4 face healthcare fraud, identity theft charges

McALLEN — Four people tied to a defunct Pharr durable medical equipment supplier face charges in a 22-count indictment that they tallied millions in fraudulent bills paid for medical equipment that on some occasions was supposedly delivered to patients who were dead. 

Arrested on Thursday were Marcello Herrera, 39, owner of RGV DME, his wife, Carla Cantu Herrera, 31, who served as marketing director, and former employees Ramon de la Garza, 51, and Beatriz Ramos, 27.

Charges filed in the case include one count of conspiracy to commit healthcare fraud, six counts of healthcare fraud, five counts of wire fraud and 10 counts of aggravated identity theft. The charges came in an indictment unsealed following the four defendants’ arrests Thursday morning, however that document had not been made available on the federal court’s online filing system Thursday afternoon. 

Federal prosecutors say Marcello Herrera submitted fake claims to Medicare and Texas Medicaid for power wheelchairs, incontinence supplies, hospital beds and mattresses, including other DME supplies. 

The indictment alleges that Carla Cantu Herrera, De La Garza and Ramos participated in the conspiracy, aiding Marcello Herrera by submitting fraudulent bills, wire fraud and identity theft of beneficiaries and doctors. 

Prosecutors say RGV DME submitted about 25,000 claims that totaled about $11 million to the state and federal healthcare programs and the government paid more than $7.1 million in reimbursements to the business. Between 80 percent and 90 percent of the billings were fraudulent, U.S. Attorney Kenneth Magidson said in a statement issued Thursday. 

The indictment accuses the four defendants of making illegal payments to marketers, who obtained Medicare and Medicaid identification numbers and other information from beneficiaries that was used to submit fake bills to the government, prosecutors said. 

Most of the false billing reimbursed by the government was for wheelchairs, hospital beds and mattresses, incontinence supplies, prosecutors said.

The defendants billed for medical equipment never prescribed by doctors, never delivered to customers and in some cases, went to patients who had already died when the equipment was delivered, prosecutors said. 

To hide the scheme, the indictment accuses the four defendants of forging documents and using patients’ and doctors’ identities on the fake bills, prosecutors said. 

Herrera and his wife, de la Garza and Ramos all are expected to make an initial appearance before U.S. Magistrate Peter Ormsby in McAllen by Friday. 

The Rio Grande Valley — Hidalgo County in particular — has been a magnet for healthcare fraud cases in recent years. In February, former Weslaco durable medical equipment proprietor Juan De Leon was sentenced to 10 years in prison after he admitted to a similar scheme involving power wheelchairs and fraud.

And siblings Valente and Velma Alaniz, relatives of Palmview City Manager Johnn Valente Alaniz, each admitted in December 2011 to their own scheme involving billing the government for wheelchairs more expensive than those delivered to patients. Their case is set for sentencing in August. 

Wire fraud carries a maximum sentence of 20 year in prison and a $250,000 fine on each count. The other charges carry a range of sentences between two and 10 years in prison, and a $250,000 fine on each count. 

Jared Taylor covers courts and general assignments for The Monitor. He can be reached at jtaylor@themonitor.com and (956) 683-4439. 

Follow Jared Taylor on Twitter: @jaredataylor


Article source: http://www.themonitor.com/news/fraud-61910-health-identity.html

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