McALLEN, Texas ‐ A McAllen federal jury has convicted the owner of an area durable medical equipment (DME) company owner on all counts for her scheme to defraud Texas Medicaid through fraudulent billings, announced U.S. Attorney Kenneth Magidson. The jury deliberated for six hours following a seven-day trial before convicting Maria Garza, 41, of McAllen, on all 18 counts as charged.
Garza was an owner of the DME company Hacienda DME in McAllen.
She was found guilty of causing others to submit false and fraudulent claims to Texas Medicaid for incontinence supplies that were not provided and/or were not authorized by a physician. Garza and her co-conspirators forged and/or caused others to forge the signatures of physicians on the required prescription forms. She then billed or caused others to bill for larger, higher-paying sizes of pull-ups and diapers regardless of whether those sizes were needed or provided in order to receive higher reimbursements from Texas Medicaid.
The jury heard that from March 2008 through August 2013, Garza sent false and fraudulent claims totaling approximately $2,505,064.50 to Texas Medicaid for DME allegedly provided to Texas Medicaid recipients. The billings were false and fraudulent because the DME was not delivered and/or was not authorized as claimed. Texas Medicaid paid out $1,805,940.12 on the false and fraudulent claims. The jury also heard that Garza and her co-conspirators illegally used the identities of physicians in submitting the unlawful billings to Texas Medicaid.
Garza paid illegal kickbacks in the form of cash and/or checks in exchange for patient information, specifically, the patient Texas Medicaid numbers. Further, she and her co-conspirators bought back supplies that had previously been delivered to Texas Medicaid recipients so that they could utilize the same supplies again in a scheme to defraud Texas Medicaid.
She faces up to 10 years in federal prison for conspiracy to commit health care fraud and each of the 11 counts of health care fraud. For the two counts of witness tampering, the punishment is a possible 20-year-maximum sentence. Further, she must face an additional and mandatory 24 months for the four counts of aggravated identity theft which must be served consecutively to the other sentences imposed.
The Texas Attorney General’s Medicaid Fraud Control Unit, FBI and the Department of Health and Human Services‐Office of Inspector General conducted the investigation. Assistant U.S. Attorneys Michael Day and Andrew Swartz are prosecuting the case.