What was meant to be a helping hand for struggling Americans turned into a money-making machine for one Florida executive.
Authorities have confirmed that a high-ranking insurance broker admitted to playing a central role in a scheme that funneled millions of dollars in fraudulent government subsidies through the Affordable Care Act (ACA).
The scam, which relied on tricking the system designed to provide affordable health care, involved enrolling people who weren’t actually eligible—and doing it on a massive scale.
Now, that executive could be facing serious prison time.
A Manipulated System Meant to Help the Vulnerable
According to federal investigators, 54-year-old Dafud Iza, who served as executive vice president at an insurance brokerage firm, was behind a plan to cheat the ACA system.
The idea? Enroll ineligible individuals in health insurance plans that were entirely covered by government subsidies.
Those subsidies, meant to help low-income individuals afford care, instead ended up benefiting Iza and his team.
By inflating applicants’ income on forms and submitting phony details, the group managed to trick the system into providing taxpayer-funded health care coverage to people who didn’t qualify.
In exchange, the insurance company paid commissions for each new enrollee—money that flowed straight into Iza’s pocket.
Targeting the Most Vulnerable
This wasn’t just a paperwork scam—it had real-world impact.
Iza and his co-conspirators specifically went after people in extremely vulnerable situations.
They preyed on those experiencing homelessness, unemployment, addiction, and mental illness.
These individuals were approached by so-called “street marketers,” who were sometimes bribed to convince people to enroll.
To make the applications go through, those marketers often coached individuals on how to answer questions falsely, provided them with fake social security numbers, and even gave false addresses. It was all part of a coordinated effort to make sure the federal subsidies would be approved—and the commissions would keep rolling in.
The Cost to Taxpayers Was Enormous
When the dust settled, the government had shelled out more than $133.9 million in subsidies for these fake enrollments.
That’s money that was supposed to go to helping real people in need get health coverage—and instead was used to enrich a handful of fraudsters.
Iza pleaded guilty to one count of major fraud against the United States, a serious charge that could land him behind bars for up to 10 years.
His final sentence will be determined by a federal judge, who will weigh various legal and sentencing factors.
Federal Agencies Join Forces to Take Down the Fraud
The case was cracked open thanks to the combined efforts of multiple agencies.
The FBI, the Department of Health and Human Services Office of Inspector General, and the IRS Criminal Investigation Division all worked together to uncover the depth of the scheme.
Officials from each agency spoke out about the seriousness of the crime and reaffirmed their commitment to cracking down on this type of health care fraud.
The Department of Justice’s Fraud Section, which leads national efforts to stop health care scams, is handling the prosecution.
Fighting Back Against Health Care Fraud
This case is just one piece of a much bigger puzzle. Since 2007, the Health Care Fraud Strike Force has charged more than 5,800 individuals in similar schemes that, combined, attempted to defraud public and private health care systems out of over $30 billion.
Meanwhile, agencies like the Centers for Medicare & Medicaid Services are stepping up their oversight and working alongside investigators to hold individuals and providers accountable.
A Reminder: Innocent Until Proven Guilty
Although Iza has admitted guilt, the legal system still follows its process.
As with all cases, any individuals who are indicted remain presumed innocent unless proven guilty beyond a reasonable doubt in court.
For more details on how the Department of Justice is tackling health care fraud, you can visit justice.gov/criminal-fraud/health-care-fraud-unit.