneficiaries, and more than 40 beneficiaries received orders for 10 or more orthotics.

Moreover, Wilson also attempted to conceal his crimes by creating a new telemedicine company and convincing a member of his church that it was an investment opportunity. He took $20k from this member and had her open the company and bank accounts in her name, which he then took control of.

During the conspiracy, Wilson and others submitted over $56 million in false and fraudulent claims to Medicare, of which Medicare paid over $27.9 million.

In March 2021, Wilson pleaded guilty to conspiracy to commit wire fraud and health care fraud, when FBI, IRS Criminal Investigations (IRS-CI), and HHS-OIG investigated the case.

Trial Attorneys Darren C. Halverson and Nicholas K. Peone of the Criminal Division’s Fraud Section prosecuted the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of 08 strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.

Health Care Fraud Unit –

The Health Care Fraud Unit is comprised of over 75 experienced prosecutors dedicated exclusively in prosecuting the nation’s most complex health care fraud matters and criminal conduct involving the illegal prescribing and dispensing of opioids and other controlled substances. The Unit’s core mission is to protect the public fiscals, involving health care benefit programs such as Medicare, Medicaid, and TRICARE, and to protect patients from egregious fraudulent schemes that result in patient harm, including the overprescribing of controlled substances. The Unit routinely prosecutes defendants who orchestrate schemes that result in the loss of hundreds of millions of dollars, the distribution of thousands of controlled substance pills, and complex money laundering, tax, and other associated financial crime offenses.

The Health Care Fraud Unit is a leader in using advanced data analytics and algorithmic methods to identify newly emerging health care fraud schemes and to target the most egregious fraudsters. The Unit’s team of dedicated data analysts work with prosecutors to identify, investigate, and prosecute cases using data analytics. This novel approach has led to some of the Fraud Section’s largest cases and initiatives. 

The Health Care Fraud Unit employs a recognised and successful Strike Force Model for effectively and efficiently prosecuting health care fraud and illegal prescription cases across the United States. Unit prosecutors currently operate in 08 Strike Forces across the country. The Strike Force Model centres on a cross-agency collaborative approach, bringing together the investigative and analytical resources of the Fraud Section, Federal Bureau of Investigation, U.S. Department of Health and Human Services-Office of the Inspector General, Centers for Medicare & Medicaid Services, Drug Enforcement Administration, Defence Criminal Investigative Service, Federal Deposit Insurance Corporation-Office of the Inspector General, Internal Revenue Service-Criminal Investigations, Department of Labour Office of the Inspector General, United States Postal Service-Office of the Inspector General, Veterans Administration-Office of the Inspector General, and other agencies. 

The Health Care Fraud Unit conducts more trials than any other component of the Department of Justice. Its prosecutors are known for conducting the largest and most complex health care fraud trials in districts located across the country. 

Team Maverick.