McAllen Area Marketer Sentenced in Health Care Fraud Scheme

McALLEN, Texas ‐ A marketer for several area home health agencies has been ordered to federal prison following her conviction of 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, pleaded guilty Aug. 28, 2015, admitting to engaging in a kickback scheme of exchanging referrals of Medicare beneficiaries for money.

Today, U.S. District Judge Randy Crane, who accepted the plea today, handed Flores a sentence of 24 months in federal prison to be immediately followed by three years of supervised release. She was further ordered to pay $267,981.16 in restitution.

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. Cavazos previously pleaded guilty to illegal remunerations for her role in the scheme and was sentenced to six months of home confinement and three years of probation.

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.    

Previously released on bond, Flores was permitted to remain on bond and voluntarily surrender to a U.S. Bureau of Prisons facility to be determined in the near future.

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.