Florida Residents Sentenced for $34.8 Million Medicare Fraud

On Friday, two individuals from Florida were sentenced to prison for orchestrating a fraudulent scheme that bilked $34.8 million from the federal health program, Medicare, as reported by the U.S. Department of Justice.

Kenneth Charles Kessler III, a 43-year-old Miami resident, received a 33-month prison sentence, while Michael Andrew Gómez, who is also 43 and lives in Miramar, was handed a 24-month sentence.

Back in May of this year, both men admitted guilt to a charge of conspiracy to commit healthcare fraud.

The Fraudulent Operations Unveiled

Court documents revealed that Kessler and Gómez owned and managed seven Florida-based medical supply companies. Through these businesses, they submitted fraudulent claims to Medicare for orthopedic braces that patients neither needed nor requested.

The scheme involved bribing individuals to obtain fraudulently signed medical orders, which were then used to send orthopedic devices to Medicare beneficiaries nationwide.

Efforts to Evade Detection

To sidestep payment suspensions imposed by Medicare when irregularities were detected, Kessler and Gómez rotated billing among their various companies, complicating the detection of their fraudulent activities.

Kessler personally pocketed over $1.4 million, whereas Gómez's illicit gains exceeded $2.3 million.

Government's Stance on Medicare Fraud

"These fraudsters billed Medicare $34.8 million for devices that patients didn't need or request, and now they are facing the consequences," stated Colin M. McDonald, Deputy Attorney General of the Justice Department's National Fraud Enforcement Division.

He further remarked, "They paid bribes for false medical orders, rotated billing across multiple companies to evade payment suspensions, and lined their pockets with millions that belonged to American taxpayers."

Jason A. Reding Quiñones, the U.S. Attorney for the Southern District of Florida, emphasized, "Medicare is not a blank check for fraudsters. If you steal from our health programs, we will find you, prosecute you, and hold you accountable."

Broader Federal Crackdown

This case was investigated by the FBI's Miami field office and the Office of Inspector General of the Department of Health and Human Services. The sentencing aligns with a broader federal crackdown on healthcare fraud in South Florida, a region deemed the national epicenter for such crimes.

In June, several South Florida individuals faced charges for similar schemes involving orthopedic devices and Medicare. The 2026 national healthcare fraud operation was the largest in Justice Department history, charging 455 defendants for false claims exceeding $6.5 billion, involving 56 federal and 45 state prosecutors.

Since 2007, the Department of Justice's Health Care Fraud Strike Force has prosecuted over 6,200 defendants who collectively billed more than $45 billion to federal health programs and private insurers, highlighting the problem's scale nationwide.