FWA- Investigation by Paxton’s Medicaid Fraud Unit Results in $1.1M in Restitution to Health Care Programs

 
 

MM Curator summary

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

[MM Curator Summary]: These two yahoos stole $907k from Medicare and $218k from Medicaid- but really they stole the full $1.1M from you, the taxpayer.

 
 

Clipped from: https://www.texasattorneygeneral.gov/news/releases/investigation-paxtons-medicaid-fraud-unit-results-11m-restitution-health-care-programs

An investigation by Attorney General Paxton’s Medicaid Fraud Control Unit has led to the sentencing for health care fraud of two individuals in federal court in Del Rio, Texas.  

Melody Ann Villarreal and Oscar Gutierrez, Jr. were both found guilty of submitting fraudulent run sheets for ambulance transports that did not occur and submitting them to both Medicare and Medicaid for payment.  

Villarreal and Gutierrez were ordered to pay $907,376.41 in restitution to Medicare and $218,651.23 to Medicaid. Villarreal was sentenced to 48 months of incarceration, followed by three years of supervised release, and Gutierrez was sentenced to 60 months of incarceration, also followed by three years of supervised release. 

“My office will continue to crack down on those who commit fraud, drive up the cost of health care for Texans, and try to compromise the integrity of our health care system,” said Attorney General Paxton. “I’m proud to say that the hard work of my Medicaid Fraud Control Unit and our law enforcement partners has ensured that justice was done in this case and that Texas taxpayer funds were recovered.” 

The case was investigated by Lieutenant Jeff Winney, Investigative Auditor Michael Youngs, and Captain Raúl González of the Medicaid Fraud Control Unit, in cooperation with the Department of Health and Human Services’ Office of the Inspector General and the FBI. The case was prosecuted by Assistant United States Attorney Rex Beasley out of the Western District of Texas. 

The Texas Medicaid Fraud Control Unit is responsible for investigating and prosecuting Medicaid fraud and patient neglect and abuse. If you suspect Medicaid fraud or abuse, or patient neglect, please report it by calling (512) 371-4700 or visiting the Texas Attorney General’s website.