Healthcare Fraud: Elva Acevedo Santos Sentenced In a Scheme to Defraud Texas Medicaid Through Fraudulent Billings

Healthcare Fraud
Rio Grande Valley Area DME Company Owner Sentenced in Health Care Fraud Scheme

Rio Grande Valley Area DME Company Owner Sentenced in Health Care Fraud Scheme

McALLEN, Texas ‐ The owner of a Rio Grande Valley area durable medical equipment (DME) company has been ordered to federal prison following her conviction in a scheme to defraud Texas Medicaid through fraudulent billings, announced Acting U.S. Attorney Abe Martinez. Elva Acevedo Santos, 37, of McAllen, pleaded guilty April 8, 2016, admitting she submitted false and fraudulent claims to Texas Medicaid for DME that was not authorized and/or not provided.

Today, U.S. District Judge Randy Crane handed Santos a 21-month sentence to be immediately followed by three years of supervised release. She was further ordered to pay $581,743.39 in restitution to the Texas Medicaid program as a result of the fraudulent claims she submitted.

Santos was the owner of Hope & Miracle DME in Mission. As part of her plea, Santos admitted she forged and/or caused others to forge the signatures of physicians on the required DME prescription forms also known as Title XIX forms. Santos subsequently used the fraudulent forms as the basis to submit claims to Texas Medicaid and Medicare in order to receive reimbursements.

Santos further admitted she submitted or caused others to submit false or fraudulent claims with Medicare for a patient who was deceased on dates that Santos claimed to have provided diabetic supplies to the patient. The delivery tickets maintained by Hope & Miracle DME contained forged signatures of the deceased beneficiary after the date of her death.

Previously released on bond, Santos was permitted to remain on bond and voluntarily surrender to a U.S. Bureau of Prisons facility to be determined in the near future.

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

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