March 27, 2009
LOCAL COUPLE AND TWO SAN ANTONIO ORTHOTISTS INDICTED FOR FRAUD
(CORPUS CHRISTI, Texas) - A Corpus Christi couple and two brothers from the San Antonio area have been indicted for allegedly defrauding Medicare and the Texas Medicaid Program, acting United States Attorney Tim Johnson and Texas Attorney General Greg Abbott announced today.
Jeanette Garcia, 43, the owner of Orthopedic Specialists DME Inc., located on the 2200 block of Morgan Avenue in Corpus Christi, and her husband Eleazar (Eli) Garcia, 52, both of Corpus Christi, were indicted by a federal grand jury on March 25, 2009. Also indicted were John D. Martinez, 50, and his brother Frank D. Martinez, 46, both licensed orthotists and owners of San Antonio Orthotics & Artificial Limbs located on the 7200 block of Louis Pasteur Drive in San Antonio, Texas. The indictment is the result of a three-and-a-half-year joint investigation conducted by agents of the Texas Attorney General's Medicaid Fraud Control Unit in Corpus Christi, the U.S. Department of Health & Human Services - Office of the Inspector General and the FBI.
The Garcias surrendered to the United States Marshal in Corpus Christi this morning and had their first appearance before the Magistrate in Corpus Christi, while Frank and John Martinez surrendered to the United States Marshal in San Antonio this morning and had their first appearance before the Magistrate there. All defendants were released on $100,000 bonds and are due back in court in Corpus Christi for arraignment on April 1, 2009, at 10:00 am.
All four defendants are charged with multiple counts of health care fraud for submitting or assisting in the submission of false or fraudulent claims to Medicare and Medicaid for orthotic and prosthetic goods furnished by Eli Garcia and or Orthopedic Specialists DME Inc. and with conspiracy.
The 11-count indictment alleges that Jeanette Garcia hired her husband, Eli Garcia, to provide orthotic and prosthetic goods and services to diabetic patients and others on behalf of Orthopedic Specialists DME Inc. The indictment alleges that Eli Garcia has never held a license to practice orthotics in the State of Texas, that he has taken and failed the test to become a licensed orthototist five times and has been under an order from the Texas Board of Orthotics and Prosthetics to cease and desist practicing orthotics since Oct. 9, 2001.
The indictment alleges that on and before Dec. 31, 2001, Orthopedic Specialists DME Inc. did not have a licensed orthotist on-site as required by Texas Law, and the Texas Board of Orthotics and Prosthetics did not renew the company’s facility accreditation in January 2002. As a result of losing its state Facility Accreditation, the Medicare provider number of Orthopedic Specialists DME Inc. was revoked effective Dec. 31, 2001.
The indictment alleges that beginning in February 2002 and continuing until at least Dec. 23, 2008, Jeanette and Eli Garcia, John and Frank Martinez conspired to execute and thereafter did execute a scheme to submit false and fraudulent bills to Medicare and Medicaid for orthotic and prosthetic goods and services provided by Eli Garcia. The indictment alleges that as part of and in furtherance of the conspiracy and scheme to defraud, the defendants obtained and maintained reinstatement of the facility accreditation of Orthopedic Specialists DME Inc. and its Medicare provider number through representations that John D. and/or Frank D. Martinez were and would be the licensed orthotists on-site at Orthopedic Specialists DME Inc. in Corpus Christi. The indictment alleges that after reinstatement of the facility accreditation and the Medicare supplier number, Eli Garcia continued to supply orthotic and prosthetic goods and services to diabetic patients and others in Corpus Christi, that Orthopedic Specialists DME Inc. submitted bills to Medicare and Medicaid for the work of Eli Garcia and then paid defendants John D. and Frank D. Martinez a percentage of the money obtained from Medicare and Medicaid for the work of Eli Garcia.
The indictment alleged that for the period of March 4, 2002, through Dec. 23, 2008, the defendants submitted, caused to be submitted or assisted in the submission of false and fraudulent claims to Medicare and Medicaid in the approximate sum of $1,161,185.31 for which Orthopedic Specialists DME Inc. was paid the approximate sum of sum of $800,529.85, of which amount the approximate sum of $642,969.74 was paid to San Antonio Orthotics & Artificial Limbs, owned by John D. Martinez and Frank D. Martinez.
Each of the 11 counts of health care fraud carries a maximum statutory penalty of not more than 10 years imprisonment and not more than a $250,000 fine, upon conviction.
This case is being prosecuted by Assistant U.S. Attorney Michael Hess and Special Assistant U.S. Attorney Rex G. Beasley.
Indictments are formal accusations of criminal conduct, not evidence. A defendant is presumed innocent unless convicted through due process of law.
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