Texas Attorney General Greg Abbott released the following statement this past week:
The co-owner of a now defunct McAllen area durable medical equipment (DME) business and a former medical biller have been ordered to prison for their roles in a conspiracy and scheme to defraud Medicare and Medicaid through fraudulent billings, United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott announced today.
Former RGV DME Co-Owner Carla Cantu Herrera, 32 along with her ex-husband Marcelo Herrera, 41, and their former employee Ramon De La Garza, 52, all of Mission, pleaded guilty on Feb. 21, 2013, to conspiring to defraud Medicare and Texas Medicaid. Beatriz Ramos, 29, of Edinburg, a former biller for RGV DME, pleaded guilty to the conspiracy on Oct. 16, 2012. Marcelo Herrera and De La Garza also pleaded guilty to one count of aggravated identity theft for unlawfully using the identity of a beneficiary to bill Medicare and Medicaid $5,000 for a power wheelchair that was not requested, prescribed, needed or delivered.
[…]
I was going to say you could read more of details of the case in the full press release, but they seem to have removed it from the site today, even though I know it was there this morning because I called them this morning to ask some questions about the release. I’m sure it’s just a coincidence that it disappeared after my call, right? In any event, here is the part of the release that was available on their site (cached copy here) I want to emphasize because it involves medical ID theft that could have come back to impact the victims:
From early 2004 through late 2011, Marcelo Herrera, who did business as RGV DME in the McAllen area, engaged in and directed a scheme to submit fraudulent claims to Medicare and Texas Medicaid for power wheelchairs, incontinent supplies, hospital beds and mattresses as well as other DME supplies. From January 2006 through February 2010, his ex-wife, Carla Cantu Herrera – who admitted to being marketing director, chief financial officer, chief operating officer, office manager, human resources manager and co-owner of RGV DME – and billers De La Garza and Ramos all participated in the conspiracy and aided Marcello Herrera and each other in the submission of fraudulent billings, wire fraud and theft of the identities of beneficiaries and doctors.
…. The trio also admitted that marketers were used to obtain Medicare and Medicaid identification numbers and other information from beneficiaries which they in turn used to fraudulently bill Medicare and Medicaid for DME that was either never prescribed or prescribed but never delivered. (emphasis added by Dissent)
The press release does not indicate how many patients were totally innocent victims of the fraud conspiracy, nor whether they suffered any adverse consequences from having their information misused for fraud. The U.S. Attorney’s Office that prosecuted the case did not respond to a voicemail I left for them this morning asking for more information on the number of patients whose information was misused and whether the patients suffered any adverse effects as a result of the fraud. If they do get back to me, I’ll update this entry.