{"id":163404,"date":"2026-09-21T12:33:03","date_gmt":"2026-09-21T16:33:03","guid":{"rendered":"https:\/\/alofokedeportes.com\/en\/sin-categoria\/fraud-at-senasa-doctors-allegedly-charged-rd41-million-for-fake-services\/"},"modified":"2026-09-21T12:33:03","modified_gmt":"2026-09-21T16:33:03","slug":"fraud-at-senasa-doctors-allegedly-charged-rd41-million-for-fake-services","status":"publish","type":"post","link":"https:\/\/alofokedeportes.com\/en\/national\/fraud-at-senasa-doctors-allegedly-charged-rd41-million-for-fake-services\/","title":{"rendered":"Fraud at SeNaSa: Doctors allegedly charged RD$41 million for fake services"},"content":{"rendered":"<h2 class=\"wp-block-heading\">Operation COBRA 2.0-A: Million-dollar fraud scheme in medical services revealed<\/h2>\n\n<p>The Public Prosecutor&#8217;s Office has brought to light compelling details regarding the investigation known as COBRA 2.0-A, which uncovers a scheme of irregularities in the management of medical services amounting to a millionaire figure. According to the data collected, a total of 4,363 authorizations were processed illicitly through three telephone lines linked to the case.<\/p>\n\n<p>The accumulated amount from these fraudulent operations reaches RD$41,125,551.02. According to the judicial file, these procedures mainly comprised minor outpatient surgeries and consultations in various specialties, carried out in a period between January 28, 2021, and February 20, 2025.<\/p>\n\n<h3 class=\"wp-block-heading\">The origin of the research<\/h3>\n\n<p>The authorities initiated investigations following a formal complaint filed by ARS SeNaSa on November 28, 2024. The entity reported having received alerts regarding anomalies in the authorization system, which led to an exhaustive internal audit and subsequent criminal investigation.<\/p>\n\n<p>The modus operandi consisted of the misuse of personal data of real affiliates. In many of the documented cases, patients flatly denied having requested or received the medical services that appeared in the official records.<\/p>\n\n<h3 class=\"wp-block-heading\">Operational scheme details<\/h3>\n\n\n<ul class=\"wp-block-list\"><li><strong>Internal participation:<\/strong> \u00c1ngel Lu\u00eds Guzm\u00e1n V\u00e1squez, who worked as an assistant in the SeNaSa Medical Authorization Department between March 2021 and November 2022, is pointed out as a key figure who knew the institution&#8217;s internal protocols.<\/li><li><strong>Complicity network:<\/strong> The scheme allegedly involved a structure of employees and former employees of the insurer in coordination with healthcare professionals.<\/li><li><strong>False billing:<\/strong> The fraudulent authorizations served as technical support to process claims and obtain payments for services that, in reality, were never performed.<\/li><\/ul>\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p>The Public Prosecutor&#8217;s Office maintains that in-depth knowledge of the authorization protocols allowed those involved to evade standard controls to facilitate the irregular collection of medical services not rendered.<\/p><\/blockquote>\n\n<p>The case remains under the scrutiny of the authorities, who are seeking to determine the full extent of the network and establish the corresponding criminal responsibilities for those involved in this fraud that affects the public health system.<\/p>","protected":false},"excerpt":{"rendered":"<p>Operation COBRA 2.0-A: Million-dollar fraud scheme in medical services revealed The Public Prosecutor&#8217;s Office has brought to light compelling details regarding the investigation known as COBRA 2.0-A, which uncovers a scheme of irregularities in the management of medical services amounting to a millionaire figure. According to the data collected, a total of 4,363 authorizations were [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":163405,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12809],"tags":[6357,4175,3801,12936],"class_list":{"0":"post-163404","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-national","8":"tag-corruption","9":"tag-fraud","10":"tag-public-ministry","11":"tag-senasa"},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/posts\/163404","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/comments?post=163404"}],"version-history":[{"count":0,"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/posts\/163404\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/media\/163405"}],"wp:attachment":[{"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/media?parent=163404"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/categories?post=163404"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/alofokedeportes.com\/en\/wp-json\/wp\/v2\/tags?post=163404"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}