McAllen Area Ambulance Company Owner Pleads Guilty In Health Care Fraud Scheme

‪‪McALLEN, Texas ‐ Frank Gonzalez, 32, has pleaded guilty to conspiracy to commit health care fraud and aggravated identity theft, announced U.S. Attorney Kenneth Magidson and Texas Attorney General Ken Paxton. Gonzalez, of Mission, is the owner of a McAllen area ambulance transportation company who was charged in a federal indictment for his role in a scheme to defraud Medicare and Texas Medicaid through fraudulent billings.

Gonzalez, the owner of River Valley Transport (dba Med-Alert EMS), was charged in October 2013. As part of his plea today, he admitted he submitted or caused others to submit claims with Medicare and Texas Medicaid for reimbursement of ambulance transportation services that were not provided. Specifically, he billed for transporting beneficiaries to and from dialysis clinics on dates when the beneficiaries did not receive dialysis treatments or even go to the dialysis clinics.

Altogether, Gonzalez was responsible for the submission of $601,000 in fraudulent claims to Medicare and Texas Medicaid, resulting in the payment of $317,795.34 to Gonzalez.

Gonzalez admitted to creating or causing the creation of falsified documents which were intended to make the fraudulent claims submitted to Medicare and Texas Medicaid appear legitimate. The falsified documents were completed to make it appear that a particular emergency medical technician had been involved in the transportation of a patient when in fact they had not. Gonzalez also admitted to forging or caused others to forge the signatures of the emergency medical technicians on documents without their authorization or permission.

Gonzalez admitted to the use of a private vehicle, specifically a mini-van, to transport patients. Gonzalez then billed or caused others to bill those transports as ambulance transportation services and also billed at the higher-paying level of ambulance transportation services known as advanced life support. 

To further execute his scheme, Gonzalez used or caused others to use the Medicare number of a patient to submit false and fraudulent billings to Medicare and Texas Medicaid. As part of the plea, Gonzalez will pay $317,795.34 in restitution to Medicare and Texas Medicaid.

U.S. District Judge Ricardo Hinojosa, who accepted the plea today, has set sentencing for May 8, 2015. For the conspiracy to commit health care fraud, he faces a maximum of 10 years in federal prison and a possible $250,000 fine. In addition, he will receive a  mandatory two-year prison term for the identity theft which must be served consecutively to the other sentence imposed. Gonzalez was permitted to remain on bond pending that hearing.  

The investigation was conducted by the U.S. Department of Health and Human Services‐Office of Inspector General and the Texas Attorney General’s Medicaid Fraud Control Unit. Assistant U.S. Attorney Michael Day is prosecuting the case.