Former Commissioner and Wife Convicted of Health Care Fraud Sentenced to Prison

McALLEN, TX—Former Hidalgo County Commissioner Guadalupe Garces Jr. and his wife, Araceli Garces, found guilty in April by a jury of multiple counts of health care fraud arising from the submission of millions of dollars in false and fraudulent claims to both the Medicare and Medicaid health care programs, have been sentenced to prison, United States Attorney José Angel Moreno and Texas Attorney General Greg Abbott announced today.

Chief United States District Judge Ricardo Hinojosa sentenced Garces Jr., 52, to 41 months in federal prison, while his wife, 48, received 33 months. In addition to the prison terms, Chief Judge Hinojosa ordered the couple to pay a total of $636,742.61 in restitution to the Medicare and Medicaid programs. Following their release from prison, the court has further ordered both defendants to three-year terms of supervised release.

The Garces were convicted of multiple counts of health care fraud arising from the operation of two ambulance companies A-Stat Ambulance Inc. and A-Care EMS, both located in Edinburg, Texas, following a 13-day jury trial in April 2008. Initially indicted on Dec. 6, 2006, Guadalupe and Araceli Garces were accused of conspiring to and defrauding Medicaid and Medicare by means of false and fraudulent claims in connection with the transportation by ambulance of beneficiaries to and from dialysis clinics when ambulance transport was not medically necessary. From May 2001 to June 2004, A-Stat Ambulance, owned and operated by the Garces, billed Medicare/Medicaid approximately $12 million for transporting dialysis patients, even though the Garces knew transportation by ambulance was not medically necessary, and they received approximately $4.5 million in payments for these claims.

In May 2007, a federal grand jury returned a superseding indictment charging the Garces and Rodney Ramos, the director of operations, with health care fraud arising from their operation of the A Care E.M.S. Inc. After Medicare and Medicaid suspended all payments to A-Stat Ambulance because of the fraudulent billing, the Garces incorporated A-Care EMS Inc. in their 20-year-old son’s name and urged him to apply and receive Medicare and Medicaid provider numbers. The Garces continued to transport dialysis patients via ambulance when it was not medically necessary and billed Medicare/Medicaid approximately $3 million between March 2005 and December 2006. The health care benefit programs paid $1.6 million based upon these claims.

Ramos pleaded guilty to his role in the scheme and is pending sentencing.

The Garces have been permitted to remain on bond pending an order to surrender to a Bureau of Prisons facility to be designated in the near future where they will serve their sentences.

The investigation leading to the charges in this case was conducted by the Health and Human Services – Office of Inspector General, the FBI, and the Texas Attorney General’s Office – Medicaid Fraud Control Unit. Assistant United States Attorneys Anibal J. Alaniz and Carolyn Ferko prosecuted the case.