Dallas Physician and His Employee Arrested for Alleged $5.2 Million Medicare Fraud Scheme
A physician who ran a medical house call service business in Dallas, and an employee of that business were arrested this morning on charges related to their alleged participation in a $5.2 million health care fraud scheme.
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Acting U.S. Attorney John R. Parker of the Northern District of Texas, Special Agent in Charge Mike Fields of the Department of Health and Human Services’ Office of the Inspector General’s (HHS-OIG) Dallas Regional Office, the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU), Special Agent in Charge Thomas M. Class, Sr. of the FBI’s Dallas Division and Special Agent in Charge Max Eamiguel of the U.S. Postal Service’s Office of the Inspector General’s (USPS-OIG) Southern Area Field Office made the announcement.
Hector Molina, M.D., 51, of Irving, Texas, and Blanca Mata, 46, of Forney, Texas, were charged with one count of conspiracy to commit health care fraud. In addition, Molina was charged with eight counts of health care fraud, and Mata was charged with four counts of health care fraud. Both defendants made their initial appearances before U.S. Magistrate Judge Renée Harris Toliver of the Northern District of Texas earlier today and were released on bond.
According to allegations in the indictment, Molina owned and operated Molina Medical Housecall Services in Dallas, and Mata was an employee of that business. The indictment alleges that from approximately June 2012 through January 2015, Molina and Mata conspired to defraud Medicare by billing for home visits performed by Mata, who was not a physician, as if Molina had performed the home visits. Additionally, the indictment alleges that Molina billed for home visits performed in the Dallas area while he was out of the country.
An indictment is merely an allegation and defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.
This case is being investigated by HHS-OIG, the Texas Attorney General’s MFCU, the FBI and USPS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Northern District of Texas. The case is being prosecuted by Trial Attorney Jason Knutson of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion. In addition, the HHS Centers for Medicare & 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 Team (HEAT), go to: www.stopmedicarefraud.gov.