The owner of a south Texas medical equipment company who admitted to sending false claims of more than $11.1 million was convicted of fraud to Medicare and Medicaid on Friday.
Marcello Herrera, 40, and his wife Carla Cantu Herrera, 32, along with Ramon De La Garza, 52, all of Mission, pleaded guilty in the case.
“From early 2004 through late 2011, Marcello Herrera, who did business as RGV DME in the McAllen area, engaged in and directed a scheme to submit fraudulent claims to Medicare and Texas Medicaid for power wheelchairs, incontinent supplies, hospital beds, and mattresses as well as other DME supplies,” announced U.S. Attorney Kenneth Magidson.
“At various times, Carla Cantu Herrera, De La Garza, and Beatriz Ramos, 28, of Edinburg, participated in the conspiracy and aided Marcello Herrera and each other in the submission of fraudulent billings, wire fraud, and theft of the identities of beneficiaries and doctors.”
Herrera and De La Garza also each pleaded guilty to identity theft for unlawfully using the identity of a beneficiary to bill Medicare and Medicaid $5,000 for a power wheelchair that was not requested, prescribed, needed, or delivered.
The criminals all admitted that 85 percent of their Medicare and Texas Medicaid billings were false and fraudulent.
They used marketers to obtain Medicare and Medicaid identification numbers and information beneficiaries to submit false bills for equipment that was never prescribed or delivered.
The Herreras also admitted that they or their marketers attempted to obtain referrals of patients or orders for the medical equipment from doctors in exchange for gifts.
Conspiracy to commit health care fraud carries a maximum punishment of 10 years in federal prison without parole and a $250,000 fine upon conviction. Aggravated identity theft carries a mandatory two-year additional prison term.
In addition to turning in a warehouse full of equipment, Marcelo Herrera and Carla Cantu Herrera agreed to the entry of money judgments against themselves in the sums of $6,103,953.74 and $5,519,703.37, respectively. The money judgment against De La Garza is $5,059,198.96.
Sentencing of the defendants was scheduled for May 16, 2013. Marcelo Herrera and De La Garza, who have been in custody since June 28, 2012, will remain in custody.
Carla Cantu Herrera was permitted to remain on bond pending a hearing on February 27, 2103.
Ramos entered a guilty plea on October 16, 2012, to one count of conspiracy to commit health care fraud and remains free on bond awaiting sentencing, set for April 17, 2013.
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