Weslaco man sentenced to prison for ambulance scam

McALLEN — A Weslaco ambulance company owner was sentenced to two years in prison Monday for defrauding government health care programs out of more than $1 million.

Jesus Jorge Flores Jr., 38, scammed the Medicare and Medicaid programs by paying people to take unnecessary ambulance trips to and from local clinics and then submitting fake claims for reimbursement.

He pleaded guilty in July 2008 to conspiracy to commit health care fraud, after admitting his company – St. Mary’s Ambulance Service -- drove seven dialysis patients to local clinics even though all of them were healthy enough to walk or sit in a wheelchair, according to court documents.

Medicare and Medicaid only reimburse companies for transporting bedridden patients unable to move on their own. Dialysis patients suffering from severe kidney failure can often need three to four treatments a week.

Flores was allowed to remain free on bond until June 7, when he must surrender to the U.S. Marshals Service. He will be transported from McAllen to a federal prison facility where he will serve his sentence.

In addition to the prison term, he was also ordered to pay more than $650,000 in restitution to the Center for Medicare and Medicaid Services more and serve a three-year term of court supervision upon his release.

Medicare is a federally funded program offering healthcare assistance for individuals who are 65 and older and for the disabled. Medicaid is a federal-state program that helps pay for health care for the needy, aged, blind and disabled and for low-income families with children.

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Ana Ley covers law enforcement and general assignments for The Monitor. She can be reached at (956) 683-4428.