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Justice News

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

Thursday, December 20, 2018

RGV Company Owner Charged with Submitting False Claims to Medicaid

McALLEN, Texas – A 47-year old resident of Rio Grande City has been indicted based on false statements he manufactured in connection with the operation of his Texas Medicaid-based durable medical equipment (DME) business, announced U.S. Attorney Ryan K. Patrick.

A federal grand jury returned the sealed indictment against Omar Cuate Canales on Dec. 18, 2018. It was unsealed today as authorities took him into custody. Canales is expected to make his initial appearance before U.S. Magistrate Judge Juan Alanis Friday morning.

The indictment alleges Canales, the owner and operator of Bluebonnet DME located in Roma, committed one count of conspiracy to submit false statements relating to health care matters, eight counts of false statements relating to health care matters and five counts of aggravated identity theft of local physicians’ names, medical license numbers and national provider identifier numbers.  

From on or about January 2010 to on or about October 2016, Canales allegedly billed Texas Medicaid in excess of $1 million for claims that were supported by either false documentation Canales created or documentation that did not exist in Bluebonnet DME records. Canales is alleged to have deliberately destroyed patient records to conceal his false claims to Medicaid.  

Each of the counts of false statements related to health care matters carries a maximum punishment of five years in federal prison and a $250,000 possible fine, upon conviction. If convicted of aggravated identity theft, Canales will also face an additional and mandatory two years in federal prison which must be served consecutively to any other prison sentence imposed.

Texas Attorney General’s Medicaid Fraud Control Unit, FBI and Department of Health and Human Services – Office of Inspector General conducted the investigation. Special Assistant U.S. Attorney Marian Swanberg and Assistant U.S. Attorney Andrew Swartz are prosecuting the case. 

An indictment is a formal accusation of criminal conduct, not evidence.
A defendant is presumed innocent unless convicted through due process of law.

Health Care Fraud
Updated December 20, 2018