Thread: Guilty Plea in $5.2 million Medicare Fraud Case

Department of Justice
Office of Public Affairs
FOR IMMEDIATE RELEASE
Thursday, October 21, 2010

Houston-area Patient Recruiter Pleads Guilty in a $5.2 Million Medicare Fraud Scheme

WASHINGTON – A patient recruiter for a Houston-based home health care company pleaded guilty today in connection with a $5.2 million Medicare fraud scheme, announced the Departments of Justice and Health and Human Services (HHS).

Cynthia Garza-Williams, 49, pleaded guilty to conspiracy to commit health care fraud before U.S. District Court Judge Nancy Atlas in Houston. According to court documents, Family Healthcare Group (Family Group) purported to provide skilled nursing to Medicare beneficiaries. The owner hired co-conspirators, including Garza-Williams, to recruit Medicare beneficiaries for the purposes of filing claims with Medicare for skilled nursing. Family Group then used the Medicare beneficiary numbers to submit claims to Medicare for skilled nursing that was medically unnecessary and/or not provided.

Garza-Williams admitted that on a monthly basis she gave cash-filled envelopes to a medical doctor. In return, the medical doctor signed plans of care for home health care services that were not medically necessary. In total, Family Group was paid approximately $5.2 million by Medicare based on the submission of fraudulent claims.

At sentencing, scheduled for Apr. 18, 2011, Garza-Williams faces a maximum sentence of 10 years in prison.

Today’s guilty plea was announced by Assistant Attorney General of the Criminal Division Lanny A. Breuer; U.S. Attorney José Angel Moreno of the Southern District of Texas; Special Agent-in-Charge Richard C. Powers of the FBI’s Houston Field Office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of HHS Office of Inspector General (HHS-OIG), Office of Investigations; and the Texas Attorney General Greg Abbott.

This case is being prosecuted by Trial Attorneys Charles D. Reed and Sam S. Sheldon of the Criminal Division’s Fraud Section. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.

Since their inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than 825 individuals who collectively have falsely billed the Medicare program for more than $2 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov .

10-1179 Criminal Division

http://www.justice.gov/opa/pr/2010/Octo ... -1179.html

It should be noted that the annual 60 BILLION medicare fraud is much higher than the combined profits of all the top insurance companies in the U.S. Obama keeps saying how insurance co.'s are ripping people off.....

Every week, sometimes every day of the week, there are more reports of arrest for Medicare Fraud.

RELATED

Indictments for $200 Million Medicare Fraud

http://www.alipac.us/ftopict-215849.html