McAllen-Area Marketer Pleads Guilty to Health Care Fraud Scheme
MCALLEN, TX—A marketer for several area home health agencies has entered a guilty plea to conspiracy to commit health care fraud for her role in a scheme to defraud the Medicare program, announced U.S. Attorney Kenneth Magidson.
Martha Lidia Flores, 51, of Pharr, admitted to engaging in a kickback scheme of exchanging referrals of Medicare beneficiaries for money. From Nov. 15, 2010, to July 9, 2012, Flores issued 11 illegal kickback checks to co-conspirator Argentina Cavazos, 57, of Hidalgo, in exchange for referrals of Medicare beneficiaries. The information was then used by home health care companies to bill Medicare.
Flores admitted to using the patient information she bought from Cavazos to create fraudulent referral forms to submit to the numerous home health companies where she was employed. Claims were subsequently filed with Medicare based on the fraudulent referral forms.
Flores admitted she forged the signatures of physicians on the referral forms, knowing that the physicians did not authorize the need for home health services and/or that the beneficiaries did not need or qualify for home health services. Flores also admitted that she was illegally compensated for the patient referrals.
U.S. District Judge Randy Crane, who accepted the plea today, has set sentencing for Nov. 9, 2015. At that time, she faces up to 10 years in federal prison and a possible $250,000 fine. Flores previously pleaded guilty to illegal remunerations for her role in the scheme and will be sentenced Oct. 15, 2015.
The investigation leading to the charges was conducted by the U.S. Department of Health and Human Services ‐ Office of Inspector General and the FBI. Assistant U.S. Attorney Michael Day is prosecuting the case.