Two plead guilty in healthcare fraud case

McALLEN — The owner and an employee of a now-closed durable medical equipment business each pleaded guilty to healthcare fraud charges, court records show.

Standing before U.S. District Judge Micaela Alvarez, Everardo Villarreal and Delilah Rae Robles each pleaded guilty to the first of a seven-count indictment accusing them of devising a scheme that allegedly defrauded federal and state healthcare benefit programs of more than $850,000 after submitting more than $1.5 million in claims.

Villarreal, 46, and Robles, 38, each pleaded guilty to one count of attempt and conspiracy to commit mail fraud, court notes show. Read the indictment here.

In exchange, government prosecutors agree to dismiss the remaining six charges against them each, at the time of their sentencing, court records 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 shows.

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

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 read. “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 read. “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 was facing 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.

Robles and Villarreal, will remain free on their respective bonds of $50,000, court notes show.

Both defendants are scheduled back before Alvarez on Sept. 12, for their respective sentencing hearings where they could face up to 10 years in federal prison. The charges also carry a $250,000 maximum possible fine.