Hospice medical director sentenced for $150M hospice fraud scheme

McALLEN, Texas – A 52-year-old San Antonio man has been sentenced for his function in a scheme that concerned the submission of over $150 million in false and fraudulent claims to Medicare for hospice and different well being care companies.

Jesus Virlar-Cadena pleaded responsible June 4, 2019.

U.S. District Decide Rolando Olvera has now ordered Virlar-Cadena to serve 50 months in federal jail to be instantly adopted by one 12 months of supervised launch. The courtroom additionally ordered Virlar-Cadena to pay $9 million in restitution and $9 million in forfeiture.

From 2009 to 2018, Virlar-Cadena served because the medical director of the Merida Group, a big well being care firm that operated dozens of areas all through Texas. He was a doctor however the Texas Medical Board later suspended his medical license.

A federal jury convicted co-conspirators Rodney Mesquias, 53, San Antonio, Henry McInnis, 52, Harlingen, and Francisco Pena in October 2019.

Proof on the trial confirmed that the Merida Group marketed their hospice applications by a gaggle of firms. They enrolled sufferers with long-term incurable illnesses resembling Alzheimers and dementia in addition to sufferers with restricted psychological capability who lived at group houses, nursing houses and in housing tasks. In some situations, Merida Group entrepreneurs falsely informed sufferers they’d lower than six months to reside. In addition they despatched chaplains to the sufferers based mostly on the false pretense they have been close to loss of life.

In an effort to invoice Medicare for these companies, the Merida Group employed Virlar and different medical administrators however made cost of their medical director charges contingent upon an settlement to certify unqualified sufferers for hospice. Along with common medical director funds, Virlar obtained luxurious journeys, bottle service at unique nightclubs and different perks in trade for his certification of pointless hospice sufferers. In trade for these unlawful kickbacks, Virlar himself licensed over $18 million in pointless hospice companies as a part of the over $150 million conspiracy.

Mesquias and McInnis have been beforehand sentenced to twenty and 15 years in jail, respectively. Pena is now deceased.

Virlar-Cadena was permitted to stay on bond pending switch to a U.S. Bureau of Prisons facility to be decided within the close to future.

Division of Well being and Human Providers – Workplace of Inspector Normal (OIG), FBI and Texas Well being and Human Providers Fee – Workplace of Inspector Normal investigated the case.

Assistant U.S. Lawyer Andrew Swartz prosecuted the case together with Principal Assistant Chief Jacob Foster and former Trial Lawyer Kevin Lowell of the Prison Division’s Fraud Part.

Check Also

Youngsters’s hospice nurse honoured by Prince Harry and charity

A hospice nurse, who specialises in caring for youngsters who require air flow, has acquired …