Thursday, September 5, 2013

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Two Robstown Women Convicted of Health Care Fraud in a Probe by State, City and Federal Officials

The U.S. Attorney for the Southern District of Texas issued the following news release on Sept. 4, 2013:

Two Area Women Convicted in Home Health Services Conspiracy

CORPUS CHRISTI - Sylvia Salinas Ramirez, of Driscoll, and Debra Jean Velasquez, of Robstown, have been convicted of wire fraud and conspiring to do so as part of a scheme to defraud the Texas Medicaid program through fraudulent home health billings, United States Attorney Kenneth Magidson announced today along with Texas Attorney General Greg Abbott.

Ramirez, 52, and Velasquez, 41, were charged in a 14-count federal indictment returned Wednesday, May 8, 2013. Today, they appeared before U.S. District Judge Nelva Gonzales Ramos and entered pleas of guilty to conspiring to submit false and fraudulent bills to the Texas Medicaid Program by wire transmissions as well as wire fraud for using interstate wire transmissions to bill.

The two women admitted that from or about Aug. 1, 2009, through on or about June 15, 2010, they were employed by the Corpus Christi office of MRNG Inc. doing business as Caring Touch Home Health. During that time, they conspired to submit false and fraudulent bills through wire transmissions to the Texas Medicaid program and the Medicaid funded managed care organizations known as Evercare of Texas LLC and Superior Health Plan Inc. for home health services that had not been provided. Ramirez and Velasquez admitted they created false and fraudulent time sheets for former Caring Touch employees for home health services that had not been provided and then fraudulently billed Medicaid, Evercare and Superior in the name of Caring Touch for those non-existent services. They sent approximately 562 of those false and fraudulent bills by wire.

Ramirez and Velasquez also admitted that in order to personally profit from their fraudulent billings, they created phony payroll records from the fraudulent time sheet which they then sent to Caring Tough’s payroll staff. Ramirez and Velasquez then obtained the payroll checks generated from the false and fraudulent time records, forged the signatures of the former Caring Touch employees, then cashed the checks and divided the money among themselves. Caring Touch and the former employees whose names were used on the false time sheets and checks were not accused of any wrongdoing.

Ramirez and Velasquez admitted that as a result of their false and fraudulent claims, Texas Medicaid, Evercare and Superior paid the approximate aggregate sum of $155,127.72. As part of their pleas, the women have agreed to pay restitution in that amount.

Conspiracy to commit wire fraud and wire fraud each carry a maximum punishment of 20 years in federal prison without parole as well as a possible $250,000 fine. Judge Ramos has set sentencing Dec. 3, 2013. Ramirez and Velasquez were permitted to remain on bond pending that hearing.

The charges were the result of a joint investigation conducted by officers and agents of the Corpus Christi Police Department, the FBI, Department of Health and Human Services - Office of Inspector General and the Texas Attorney General’s Medicaid Fraud Control Unit. Special Assistant United States Attorney Rex Beasley and Assistant United States Attorney Jeffery Preston are prosecuting the case.