Texas pair charged in separate, similar Medicaid fraud cases 

Two people are facing federal charges in connection with defrauding and scheming to defraud through false billing via their local medical equipment companies. But the two cases, however similar, are not linked to each other, according to a news release from the U.S. Department of Justice.

Both parties are accused of using several tactics, including forging physician signatures on prescription forms, to cover up their crimes as stated in their indictment documents.

Elva Santos, 36, of McAllen, owned Hope & Miracle DME – short for durable medical equipment – in Mission. She allegedly submitted false and fraudulent claims for a total of $713,759.73, the release states. Texas Medicaid allegedly paid out $581,743.39 to Santos’ company.

Santos is accused of submitting false claims from Jan. 20, 2011, to May 10, 2013. Those claims include Santos or her co-conspirators so submit fraudulent Medicare claims for a deceased woman, according to indictment documents against Santos. Hope & Miracle DME allegedly kept receipts for false equipment deliveries to the woman after her death — her signature forged on all of them.

Manuel Gomez, Jr., 34, of Katy, was the owner of two Rio Grande Valley-based medical equipment companies: Illusion Medical Equipment and Illusion Medical Equipment II LLC. He stands charged with conspiracy to commit healthcare fraud, six counts of healthcare fraud and one count of aggravated identity theft.

Like Santos, Gomez and his co-conspirators sent large monetary claims to Texas Medicaid — $2,347,841.71 — and the program allegedly paid them $2,088,473.67. The indictment against him states that he conducted his scheme from Dec. 1, 2007, to Nov. 30, 2011. During that time, Gomez and those who assisted him are accused of submitting false and fraudulent billings as well as misusing identifying information of state Medicaid recipients.

Source: Pair charged in separate, similar healthcare fraud cases – The Monitor: Local News

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