TEXAS COMPANY BILKED MEDICARE OUT OF MILLIONS
June 28, 2012 + CHICAGO TRIBUNE
MCALLEN, Texas (Reuters) - Federal agents on Thursday arrested four employees of a now-defunct Texas medical equipment supplier who are accused of bilking Medicare and Medicaid out of millions of dollars via fake claims, including some made on behalf of dead people, according to court documents.
The owner and three employees of RGV DME, a onetime medical supplier near the U.S.-Mexican border in Pharr, Texas, each face allegations of 22 counts of health care and wire fraud, conspiracy and aggravated identity theft, according to a federal indictment unsealed on Thursday.
The durable medical equipment supplier received about $7.1 million in reimbursements from the Medicare and Texas Medicaid programs for power wheelchairs, mattresses, incontinence supplies and other products, U.S. Attorney Kenneth Magidson, who heads the Southern District of Texas, said in a statement.
The defendants billed the government for medical equipment never prescribed by doctors or delivered to customers â some of whom were dead when the claims were filed, Magidson said.
Of the approximately 25,000 claims the company filed with the state and federal health care programs between 2004 and 2010, as many as 90 percent were fraudulent, Magidson said.
Arrested Thursday were Marcello Herrera, 39, the medical equipment company's owner, his wife, Carla Cantu Herrera, 31, who served as its marketing director, and former employees Ramon de la Garza, 51, and Beatriz Ramos, 27, court records showed.
All four are accused of working together to forge patients' and doctors' names on forms filed with the federal Medicare program for the elderly and the federal-state Medicaid program for low-income people, Magidson said.
If convicted of wire fraud â the most severe charge lodged Thursday â each defendant faces up to 20 years in prison and a $250,000 fine. Penalties for the other charges range from two to 10 years in prison.
Federal court records listed no defense attorneys retained by any of the defendants.
In Washington, the U.S. Supreme Court on Thursday upheld President Barack Obama's healthcare law, the most sweeping overhaul since the 1960s of the unwieldy U.S. healthcare system.
In a 5-4 ruling based on the power of Congress to impose taxes, the nation's highest court preserved the law's "individual mandate" requiring that most Americans obtain health insurance by 2014 or pay a tax.
(Editing by Corrie MacLaggan and Tim Gaynor)