Florida Man Sentenced to 63 Months for Medicaid Fraud Scheme

Jose Davila Nunez sentenced to 63 months for Medicaid fraud, ordered to pay nearly $3.9 million in restitution.Photo byaurora.kreativonUnsplash

Jose Davila Nunez, 51, of Miami, was sentenced on October 11 to 63 months in federal prison for orchestrating a Medicaid fraud scheme, the U.S. Attorney’s Office for the Southern District of Florida announced today.

In addition to his prison sentence, Davila was ordered to pay $3,869,703 in restitution and will serve three years of supervised release.

According to court documents, Davila and his co-conspirators established a mental health clinic, New Behavior Health Direction, Incorporated (New Behavior), in Hialeah Gardens, Florida.

The court records state that between April 2019 and September 2020, Davila and his associates submitted fraudulent claims totaling $3,869,703 to Medicaid for psychosocial rehabilitation (PSR) services, which are intended to provide mental health counseling for individuals suffering from depression, anxiety, and other mental health disorders.

The U.S. Attorney’s Office revealed that, in September 2020, the nominee owner withdrew a significant portion of the fraudulent proceeds, some of which were funneled to Davila, before fleeing to Cuba.

Davila's company, Max Medical Consulting Services, Incorporated, received approximately $500,000 in fraudulent proceeds from New Behavior, according to the department.

At his sentencing hearing, Davila was also held responsible for an additional $2,617,992 in fraudulent activity.

Court documents indicate that this amount was connected to illegal bribes paid to patients between November 2018 and December 2022 for PSR services at three other Miami clinics: Davila Medical Center, Incorporated; Advanced Community Wellness Center; and Larkin Behavior Health, Incorporated.

The department stated that the U.S. government was able to seize approximately $1.7 million in cash from New Behavior’s bank accounts as part of its efforts to recover funds linked to the fraud.

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