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Justice News

Department of Justice
U.S. Attorney’s Office
Southern District of Texas

Thursday, September 8, 2016

Medical Equipment Company Owner and Biller Plead Guilty in Health Care Fraud Scheme

McALLEN, Texas ‐ The owner of a Rio Grande Valley area durable medical equipment (DME) company has been convicted of conspiracy to commit health care fraud, announced U.S. Attorney Kenneth Magidson. Veronica Vela, 42, of Mission, entered her plea today before U.S. District Judge Micaela Alvarez. 

Vela, the owner of ABC DME, admitted to engaging in a scheme with her co-conspirator and biller, Cynthia Zapata, 50, also of Mission, to submit fraudulent claims to Texas Medicaid for incontinence supplies that were not provided as claimed. The defendants also billed for durable equipment that the recipients’ physicians did not authorize.  

Zapata pleaded guilty to conspiracy to commit health care fraud for her role in the scheme. As part of their pleas, the defendants admitted they billed for the maximum quantity of pull-ups allowed under Texas Medicaid rules when it was not needed or provided. Further, they also billed for larger sizes of pull-ups than were needed in order to receive higher reimbursements from Texas Medicaid.    

Judge Alvarez has set sentencing for Nov. 17, 2016, at 2:00 p.m., at which time both face up to 10 years in federal prison and a possible $250,000 fine for the conspiracy.  

The Texas Attorney General’s Medicaid Fraud Control Unit, U.S. Department of Health and Human Services‐Office of Inspector General and the FBI investigated. Assistant U.S. Attorneys Michael Day and Linda Requenez are prosecuting the case.

Healthcare Fraud
Updated September 8, 2016