Former Hidalgo County Commissioner and wife found guilty of defrauding healthcare programs

McALLEN - A federal jury on Monday convicted former Hidalgo County commissioner Guadalupe Garces and his wife Araceli of using their ambulance company to defraud Medicare and Medicaid of millions of dollars.

The Garceses were found guilty in the U.S. District Court for the Southern District of Texas of conspiracy to commit health care fraud and several counts of health care fraud while operating A-Stat Ambulance Inc. The couple submitted more than $14 million in fraudulent claims to Medicare and Medicaid from 2001-2006, according to the U.S. Attorney's office.

The ambulance company would pick up dialysis patients who were able to walk or sit in a wheelchair and take them to treatment, knowing that transporting them was not necessary and would not merit reimbursement from Medicare of Medicaid.

Medicare covers scheduled, non-emergency ambulance services only if patients are bed-ridden or cannot sit in a chair or wheelchair or if their medical conditions require them to be taken to treatment via ambulance.

But in A-Stat's case, it would bill Medicare and Medicaid for reimbursement, using falsified run sheets that stated the patients met transportation criteria.

The couple also incorporated another ambulance company, A Care E.M.S., in 2004 under their 20-year-old son's name and had him apply for Medicare and Medicaid provider numbers after Medicare suspended all payments to A-Stat Ambulance.

The former operations director for that company, Rodney Lee Ramos, pleaded guilty to fraud charges last year and awaits sentencing.

Guadalupe Garces was a Hidalgo County commissioner representing Precinct 4 from 1995-1999 and an Edinburg-area justice of the peace before his election to the commission.

He and his wife are each out on $100,000 bond while they await sentencing. A hearing has been scheduled for 9:30 a.m. July 18 in U.S. District Court for the Southern District of Texas.

They face a maximum punishment of up to 10 years in prison and $250,000 fine plus restitution, according to the U.S. Attorney's Office.

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Jennifer L. Berghom covers education and general assignments for The Monitor. She can be reached at (956) 683-4462.