A U.S. District Judge sentenced Felipe Ruiz, 52, of Fresno, and Jose Gabriel Aguirre, 53, of Clovis, to 63 months in prison for conspiracy to commit health care fraud. The Judge also ordered forfeiture of nine properties owned by Aguirre and Ruiz, as well as a $2.6 million personal forfeiture money judgement against Aguirre and a $12.1 million personal forfeiture money judgement against Ruiz.
According to court documents, Ruiz was a podiatrist and the sole owner of West Coast Podiatry Inc. (WCP), a podiatric medical practice with locations in Fresno, Madera, and Stanislaus Counties. Aguirre was a pharmaceutical sales representative who sold skin grafts to Ruiz and WCP. Aguirre was not licensed to practice medicine.
Between June 2021 and January 2024, Ruiz purchased skin grafts from Aguirre and permitted Aguirre to apply skin grafts and perform other medical procedures on patients suffering from severe wounds, including foot amputations. Application of the skin grafts required sharp debridement, which means using a scalpel to scrape the wound until it bleeds. Some patients believed Aguirre was a physician, referring to him as “Dr. Gabe.” Aguirre would perform medical procedures alone without supervision from a trained physician.
Ruiz and Aguirre submitted fraudulent claims to Medicare, Medicaid, and Medi-Cal that falsely represented that Ruiz and other physicians had performed the medical procedures, such as applying skin grafts to patients, when Aguirre had actually rendered the services.
In one example, WCP submitted $150,000 in claims to Medicare in 2023, claiming a physician performed the procedures, when in fact the physician was out of the country on vacation. In another example, Aguirre cut into patients with recently amputated feet with a scalpel and apply skin grafts without a physician’s supervision. Ruiz knew about Aguirre’s conduct and dismissed staff’s concerns about Aguirre.
Throughout the period, staff and third-party auditors raised concerns about Ruiz and Aguirre’s billing practices. The two ignored those warnings and continued to bill Medicare and Medicaid for services performed by Aguirre.
As a result, Ruiz submitted approximately $3,200,000 in false claims to Medicare, Medicaid, and Medi-Cal between 2021 and 2024.
The U.S. Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation conducted the investigation. Assistant U.S. Attorneys Brittany M. Gunter and Cody S. Chapple prosecuted the case.