South Florida - Thursday April 8, 2024: In Miami Federal Court Wednesday Joseph Toro was sentenced to four years in federal prison after he plead guilty in February to defrauding over $4 million from the Federal Employee Health Benefits Program (FEHBP) to fund a lavish lifestyle.
U.S. District Judge Rodney Smith handed down the sentence. The Judge also imposed three years of supervised release, and ordered Toro to pay $4,444,417.65 in restitution, for defrauding the FEHBP.
The 39-year-old Toro of Jupiter was the owner of the now closed Reawakenings Wellness Center (RWC), a substance abuse facility that treated patients, including FEHBP beneficiaries. The facility was located in Miramar and operated from 2013 until January 2018, when Toro was evicted and RWC was shut down.
After the eviction, Toro continued to submit FEHBP insurance claims, using personal identifying information of former RWC patients, for substance abuse treatment that was never provided. To do so, he called the FEHBP hotline, impersonated former patients, and changed their mailing addresses to addresses that he controlled so he could obtain the fraudulent insurance reimbursement checks.
For over a year, Toro submitted fraudulent claims on behalf of 29 former RWC patients for over $6.7 million in substance abuse treatment that he knew RWC never provided. As a result of Toro’s fraudulent claims, he obtained nearly $4.2 million in proceeds from the FEHBP. Toro also applied for and obtained a $150,000 Economic Injury Disaster Loan (EIDL) from the U.S. Small Business Administration (SBA) during the COVID-19 pandemic. That application misrepresented that RWC had five employees and grossed over $1.4 million in 2019, when in truth RWC had shut down years prior.
With the fraudulently obtained proceeds, Toro purchased a waterfront mansion in Jupiter, a Lamborghini Aventador, a Mercedes G Wagon, two Cadillac Escalades, an Audemars Piguet watch, and various other properties and luxury goods.
U.S. Attorney Markenzy Lapointe for the Southern District of Florida and Special Agent in Charge Derek M. Holt of the U.S. Office of Personnel Management Office of the Inspector General (OPM OIG) announced the sentence.OPM OIG investigated the case. Assistant U.S. Attorney Joseph Egozi prosecuted it. Assistant U.S. Attorney Joshua Paster handled asset forfeiture.