Puerto Rican Doctor Pleads Guilty to Falsifying Medical Credentials and Committing Healthcare Fraud

Raúl D. Villalobos-Melendez, a 36-year-old doctor from San Juan, Puerto Rico, pleaded guilty to making false statements and representations to a federal agency by falsifying his medical credentials and committing healthcare fraud. According to the Information, Villalobos-Melendez knowingly falsified and forged documents and made materially false statements to the Centers for Medicare and Medicaid Services (CMS) representing himself to be a licensed physician.

Key Takeaways:

• Villalobos-Melendez pleaded guilty to making false statements and representations to a federal agency in violation of 18 U.S.C. § 1001(a)(2).
• He falsified and forged medical documents, including a Physician Assistant license, to present himself as a licensed physician.
• Villalobos-Melendez submitted a fraudulent application for a position in the Post-Graduate Medical Education Internship Program at Hospital del Maestro in San Juan, PR, including forged documents and false USMLE score reports.
• He received a salary to practice as a physician in the Transitional Internship program at the Hospital del Maestro from June 1, 2023, to May 31, 2024.
• Villalobos-Melendez knowingly submitted false information on a CMS-855I form to CMS when requesting enrollment as a physician practitioner and to become a Medicare provider.
• The case was investigated by the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), and other law enforcement agencies.
• Villalobos-Melendez faces a maximum penalty of five years in prison, a fine not to exceed $250,000, and a term of supervised release.
• The sentencing hearing has been scheduled for October 22, 2025.
• The case is part of Caribbean HEAT -- a Healthcare Enforcement and Accountability Task Force and Working Group formed in 2024 to investigate and prosecute violations of federal law related to health care fraud, harm to patients and consumers, and health care program waste, fraud, and abuse.

Statistics:

• Villalobos-Melendez was 36 years old at the time of his plea.
• The defendant falsified and forged documents to present himself as a licensed physician.
• Villalobos-Melendez received a salary to practice as a physician in the Transitional Internship program at the Hospital del Maestro from June 1, 2023, to May 31, 2024.
• The defendant was charged with violating 18 U.S.C. § 1001(a)(2) and faces a maximum penalty of five years in prison.
• The case was investigated by the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), and other law enforcement agencies.
• The sentencing hearing has been scheduled for October 22, 2025.

Sources:

• United States Attorney's Office for the District of Puerto Rico
• Centers for Medicare and Medicaid Services (CMS)
• U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG)
• Federal Bureau of Investigation (FBI)
• Caribbean HEAT -- a Healthcare Enforcement and Accountability Task Force and Working Group
• U.S. District Court for the District of Puerto Rico
• Puerto Rico Medicaid Fraud Control Unit