Healthcare fraud suspects appear in court; accused of billing Medicaid $1.5M

McALLEN — The owner and an employee of a now-closed durable medical equipment, or DME business each made their first appearance before a federal magistrate judge in connection with healthcare fraud charges.

Standing before U.S. Magistrate J. Scott Hacker a day after federal agents made their arrest, Everardo Villarreal and Delilah Rae Robles each learned of the seven charges against them in connection with a scheme that allegedly defrauded a federal and state healthcare benefit program of more than $850,000 — this after submitting more than $1.5 million in claims.

During their respective appearances Friday morning before Hacker, both Villarreal, 46, and Robles, 38, the two said they would each seek to retain their own respective attorney, court notes show.

According to the eight-page unsealed indictment, Villarreal, owner of the now-shuttered Elsa-based DME Medical Supply Depot, and Robles, who Villarreal employed as his secretary, conspired to defraud Texas Medicaid by submitting fake claims in an effort to “unlawfully enrich” themselves.

Government prosecutors allege that the scheme, which began sometime in April 2010, and ended more than four years later in September 2014, was executed by Villarreal and Robles “by submitting or causing others to submit false and fraudulent claims to Medicaid,” the record show.

In some instances, Villarreal allegedly paid kickbacks to an unnamed co-conspirator, referred to in the indictment by the initials “B.D.,” the document shows.

Delilah Robles

Villarreal, a native of Edinburg, paid B.D. kickbacks in the form of checks in exchange for patient information — specifically the names and personal identification numbers of Medicaid beneficiaries.

“As part of the kickback arrangement between Villarreal and B.D., B.D. bought back incontinence supplies from certain Medicaid beneficiaries whose patient information Villarreal purchased from B.D.,” the indictment states. “Villarreal used the patient information purchased from B.D. to submit or cause others to submit false and fraudulent claims to Medicaid in order to cause Medicaid to render payment.”

In addition, Villarreal instructed Robles, of Weslaco, to bill Medicaid for supplies that had not been delivered to Medicaid beneficiaries.

“Robles coordinated with B.D. to supply patient information to Villarreal in exchange for kickback payments from Villarreal,” the document states. “The defendants and their co-conspirators offered to pay cash to Medicaid beneficiaries in exchange for supplies.”

In all government prosecutors allege the pair submitted “in excess of $1,500,000 in claims to Medicaid,” and for which Medicaid paid in excess of $850,000 in false and fraudulent claims.

The government is also seeking to seize “all property, real or personal,” and a monetary judgment against the defendants.

The pair faces seven charges, including one count of conspiracy to commit healthcare fraud, four counts of healthcare fraud, and two counts of aggravated identity theft, the indictment stated.

Both will be back before Hacker on March 5 for their respective detention hearings where they could potentially be released on bond.

If convicted, the Valley residents could face up to 10 years in federal prison; and if convicted of identity theft, they each also face a mandatory two years in prison, which must be served consecutively to any other sentence imposed. The charges also carry a $250,000 maximum possible fine.