A Rio Grande City man is scheduled to make his initial appearance in federal court Friday in connection with allegations that he fraudulently billed Texas Medicaid more than $1 million in claims, according to a news release.
The Southern District of Texas U.S. Attorney’s office said in a release that Omar Cuate Canales is scheduled for his initial hearing Friday in connection with a scheme that purportedly ran for more than six years.
Between January 2010 to about October 2016, Canales allegedly billed Texas Medicaid in excess of $1 million for claims that were supported by either false documentation that he created or documentation that did not exist in Bluebonnet DME, a Roma-based durable medical equipment business.
According to the release, the 47-year-old man is the owner and operator of Bluebonnet DME.
“Canales is alleged to have deliberately destroyed patient records to conceal his false claims to Medicaid,” the release states.
The indictment, returned by a federal grand jury Dec. 18, and unsealed today, alleges Canales committed “one count of conspiracy to submit false statements relating to health care matters, eight counts of false statements relating to health care matters and five counts of aggravated identity theft of local physicians’ names, medical license numbers and national provider identifier numbers.”
According to the Southern District of Texas U.S. Attorney’s Office, each of the counts of false statements related to health care matters carries a maximum punishment of five years in federal prison and a $250,000 possible fine, upon conviction. If convicted of aggravated identity theft, Canales could also face an additional and mandatory two years in federal prison, which must be served consecutively to any other prison sentence imposed.
Canales’ indictment comes on the heels of two other convictions related to healthcare fraud just this week.
On Wednesday, George Louis Moreno, of McAllen, and Oscar Elizondo, a former Pharr commissioner, were each convicted in separate healthcare fraud cases.
Elizondo was handed a 22-month federal prison sentence, for what the court characterized as “blatant fraud,” in a scheme that fraudulently billed an healthcare insurance company of nearly $1.8 million.
Moreno will serve 36 months for his role in a scheme of his own, related to a durable medical equipment company he operated in McAllen.
Multiple agencies worked together on the investigation into Canales alleged fraud, including the Texas Attorney General’s Medicaid Fraud Control Unit, the FBI and the Department of Health and Human Services – Office of Inspector General.
Special Assistant U.S. Attorney Marian Swanberg and Assistant U.S. Attorney Andrew Swartz are prosecuting the case, the release states.