Ana Ramirez-Ambriz, the owner of Compassionate Medical Supply, has pled guilty of Texas Medicaid fraud. Ramirez-Ambriz confessed to having filed false Medicaid claims in the amount of $4.5 million between 2007 and 2013.
According to the Department of Justice, Medicaid was cheated out of $3.1 million, which is the amount that was effectively paid out.
Based in Edinburg, Texas, the medical supply company owner was directly responsible for filing fraudulent Medicaid claims for incontinence products and services. In January, she was arrested after a grand jury indictment on several counts of aggravated identity theft and healthcare fraud. The arrest and the guilty plea are both victories for the Texas Medicaid Fraud Control Unit, which acted in conjunction with the FBI and the Department of Health and Human Services.
Texas Medicaid Claims for Services Not Prescribed or Delivered Part of Fraud
Ramirez-Ambriz routinely billed Texas Medicaid for services that were never provided, services never prescribed by a physician, supplies that were not delivered or only partially delivered, and pricier supplies than had been prescribed.
After her arrest, the defendant pled not guilty, but in sight of an imminent trial, she ended up changing her plea. She is scheduled to be sentenced in June, 2017. The DOJ has already stated that it will seek to recover the $3.1 million, if necessary, through the forfeiture of property.
Ramirez-Ambriz may also face a maximum of $250,000 in fines and up to 10 years in prison. The aggravated identity theft charge carries a mandatory two years in prison.
State of Texas Coming Down Hard on Medicaid Fraud
The state of Texas is aggressively combating Medicaid fraud through a special task force. “We are pleased to make progress combating Medicaid fraud in the Rio Grande Valley,” Assistant U.S. Attorney Andrew R. Swartz has commented.
Medicaid is meant to service those in need. Dishonest medical suppliers that defraud government health programs take away from the people who actually need care and supplies. Medicare and Medicaid process millions of claims each day, filed by over 1.5 million providers nationwide.
Schemes to defraud Medicaid involving services that were never rendered, claims for medically unnecessary services, and overbilling are not uncommon. The arrest and likely conviction of Ramirez-Ambriz send a clear message that not only companies, but also individuals will be held accountable in cases of Texas Medicaid fraud.
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