According to an FBI news release dated September 4, 2013, two Corpus Christi Texas area women pleaded guilty before U.S. District Judge Nelva Gonzales Ramos on this date to conspiring to submit false and fraudulent bills to the Texas Medicaid Program by wire transmissions, as well as wire fraud for using interstate wire transmissions to bill.
Sylvia Salinas Ramirez, 52, of Driscoll, and Debra Jean Velasquez, 41, of Robstown, have been convicted of wire fraud and conspiring to do so as part of a scheme to defraud the Texas Medicaid program through fraudulent home health billings, United States Attorney Kenneth Magidson announced today along with Texas Attorney General Greg Abbott.
Ramirez and Velasquez were charged in a 14-count federal indictment returned Wednesday, May 8, 2013.
The two women admitted that from or about August 1, 2009 through on or about June 15, 2010, they were employed by the Corpus Christi office of MRNG Inc. doing business as Caring Touch Home Health. During that time, they conspired to submit false and fraudulent bills through wire transmissions to the Texas Medicaid program and the Medicaid funded managed care organizations known as Evercare of Texas LLC and Superior Health Plan Inc. for home health services that had not been provided. Ramirez and Velasquez admitted they created false and fraudulent time sheets for former Caring Touch employees for home health services that had not been provided and then fraudulently billed Medicaid, Evercare, and Superior in the name of Caring Touch for those non-existent services. They sent approximately 562 of those false and fraudulent bills by wire. (FBI press release)
Ramirez and Velasquez also admitted that in order to personally profit from their fraudulent billings, they created phony payroll records from the fraudulent time sheet which they then sent to Caring Tough’s payroll staff. Ramirez and Velasquez then obtained the payroll checks generated from the false and fraudulent time records, forged the signatures of the former Caring Touch employees, and then cashed the checks and divided the money among themselves. Caring Touch and the former employees whose names were used on the false time sheets and checks were not accused of any wrongdoing. (Ibid)
In their plea agreements, they admitted that as a result of their false and fraudulent claims, Texas Medicaid, Evercare, and Superior paid the approximate aggregate sum of $155,127.72. As part of their pleas, the women have agreed to pay restitution in that amount.
The women each face maximum punishment of 20 years in federal prison on both counts without parole as well as a possible $250,000 fine. Judge Ramos has set sentencing December 3, 2013. Ramirez and Velasquez were permitted to remain free on bond pending that hearing.