Local Dentist/Orthodontist Couple Convicted of Making False Statements on Bills to Texas Medicaid
|May 16, 2012|
LAREDO, Texas - Local dentist Dr. Carlos Armin Morales-Ryan, 45, and his wife local orthodontist Dr. Nelia Patricia Garcia-Morales, 42, have pleaded guilty to a criminal information admitting they made false statements on bills to Texas Medicaid, United States Attorney Kenneth Magidson announced today.
Morales-Ryan and Garcia-Morales owned and operated Orthogenesis International Centre, a Laredo dentistry and orthodontics business, and a substantial portion of their business was targeted to rendering services to Medicaid-eligible children. Applicable Texas law and Medicaid regulations required them to be in their offices when services were rendered on Medicaid patients as a prerequisite to receiving payment for the services from Medicaid. Similar consumer protection laws and regulations are applicable to most types of physicians for many of the services they render in Texas, regardless of whether the patient is or is not a Medicaid beneficiary.
Morales-Ryan’s signed plea agreement states that though he and Garcia-Morales were in Hawaii on or about Oct. 12, 2007, he falsely represented to Medicaid that he performed an evaluation and management of a new patient on that date claiming entitlement to payment. However, at the time he made this false representation to Medicaid, he and Garcia-Morales knew the statement was false and that neither of them performed that service on or about that date. Similarly, Garcia-Morales admitted that though she and Morales-Ryan were en route to the U.S. Virgin Islands on March 23, 2007, she falsely represented to Medicaid that she performed an orthodontic retention on that date claiming entitlement to payment. However, at the time she made this false representation to Medicaid, she and Morales-Ryan knew the statement was false and that neither of them performed an orthodontic retention on or about that date.
Texas Medicaid is a health care program funded in part by the federal government through payroll taxes and in part by the State of Texas.
As a result of their plea agreements, they will be sentenced to five years probation and will pay restitution in the amount of $686,545 to the State of Texas Health and Human Services Commission - Office of Inspector General.
Morales-Ryan currently is not licensed to practice dentistry in Texas due to an unrelated criminal proceeding.
The investigation leading to this indictment was jointly conducted by the FBI, Department of Health and Human Services - Office of the Inspector General and the Texas Attorney General Medicaid Fraud Control Unit. The case is being prosecuted by Assistant United States Attorney D.J. Young.