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Justice News

Department of Justice
U.S. Attorney’s Office
District of Puerto Rico

Friday, February 5, 2021

Doctor Sentenced For Social Security Fraud

SAN JUAN, P.R. – Doctor Americo Oms-Rivera, 67, was sentenced to five years of probation by United States District Judge Francisco A. Besosa for conspiracy to commit wire fraud, announced W. Stephen Muldrow, United States Attorney for the District of Puerto Rico. Oms-Rivera plead guilty to conspiracy to commit wire fraud on October 23, 2020.

As part of the sentence imposed, Oms-Rivera will pay $321,000 in restitution in favor of the Social Security Administration (SSA) and a $7,500 fine to be paid in 60 days. Oms-Rivera will also forfeit a property in Harbour Lights Estate in Palmas Del Mar, Humacao, PR, will surrender his DEA license and will be excluded from participating in SSA case assessments, Medicare, Medicaid and all other federal health care benefit programs. 

This case was jointly investigated by the Social Security Administration Office of the Inspector General, New York Field Division, the Drug Enforcement Administration and the Puerto Rico Police Bureau, with assistance from the Federal Bureau of Investigation and the Office of the Inspector General – Health and Human Services. 

On August of 2016, a Federal Grand Jury in the District of Puerto Rico returned a 16-count indictment charging Dr. Americo Oms-Rivera, his secretary Mayte González Muñoz, and Francisco Cabrera Alvarado, a former Social Security Administration (SSA) employee, for fraud in the application process for SSA disability insurance benefits in Puerto Rico. González-Muñoz and Cabrera Alvarado plead guilty on March of 2017.  As part of this scheme, Oms-Rivera admitted having backdated medical records of patients applying for disability insurance benefits by creating fictitious medical appointments that never took place. This was done to create the appearance of a longer history of medical treatment and for the purpose of deceiving the SSA into approving disability insurance benefits.

The SSA is responsible for the implementation of the Disability Insurance Benefits Program. The SSA provides monetary benefits to workers with severe, long-term disabilities, who have worked in SSA covered employment for a required length of time. Spouses and dependent children of disabled workers may also be eligible to receive benefits.  Fraud schemes, such as the one perpetrated in this case, compromises the SSA’s limited funding and its ability to reach those in need of benefits.

“This defendant abused the trust placed in him as a professional for personal gain. We thank our law enforcement partners for their outstanding efforts and steadfast commitment to this case,” said U.S. Attorney Muldrow.

“This sentence reflects years of work by our investigators, and the U.S. Attorney’s Office, to stop this scheme to defraud taxpayers, and hold accountable those responsible,” said Inspector General Ennis. “We will continue to uphold the integrity of SSA’s disability programs by aggressively pursuing facilitators in the claims process who abuse the trust placed in them.”

Special Assistant United States Attorney Vanessa D. Bonano-Rodríguez from the Social Security Administration was in charge of the prosecution of the case. This case was investigated by the Social Security Administration Office of the Inspector General, New York Field Division, under the supervision of Special Agent-in-Charge John Grasso, jointly with the Drug Enforcement Administration and the Puerto Rico Police Bureau. The Federal Bureau of Investigation and the Office of Inspector General Health and Human Services also assisted during the investigation.

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Health Care Fraud
Updated February 5, 2021