Cuban immigrant joins Medicaid racket in Miami but flees back to island with loot, feds say
Published in News & Features
MIAMI — On paper, a Cuban immigrant by the name of Joel Regino Diaz Martin became a millionaire by declaring in corporate records that he was the owner of a Miami-area mental health clinic that collected about $4 million from Medicaid, the state’s health insurance program for low-income people.
In reality, most of the clinic’s ill-gotten profits from bogus bills to Medicaid were siphoned off to the actual owner of New Behavior Health Direction, Jose Davila Nunez, who paid off Diaz Martin to be his company’s “nominee owner,” according to court records.
Davila, a 51-year-old U.S. citizen who emigrated from Cuba, was sentenced in October to more than five years in prison after pleading guilty to a healthcare-fraud conspiracy charge. He was ordered to reimburse the federally funded Medicaid program for its losses. He is scheduled to start his prison term in January.
Two of Davila’s associates also pleaded guilty to conspiring to pay kickbacks to hundreds of patients who purportedly attended mental health sessions at three other Miami-area clinics that raked in about $12 million from Medicaid. The associates, Jesus Rojas, 44, and Luis Rivero, 50, were each sentenced to prison terms in the two-year range.
Rojas surrendered to prison authorities in August. Rivero, who shared profits from the three psychotherapy clinics with Davila, will surrender to prison next month.
Fled to Cuba, feds say
But federal prosecutors have not forgotten about Diaz Martin — Davila’s nominee owner of New Behavior in Hialeah Gardens. Diaz Martin returned to Cuba in the fall of 2020 after funneling millions of dollars from the mental health company through a half-dozen bank accounts to his boss while keeping a portion of the money for himself, according to court records.
He is believed to be charged in the healthcare-fraud conspiracy under seal, though federal prosecutors won’t comment on his case.
In the annals of Medicare and Medicaid rackets in South Florida, hundreds of Cuban immigrants like Diaz Martin have come to South Florida to participate in multimillion-dollar healthcare billing schemes — only to flee back to the island nation or another Latin American country when federal agents are on their trail. It’s a trend that was documented in a Miami Herald story called the “Rogues of Medicare” in 2018, the year that Diaz Martin arrived here.
“After September 2020, Diaz Martin made several cash withdrawals of the Medicaid fraud proceeds, gave some of the money to Davila, and then Diaz Martin traveled back to Cuba,” according to a factual statement filed with Davila’s plea agreement with prosecutors. The statement doesn’t say how much taxpayer-funded Medicaid money Diaz Martin took with him to the island nation.
The U.S. Attorney’s Office in Miami declined to comment on whether Diaz Martin has been charged in the Medicaid fraud case. There is no record of a criminal case in his name in the South Florida federal court system.
But it’s certain Diaz Martin was charged under seal. It’s customary for prosecutors to charge a suspect when he’s identified in court documents — and in this federal case, Diaz Martin’s name is sprinkled throughout the factual statement summarizing Davila’s healthcare crimes.
Stole IDs of doctor, therapist: feds
According to the statement filed with his plea agreement, Davila “directed” Diaz Martin in June 2018 to register his name as the sole owner of New Behavior in Hialeah Gardens and to enroll the clinic with Medicaid. However, agents with the FBI and Health and Human Services-Office of Inspector General questioned witnesses and found out that Davila was the real owner of New Behavior.
In 2020, federal agents discovered that Davila stole the identity of a Miami-Dade doctor to use as the supervising physician of New Behavior to facilitate the clinic’s Medicaid billing scheme, according to the factual statement. Agents interviewed the doctor and learned that he did not supervise New Behavior and did not know Davila.
The agents also discovered that Davila stole the identity of a therapist who purportedly accounted for nearly half of New Behavior’s $3.8 million in Medicaid billing. But the therapist told agents that she had never heard of New Behavior and never provided any mental health treatment to anyone there, according to the factual statement.
At the direction of agents, the therapist recorded a phone call to Davila in which he denied any knowledge of how she got linked as a healthcare provider in the Medicaid online portal to New Behavior.
According to the factual statement, Davila directed Diaz Martin to transfer the bulk of New Behavior’s illicit Medicaid payments to various companies under control of the clinic’s actual owner or the nominee owner. For example, between April 2019 and May 2020, New Behavior paid $501,097 in a series of checks to Davila’s company, Max Medical Consulting, in amounts ranging from $2,000 to $10,000 to avoid banking reporting requirements.
New Behavior also sent an unknown amount of money to other shell companies titled in the name of Diaz Martin, including Martin Catering Corp., Spirit Staffing Solutions Corp., Martin Medical Assessment Corp. and Spirit Transport Solutions Corp., court records show. New Behavior also sent money to several other entities with links to Davila.
Bank accounts in South Florida
To help move the tainted Medicaid payments around, Davila directed Diaz Martin to open a half-dozen corporate bank accounts at TD Bank, Regions Bank and Truist Bank, where Davila kept $1.7 million of illicit proceeds that were seized by federal authorities.
Video surveillance showed that Diaz Martin drove to the banks in a rental car to conduct transactions in New Behavior’s accounts, authorities said.
In September 2020, federal agents went to Diaz Martin’s last known address, a 10-bedroom apartment with a communal bathroom at 1116 Palm Ave. in Hialeah, according to Davila’s factual statement. The landlord told the agents that Davila visited the apartment in an “expensive blue car,” and that Diaz Martin confided in him that Davila was “the owner” of New Behavior. The landlord added that Diaz Martin moved out of the apartment, saying he was going to move to Homestead and work on a farm.
“After this point, law enforcement attempted to find Diaz Martin but could not locate him,” the factual statements said, adding that a government witness told federal agents that he “went back to Cuba.”
The witness said Davila admitted to him that “[Davila] was involved in New Behavior and that he was upset at Diaz Martin for trying to demand more money after the scheme began.”
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