Mexican national receives one-year prison term for health care fraud
Comments 9 | Recommend 0
Middleman in Medicare, Medicaid fraud scheme came from humble roots
January 26, 2010 7:26 PM
Jeremy Roebuck
The Monitor
McALLEN — Raul Torres earned his living selling trinkets to elderly patients at adult day care centers across the Rio Grande Valley three years ago.
By late 2007, the 60-year-old Mexican national was involved in one of the largest health care fraud schemes the region has ever seen, the U.S. Attorney’s Office said.
He was sentenced Tuesday to one year and one day in federal prison for helping McAllen cardiologist Dr. Fabian Aurignac bilk Medicare and Medicaid out of more than million.
“I didn’t know what the doctor was going,” Torres said in Spanish, dressed in a faded work shirt and slacks while pleading with the judge for leniency. “I sincerely did not know what he was up to.”
But prosecutors disagreed.
In several recorded conversations, Torres acknowledged his role in rounding up patients for the doctor and paying bribes to day care center staff for access to their clients, said Assistant U.S. Attorney Carolyn Ferko.
Torres met Aurignac — who ran McAllen’s Cardiology Care Center on the 700 block of North Ware Road — while peddling his wares at the Valley’s adult day care centers.
Since at least 2003, the doctor had been bilking the federally funded health care programs by hiring South American doctors who were not authorized to practice in the United States, giving them pre-signed prescription forms to hand out while he vacationed in Italy and Argentina, and later billing Medicare and Medicaid claiming he had overseen all of the patient visits, according to court documents.
Torres’ contacts in the elderly care industry provided just the conduit the doctor needed to expand his fraud scheme, according to a 19-count indictment filed in their case.
Aurignac paid Torres to win over management at these businesses and round up patents for treatments that were either unnecessary or never took place. Working as the physician’s middleman, Torres delivered bribes of 0 to 0 to day care managers and gave patients Walmart gift cards to submit to free health screenings.
At one such business — La Familia Adult Day Care Center in Harlingen — Aurignac’s employees set up a camper in the parking lot to see patients, another violation of Medicare and Medicaid rules requiring all procedures be conducted in sanctioned medical facilities.
The center’s manager — Martha Garcia Alaniz — pleaded guilty in July to one count of receiving kickbacks and was sentenced to one year of probation.
For his part, Torres was paid 0 for each session set up with a day care center. In the year that investigators were tracking his activity, he received more than ,000 from Aurignac.
In May, Aurignac agreed to pay back .1 million to the federal government for his fraud. He is currently serving a prison term of four-years and nine months. The Texas Medical Board suspended his license to practice in 2008.
Torres’ defense attorney maintained Tuesday that his client never really understood that what he was doing was illegal, but U.S. District Judge Randy Crane disagreed.
“He was doing Dr. Aurignac’s dirty work to some extent,” the judge said. “But without this recruiter, Dr. Aurignac would not have had this business