Friday, April 29, 2011

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Joint State and Federal Probe Leads to Health Care Fraud Conviction

The U.S. Attorney for the Southern District of Texas issued the following news release on April 28, 2011:

FORMER DME EMPLOYEE CONVICTED OF HEALTH CARE FRAUD

(McAllen, Texas) - A former employee of a McAllen-area durable medical equipment (DME) company has been convicted of conspiracy to commit health care fraud, United States Attorney Josť Angel Moreno announced today.

David Villanueva, 33, of Edinburg, Texas, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Randy Crane at a hearing this afternoon. Judge Crane scheduled sentencing for July 19, 2011, at 2 p.m. Villanueva, who was indicted in March 2011, faces up to 10 years in federal prison without parole and a $250,000 fine for the conviction.

At today’s hearing, Villanueva admitted that, from July 2008 through April 2010, he conspired with other individuals associated with United DME Inc., of Weslaco, Texas, to submit hundreds of thousands of dollars in fraudulent claims to Medicare and Medicaid related to the purported sale of power wheelchairs and diabetic supplies. Villanueva admitted that, on at least one occasion, he delivered a used power wheelchair to a Medicare/Medicaid beneficiary knowing that United would submit a claim for a brand new power wheelchair. In an attempt to conceal the fraud, Villanueva spray painted the wheelchair black to make it appear new. Villanueva also admitted to conspiring with others to submit fraudulent claims related to diabetic supplies that were billed to Medicare and Medicaid but never delivered to the beneficiaries. In particular, Villanueva frequently delivered a one-month supply of diabetic supplies to a beneficiary and, at the time of delivery, would persuade the beneficiary to sign both the delivery ticket for the instant delivery as well as additional delivery tickets for purported future deliveries of diabetic supplies which would be billed to Medicare and Medicaid but never delivered.

Villanueva has been permitted to remain on bond pending his sentencing hearing.

The investigation leading to the charges was conducted by the Department of Health and Human Services-Office of Inspector General, FBI and the Texas Attorney General’s Medicaid Fraud Control Unit. Assistant United States Attorney Greg Saikin is prosecuting the case.