Medicare fraud case ends in 144-month federal prison sentence

Fraud (NL)

FBI News Release

News Legit note: The follow persons were arrested as part of a nationwide take-down led by the Medicare Fraud Strike Force. The endeavor resulted in the arrest of 301 individuals, including 61 doctors, nurses and other licensed medical professionals. The alleged healthcare fraud schemes involved approximately $900 million in false billings in 36 federal districts.

McALLEN, Texas ‐ The owner of a Rio Grande Valley area durable medical equipment (DME) company has been ordered to federal prison for her role in a scheme to defraud Texas Medicaid through fraudulent billings, announced Acting U.S. Attorney Abe Martinez. Maria Teresa Paz Garza, 41, of McAllen, was previously found guilty by a jury on all counts on Feb. 24, 2017, following a seven-day trial and six hours of deliberation.

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Today, U.S. District Judge Randy Crane handed Garza a 144-month sentence to be immediately followed by three years of supervised release. She received 10 years for conspiracy to commit health care fraud and related health care fraud charges as well as an additional two years for aggravated identity theft which must be served consecutively for a total of 12 years in federal prison. In handing down the sentence, Judge Crane imposed enhancements for obstruction of justice for witness tampering, a leadership role and loss to a federal health care program of more than $1 million. Garza was further ordered to pay $1,814,832.98 in restitution based on the loss to the Texas Medicaid program.

Garza, an owner of Hacienda DME located in McAllen, was convicted of submitting false and fraudulent claims to Texas Medicaid for DME that were not provided and/or not authorized by a physician. Garza and her co-conspirators forged and/or caused others to forge the signatures of physicians on the required prescription forms. Hacienda DME billed for larger, higher-paying sizes of pull-ups and diapers regardless of whether those sizes were needed or provided in order to receive higher reimbursements from Texas Medicaid.

“¿Desde cuando los patos le tiran a las escopetas?” Maria Teresa Paz Garza would threaten her employees. “Since when do the ducks shoot at the shotguns?”

Garza also paid illegal kickbacks in the form of cash and/or checks in exchange for patient information, specifically the patient Texas Medicaid numbers. Garza and her co-conspirators bought back supplies that had previously been delivered to Texas Medicaid recipients so that they could utilize the same supplies again in the scheme. Further, they illegally used the identities of physicians in submitting the unlawful billings to Texas Medicaid.

Co-conspirators Bertha Lopez, 62, of Sullivan City, served as a marketer and vendor for Hacienda DME, while Miriam Aguilar, 32, of Rio Grande City, was a delivery driver and recruiter for the company. Nancy Rangel, 31, of Mission, and Yolotzi Lara, 29, of Penitas, were both recruiters for the company. Rangel was also a biller in the scheme. They all also pleaded guilty and were sentenced previously. Lopez received a 21-month-term of imprisonment and was ordered to pay $1,750,565.26 in restitution, while Aguilar was sentenced to 14 months and ordered to pay $1,715,836.99 in restitution. Rangel and Lara were each sentenced to six months of home confinement and ordered to pay $395,698.26 and $294,474.35 in restitution, respectively.

Garza has been and will remain in custody pending transfer to a U.S. Bureau of Prisons facility to be determined in the near future.

Texas Attorney General’s Medicaid Fraud Control Unit, FBI and the U.S. Department of Health and Human Services‐Office of Inspector General conducted the investigation. Assistant U.S. Attorneys Michael Day and Andrew Swartz are prosecuting the case.

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