Federal Grand Jury Indicts 2 People in Health Care Fraud Scheme

Federal Grand Jury Indicts 2 People in Health Care Fraud Scheme

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Health Care frauds are on the rise especially in wake of COVID-19

In San Antonio Texas, federal authorities arrested a former employee of medical services provider Kindred Home Health (KHH) for her role in prescription fraud and home health kickback schemes, announced U.S. Attorney Gregg N. Sofer; FBI Special Agent in Charge Christopher Combs, San Antonio Division, and Special Agent in Charge Michael Mentavlos of the Defense Criminal Investigative Service (DCIS), Southwest Field Office.

An eleven-count indictment unsealed today, charges 37-year-old former KHH employee Amber Price and 46-year-old Christopher Cruz, owner of a medical marketing business, CP Cruz Management Group, LLC (Cruz), with one count of conspiracy to violate the federal anti-kickback law.  Price is also charged with four counts of soliciting and receiving illegal kickbacks; one count of conspiracy to commit Health Care Fraud; and, five counts of Health Care Fraud and aiding and abetting Health Care Fraud.  

According to the indictment, from June 2014 to April 2019, Price created fraudulent prescriptions which were submitted for payment to federal health care benefit programs including Medicare, Medicaid, FEHBP, TRICARE and other private insurance companies.  The indictment also alleges that Price and Cruz solicited and received monies from various pharmacies and laboratories to increase their volume of signed prescriptions, lab analysis and other billable procedures. 

Price used actual hospital patient information she obtained to create fraudulent prescription forms.  To facilitate her scheme, she allegedly forged physician’s signatures on prescription forms or used pre-signed or photo copied prescription forms.  Price and Cruz accepted financial kickbacks paid by pharmacies on a per-prescription basis once they received payment from the insurance companies.  During the scheme, Price was paid over $250,000 in kickbacks by multiple different marketers.

Charges of conspiracy to violate the federal anti-kickback law and soliciting and receiving illegal kickbacks call for up to five years in federal prison upon conviction.  Charges related to Health Care Fraud call for up to ten years in federal prison upon conviction.

This indictment resulted from an investigation conducted by FBI special agents together with investigators from the Texas Medicaid Fraud Control Unit, the Department of Defense OIG – Defense Criminal Investigation Service, Health and Human Services OIG, and the Office of Personnel Management OIG. Assistant United States Attorney Justin Chung is prosecuting this case on behalf of the Government.

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