Thursday, April 16, 2026 3:44PM
FRESNO, Calif. (KFSN) — A Fresno doctor and a pharmaceutical sales representative from Clovis have been sentenced for a major healthcare fraud scheme.
Prosecutors say 52-year-old Felipe Ruiz was a podiatrist and owner of West Coast Podiatry Incorporated, where he allowed the sales rep to practice medicine.
Between 2021 and 2024, 53-year-old Jose Aguirre sold skin grafts to Ruiz and was allowed to apply those skin grafts to patients without supervision from a physician.
Ruiz and Aguirre submitted fraudulent claims to Medicare, Medicaid and Medi-Cal, saying Ruiz and other physicians had performed those procedures.
Over $3 million in false claims were submitted.
Both men have been sentenced to over five years in prison.
They also must forfeit nine properties they own and pay back millions of dollars.
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MANAGEMENT & CULTURE (THE “TONE AT THE TOP”)
Fraud thrives in “sloppy” environments where leadership ignores the rules.
- The Fraud Triangle: For fraud to occur, three elements must be present: Pressure (the need for money), Rationalization (thinking “I deserve this”), and Opportunity (weak controls). You can only control the Opportunity.
- Whistleblower Hotline: Provide an anonymous way for staff to report “odd behavior.” Most internal frauds are caught via tips, not audits.
- Background Checks: Conduct credit and criminal record checks for all employees in financial or data-sensitive roles.
- Annual Ethics Training: Make sure every staff member knows that the company has a Zero Tolerance policy toward “borrowing” from petty cash or fudging overtime.