Washington, D.C. — A Florida insurance executive has pleaded guilty to orchestrating a massive scheme to defraud the Affordable Care Act (ACA), costing the federal government nearly $134 million in subsidies meant to assist eligible Americans in accessing health coverage.
Dafud Iza, 54, the Executive Vice President of an insurance brokerage firm, entered a guilty plea to one count of major fraud against the United States. According to the Justice Department, Iza played a central role in a conspiracy that submitted thousands of fraudulent ACA applications on behalf of individuals who did not qualify for federal subsidies.
The scheme, prosecutors say, was designed to exploit ACA tax credits, which the government pays directly to insurance providers to offset monthly premiums for eligible enrollees. From 2017 through 2021, Iza and his co-conspirators knowingly falsified applications, inflating consumer incomes to meet subsidy eligibility requirements and submitting inaccurate personal information, including addresses and Social Security numbers.
In total, the federal government paid at least $133.9 million in subsidies for ACA plans fraudulently obtained through the scheme. The illicit operation enabled Iza and his firm to collect millions in commission payments from the insurance companies administering the plans.
Authorities revealed that the scheme preyed on vulnerable populations, including individuals experiencing homelessness, unemployment, and mental health or substance abuse disorders. “Street marketers” affiliated with Iza’s team reportedly offered bribes to these individuals to enroll them in plans, while coaching them on how to answer application questions to maximize government-paid subsidies.
“This fraud scheme not only exploited a vital healthcare program—it targeted society’s most vulnerable for financial gain,” said Acting Special Agent in Charge Brett Skiles of the FBI Miami Field Office.
Iza now faces a maximum sentence of 10 years in prison, with sentencing to be determined by a federal judge based on U.S. Sentencing Guidelines and statutory factors.
The plea marks another significant prosecution under the Justice Department’s Health Care Fraud Strike Force Program, which has charged over 5,800 defendants and uncovered more than $30 billion in fraudulent health care billings since its inception in 2007.
For more information on health care fraud prevention and enforcement, visit: www.justice.gov/criminal-fraud/health-care-fraud-unit.
*All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
