Two Texans Prison-Bound for Home Health Fraud

Two Texans are prison-bound for their roles in a scheme to defraud the state’s Medicaid program through false home health reimbursement claims, United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott announced on Wednesday.

Debra Jean Velasquez and Sylvia Salinas Ramirez both pleaded guilty in early September to conspiring to submit false and fraudulent bills to the Texas Medicaid Program by wire transmissions, and also entered guilty please for wire fraud.

On Dec. 18, a district judge gave Velasquez a 51-month federal prison term and handed Ramirez a 41-month term for wire fraud and conspiracy to commit wire fraud. 

The sentence was necessary considering the number of victims, Judge Janis Graham Jack determined, and the need to deter future criminal conduct and protect the public.

Valasquez and Ramire were also sentenced to two years of supervised release following the completion of their prison terms. 

From around August 1, 2009 to mid-June in 2010, both defendants were employed by the Corpus Christi office of MRNG Inc. dba 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 unrendered home health services.

The pair admitted to creating false and fraudulent time sheets for former Caring Touch employees for home health services that had not been provided, and then fraudulently billing Medicaid, Evercare, and Superior in the name of Caring Touch for those nonexistent services, according to the Federal Bureau of Investigation.

In total, approximately 562 of those false and fraudulent billings were sent by wire. 

Ramirez and Valasquez admitted that in order to personally profit from the fraudulent billings, they created phony payroll records from the fraudulent time sheet, which they then sent to Caring Touch’s payroll staff. The duo then obtained the payroll checks generated from the falsified time records, forged the signatures of the former Caring Touch employees, and then cashed the checks and divided the money between themselves. 

As a result of these false and fraudulent claims, Texas Medicaid, Evercare, and Superior paid approximately $155,127, according to the defendants. As part of their pleas, the women have agreed to pay restitution in that amount. 

The two were taken into custody following the sentencing. 

Written by Alyssa Gerace

Alyssa Gerace

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