People who commit health care fraud come in all shapes and sizes. Unlike the common stereotypes portrayed in Hollywood films, perpetrators of health care fraud aren’t the types of criminals who wear ski masks and break into homes. Their methods of stealing take on an entirely different look.

Yesterday, the United States Department of Justice announced that three individuals from Texas were found guilty for their roles in a $154 million health care fraud scheme. Mask-wearing bandits, these people were not.

One guilty party is a former Texas mayor.

According to the DoJ report, Rodney Mesquias, Henry McInnis and Francisco Pena (the former mayor of Rio Bravo) were found guilty of one count of conspiracy to commit health care fraud and one count of conspiracy to commit money laundering. Mesquias and McInnis were also found guilty of six counts of health care fraud and one count of conspiracy to obstruct justice.

“Pena was also convicted of one count of health care fraud, obstruction of health care investigations and one count of false statements, while Mesquias and Pena were each convicted of one count of conspiracy to pay and receive kickbacks,” reports the DoJ.

The scheme lasted nearly a decade.

Evidence presented during their three-week trial showed that from 2009 to 2018, the trio engaged in a scheme that involved over $150 million in false and fraudulent claims for hospice and other health care services. Mesquias was the owner of a Texas-based health care company with multiple locations, known as the Merida Group. McInnis was the CEO and Pena was a physician and medical director for the company.

The individuals told patients with long-term incurable diseases, such as Alzheimer’s and dementia, that they had less than six months to live. These horrible revelations were, in fact, false. The patients weren’t actually suffering from terminal illnesses that required them to have the hospice services the trio enrolled them in. Nevertheless, the defendants kept the patients on services for multiple years in order to increase revenue.

Threats were made to keep the scheme alive.

Mesquias went so far as to fire employees who refused to go along with the fraudulent scheme. Together with Pena, he refused to allow patients to be discharged, highlighting the fact that “the way you make money is by keeping them alive as long as possible,” according to trial testimony.

Pena covered up his involvement in the scheme by giving a false statement to the FBI. He also directed others to obstruct the FBI’s investigation. This was all during his tenure as mayor of Rio Bravo. Evidence in the trial also showed that Mesquias and McInnis obstructed justice by creating fictitious medical records purporting that their patients were indeed dying. They produced them to a federal grand jury in order to avoid Indictment. 

Evidence also demonstrated that they proceeds earned by the fraud scheme were laundered. “It’s disgusting how these three made millions by lying about and manipulating people’s end of life care,” U.S. Attorney Ryan K. Patrick of the Southern District of Texas is quoted as saying in the report, “These men won’t have season tickets or nice cars where they are headed.”

Are you an attorney who is currently trying a health care fraud case?

Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.