Feds Detail Hospice And Home Health Agencies $150 Million Health Care Fraud Scheme

A Texas man was sentenced on April 21, 2021 to 27 months in prison for his role in a conspiracy at the Merida Group, a chain of hospice and home health agencies throughout Texas, to falsely convince thousands of patients with long-term incurable diseases they had less than six months to live in order to enroll the patients in hospice programs for which they were otherwise unqualified, thereby increasing revenue to the company.

According to court documents, Jose Garza, 44, of Harlingen, was the operations manager for the Merida Group and responsible for carrying out the business’s day to day operations, including overseeing the recruitment of patients at certain locations throughout the Rio Grande Valley. Garza, and others working at his direction, recruited patients at hospitals and other medical practices by touting that the Merida Group offered “hospice that you don’t have to die to use,” pursuant to the Merida Group’s corporate marketing strategy.

At the trial of co-defendants Rodney Mesquias and Henry McInnis, witnesses testified that from 2009 to 2018, the vast majority of hospice and home health patients at the Merida Group did not qualify for services. Rather, physicians were bribed with illegal kickbacks, under the pretense of medical directorships, to falsely certify unqualified patients for services. Employees were instructed to falsify medical records, making non-terminal patients appear to be terminally ill and declining. Garza admitted to participating in the scheme, facilitating kickback payments to physicians, and directing employees to falsify medical records.

Garza pleaded guilty to one count of conspiracy to commit health care fraud on September 9, 2019. Garza was charged along with three others who were convicted by a federal jury in Brownsville, Texas, in one of the largest criminal hospice fraud cases tried to a jury. Mesquias, 50, the owner of the Merida Group, was sentenced to 20 years in prison in December 2020. McInnis, 50, the CEO of the Merida Group, was sentenced to 15 years in prison in February 2020.

In addition to the prison sentence, Garza was ordered to pay $4,700,000 in restitution.

The Department of Health and Human Service – Office of Inspector General (HHS-OIG), FBI, and Texas Health and Human Services Commission conducted the investigation.

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Visit our website or call us toll-free in the United States at 800-295-3959 to be connected with qui tam lawyers (False Claims Act lawyers) in your U.S. state who may assist you with a False Claims Act lawsuit.

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This entry was posted on Thursday, May 20th, 2021 at 5:23 am. Both comments and pings are currently closed.

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