South Floridians Take Center Stage In Nationwide $7B Health Care Fraud Crackdown

South Florida’s health care fraud industry has always maintained a certain flair for brazen improvisation and hustle. But even by local standards, the latest federal crackdown nabbed scammers and schemers who put on a masterclass in audacity.

In one case, prosecutors say a Miami man posed as a dead neurologist to help applicants bypass a key requirement for U.S. citizenship. In another, a network of clinics allegedly billed more than $100 million for phantom wound care treatments. Elsewhere, a call center allegedly pushed unnecessary genetic tests on seniors, while a billing consultant is accused of teaching others how to game Medicare without getting caught.

All told, federal authorities say the schemes — spanning Miami-Dade, Broward and Palm Beach counties — are part of a nationwide web of health care fraud schemes totaling more than $6.5 billion. The charges touch nearly every corner of the industry: durable medical equipment, lab testing, mental health services, and wound care products that existed mostly on invoices.

And as usual, South Florida didn’t just participate — the region stood out.

You can’t help but admire the gumption and ingenuity behind Eduardo Javier Ibarra’s health care scam. The 61-year-old Miamian figured out that he could make an easy stack ($1,000) pretending to be a brain doctor selling waivers for key U.S. Citizenship requirements to non-English speaking applicants.

Authorities say the 61-year-old Miami resident stole the identity of a deceased neurologist — a relative, no less — and used it to certify U.S. citizenship applicants as “disabled” so they could skip the English and civics portion of the naturalization test. At least 14 applicants became U.S. citizens based on paperwork he allegedly signed.

The forms themselves were a mess: misspelled diagnoses, inconsistent details, and contact information that didn’t quite track. That sloppiness is what tipped off immigration officials.

But here’s the kicker: Ibarra isn’t a U.S. citizen either. He’s a Cuban national who, according to investigators, was ordered deported in 2004 after a string of felony convictions that included drug possession, vehicle theft, fraud by impersonation and passing a forged instrument.

Prosecutors say he charged about $1,000 per evaluation and leaned into the role, posting photos of himself online in scrubs, lab coat and stethoscope — a costume backed by a real doctor’s credentials, just not his own.

From her base in Hialeah, Casilda Muniz Rodriguez was a major conduit for nearly a dozen phantom businesses that billed more than $117 million to Medicaid.

Rodriguez, a nurse, owned a consulting business that federal law enforcement authorities accuse of helping create at least 11 clinics that billed Medicare for wound care services that were never provided, a criminal complaint states.

Rodriguez hid the true identity of the clinics’ owners by putting the names of other people on official paperwork to obscure who was really running the show — a shell game designed to stay a step ahead of regulators.

It worked, for a while. The network pulled in more than $55 million before authorities intervened. About $27 million has since been seized, with investigators signaling they’re not done yet.

Some schemes go big. Ibrahim Hilmi’s allegedly went astronomical.

The Miami man is charged in a case involving $3.7 billion in fraudulent billing for medical equipment and wound supplies that prosecutors say never reached patients.

His companies, ABRH Care and Sunshine Senior Solutions, allegedly flooded insurers with claims while quietly funneling proceeds through bank accounts he controlled — including transfers overseas to Hong Kong.

Federal prosecutors say two men ran what amounted to high-volume Medicare fraud mills, using sham companies to bill for medical equipment that never existed.

According to court records, Hilmi and Irakli Nakashidze controlled Sunshine Senior and ABRH, which they used to allow foreign co-conspirators to submit tens of thousands of fraudulent claims using stolen patient and doctor identities to Medicare, Medicaid, federal employee health plans, and private insurers. Many of the supposed patients never requested or received the equipment, and physicians listed on claims never prescribed it.

The companies didn’t actually buy or distribute any medical supplies. Instead, prosecutors say they existed to collect reimbursements with storefront offices serving only as mail drops to make the operations appear legitimate. Within weeks of setting up Sunshine Senior, thousands of claims worth millions were already being filed.

Authorities allege the scheme generated massive billing totals—more than $3.3 billion in false claims tied to Sunshine Senior alone, with hundreds of millions processed and millions actually paid out. ABRH submitted another $420 million in claims over a shorter period. Once funds hit company accounts, the money was quickly moved—often within days—through multiple accounts and then wired to shell companies overseas, including in Hong Kong and Indonesia, in what prosecutors describe as a laundering operation.

Hilmi is also accused of fleeing the U.S. after online complaints surfaced, while continuing to help run the scheme from abroad.

Despite the staggering nine-figure sum billed to insurers, only about $5.7 million was actually paid out. Even in the world of fraud, there are limits to what clears.

If Hilmi’s operation generated the claims, Giorgi Kimeridze allegedly helped move the money.

The 43-year-old Georgian national is accused of laundering proceeds tied to companies that billed more than $1 billion to federal health programs — part of a broader investigation dubbed “Operation Gold Rush.”

Authorities say only about $4.9 million slipped through before the pipeline was disrupted.

Federal investigators say Giorgi Kimeridze helped move money in a sprawling health care fraud scheme that used fake durable medical equipment companies to bill insurers for products patients didn’t need or receive. The complaint says Kimeridze worked with Main Street DME and later ABRH Care, both of which allegedly funneled fraud proceeds through shell companies and overseas accounts.

According to the affidavit, the scheme targeted Medicare, Medigap, Medicare Advantage plans and other insurers, with more than $1 billion in false claims tied to urinary catheters, braces and wound dressings. Investigators say Kimeridze was first linked to the operation in Georgia, then later to ABRH in Miami, where he allegedly stayed in contact through Telegram and helped direct money transfers.

The complaint also says investigators found unusual billing patterns, including claims tied to dead beneficiaries and complaints from thousands of patients who said they never got the items billed in their names. Kimeridze is accused of conspiracy to commit money laundering, and the affidavit says he remains in DHS custody in South Florida.

A Coral Springs medical consultant, Laura Seiler-Anstett ran an orthopedics braces racket that bilked Medicare out of $30 million after submitting $58.3 million in fraudulent claims. She helped her clients submit claims for braces that patients didn’t need or couldn’t legitimately receive. About $30 million was paid.

The operation leaned on kickbacks and a web of suppliers, all feeding into a steady stream of claims that looked legitimate enough, according to an indictment. Seiler-Anstett didn’t just process Medicare claims. Prosecutors say she helped design the playbook.

According to federal authorities, Seiler-Anstett worked behind the scenes to help durable medical equipment companies hide their true owners, using nominee names on paperwork to avoid scrutiny. She allegedly coached operators on how to game the system. Seiler-Anstett schooled her clients on how to spread billing across multiple companies, keep claim volumes low enough to fly under the radar, and avoid states where Medicare audits were more aggressive.

Prosecutors say she also connected companies with marketers who paid illegal kickbacks to generate patient referrals — often through deceptive telemarketing that pressured seniors into accepting equipment they didn’t need. Those orders were then pushed through using telemedicine doctors or a tactic known as “doctor chasing,” where physicians were misled into signing off.

When claims were denied, authorities say Seiler-Anstett adapted — switching billing codes, rotating doctors, and shifting strategies to keep the money flowing. She also allegedly submitted false documents during Medicare audits to justify questionable claims.

Through her companies, MedAct and Intelibill, prosecutors say she helped submit more than $58 million in fraudulent claims, with Medicare paying out roughly $30 million. In return, she collected a cut of the proceeds, totaling nearly $1.8 million.

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