Two Area Women Charged with Submitting Fraudulent Bills for Home Health Services

CORPUS CHRISTI, TX—Sylvia Salinas Ramirez, of Driscoll, and Debra Jean Velasquez, of Robstown, have surrendered to authorities following the return of an indictment alleging they perpetrated 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.

The 14-count indictment was returned Wednesday, May 8, 2013. Ramirez, 51, and Velasquez, 41, were taken into custody this morning and are expected to make an appearance before U.S. Magistrate Judge Janice Ellington this afternoon, at which time the issue of bond will be decided.

Ramirez and Velasquez are charged with one count of conspiracy to commit health care fraud, six counts of health care fraud, four counts of wire fraud, and three counts of aggravated identity theft.

The indictment alleges the women were employed by the Corpus Christi office of MRNG Inc. doing business as Caring Touch Home Health. During that time, Ramirez and Velasquez allegedly submitted false and fraudulent bills to Medicaid and the managed care organizations known as Evercare of Texas LLC and Superior Health Plan Inc. for home health services that had not been provided. Evercare and Superior received funds from Medicaid to manage the home health care of Medicaid beneficiaries. According to the indictment, from on or about August 1, 2009 through on or about June 15, 2010, Ramirez and Velasquez created false and fraudulent time sheets for current and former Caring Touch employees for home health services that were not provided. The indictment accuses Ramirez and Velasquez of then fraudulently billing Medicaid, Evercare, and Superior in the name of Caring Touch for those non-existent services.

The indictment also alleges that in order to personally profit from their fraudulent billings, Ramirez and Velasquez allegedly created payroll records from the fraudulent time sheet that they sent to Caring Tough’s payroll staff. According to the indictment, Ramirez and Velasquez obtained the payroll checks generated from the false and fraudulent time records, forged the signatures of the payees, and then cashed the checks and divided the money among themselves. The indictment does not accuse Caring Touch or the employees whose names were used on the false time sheets and checks of any wrongdoing.

The indictment alleges that from or about August 1, 2009 through on or about June 15, 2010, Ramirez and Velasquez submitted and or caused others to submit approximately 628 false and false and fraudulent claims in the approximate aggregate sum of $345,393.41 for home health services that were not provided. As a result, Texas Medicaid, Evercare, and Superior paid the approximate aggregate sum of $155,127.72, according to allegations.

Conspiracy to commit health care fraud and each of the six counts of health care fraud carry a maximum punishment of 10 years in federal prison without parole, upon conviction, while the four counts of wire fraud each carries a possible 20 year sentence. All of these charges also include a possible $250,000 fine. If convicted of aggravated identity theft, the defendants will serve a mandatory two-year additional prison term on each count which must be served consecutive to any other prison sentence imposed.

The charges were the result of a joint investigation conducted by officers and agents of the Corpus Christi Police Department, the FBI, Department of Health and Human Services-Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit. Special Assistant United States Attorney Rex Beasley and Assistant United States Attorney Jeffery Preston are prosecuting the case.

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