McALLEN, Texas - A federal jury found three men associated
with a Texas health care company guilty today for their roles in a $150 million
health care fraud scheme, one of which was a mayor in Texas at the time.
After a three-week trial, the jury found Rodney Mesquias,
47, San Antonio, Henry McInnis, 47, Harlingen, and Francisco Pena, 82, Laredo,
guilty of one count of conspiracy to commit health care fraud and one count of
conspiracy to commit money laundering. In addition, Mesquias and McInnis were
found guilty of six counts of health care fraud and one count of conspiracy to
obstruct justice. Pena was also convicted of one count of health care fraud,
obstruction of health care investigations and one count of false statements, while
Mesquias and Pena were each convicted of one count of conspiracy to pay and
receive kickbacks.
U.S. District Judge Rolando Olvera presided over the trial
and set sentencing for June 17.
“Rodney Mesquias and his co-conspirators preyed on the most
vulnerable population – those in need of hospice and home health care – to line
their pockets with millions of dollars and engage in lavish spending,” said
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s
Criminal Division. “I thank our law enforcement partners for their hard work
and dedication to bringing these health care fraudsters to justice. We look
forward to continuing our partnership as we expand the Strike Force into the
Rio Grande Valley.”
“It’s disgusting how these three made millions by lying
about and manipulating people’s end of life care,” said U.S. Attorney Ryan K.
Patrick of the Southern District of Texas (SDTX). “These men won’t have season
tickets or nice cars where they are headed.”
“Hospices should provide meaningful quality of life care for
patients in the final stage of their disease. Rather than help these vulnerable
patients, Mesquias and McInnis operating as the Merida Health Care Group along
with Dr. Francisco Pena, exploited them and their families to steal millions of
dollars from the American taxpayer,” said Special Agent in Charge Christopher
Combs of the FBI’s San Antonio Field Office. “The FBI is committed to
aggressively investigating and bringing to justice those who undermine our
health care system.”
“The decision to provide hospice services should be based on
a patient’s medical condition and desire for palliative care, not the selfish
motives of hospice executives intending to line their own pockets,” said
Special Agent in Charge C.J. Porter for the U.S. Department of Health and Human
Services Office of Inspector General’s (HHS-OIG) Dallas Region. “Our agency
will continue to protect Medicare patients and Medicare itself from such
unscrupulous individuals.”
According to evidence presented at trial, from 2009 to 2018,
Mesquias, McInnis and Pena engaged in a scheme that involved over $150 million
in false and fraudulent claims for hospice and other health care services.
Mesquias owned and controlled the Merida Group, a large health care company
that operated dozens of locations throughout Texas. McInnis was CEO. Pena, a
licensed physician, was a medical director for the Merida Group and was at the
time also the mayor of Rio Bravo. According to evidence presented at trial, the
Merida Group enrolled patients with long-term incurable diseases, such as
Alzheimers and dementia, at group homes, nursing homes and in housing projects
by falsely telling them they had less than six months to live and sent
chaplains to lie to the patients and discuss last rites and preparation for
their imminent death. In fact, the patients were not suffering from a terminal
illness that was expected to result in their death within six months, as is
required to qualify for hospice services, and were in some instances walking,
driving, working and even coaching athletic sporting events. However, the
defendants kept the patients on services for multiple years in order to
increase revenue. Mesquias also fired employees who refused to go along with
the fraud and directed them not to “[expletive] with his patients, or
[expletive] with his money” by discharging patients from services. Pena told a cooperating witness that, with
respect to hospice patients, “the way you make money is by keeping them alive
as long as possible,” according to trial testimony.
The evidence further established Pena gave a false statement
to the FBI and directed others to obstruct the FBI’s investigation by covering
up Pena’s involvement in accepting kickbacks for hospice patients from his
mayoral office at Rio Bravo City Hall and elsewhere. The evidence also
established that Mesquias and McInnis obstructed justice by causing the
creation of false and fictitious medical records and produced them to a federal
grand jury in order to avoid indictment. The records added false diagnostic
information making it appear that patients were dying when, in fact, they were
not.
According to evidence presented at trial, the scheme
involved laundering the proceeds of the fraud. For example, they placed a
company in the name of the girlfriend of a co-conspirator physician to conceal
the distribution of hundreds of thousands of dollars in illegal kickbacks that
were provided to the physician in exchange for home health and hospice
referrals. Mesquias and McInnis used proceeds derived from the scheme to
purchase expensive vehicles such as a Porsche, expensive jewelry, luxury
clothing from high-end retailers such as Louis Vuitton, exclusive real estate,
season tickets for premium seating to see the San Antonio Spurs, and a security
detail and bottle service at high end Las Vegas nightclubs such as Hakkasan and
Omnia. Mesquias and McInnis treated physicians to lavish parties at these elite
nightclubs, plying them with tens of thousands of dollars in alcohol and other
perks in exchange for medically unnecessary patient referrals.
Mesquias caused kickbacks and bribes to be paid to medical
directors, including Pena, for the Merida Group’s affiliated entities in
exchange for certifying that patients qualified for services when, in fact,
they did not, and for referring patients for such services.
HHS-OIG’s McAllen Field Office; the FBI’s San Antonio Field
Office, including the Laredo and McAllen Resident Agency Offices; and the Texas
Health and Human Services Commission investigated the case with the assistance
of the Texas Attorney General’s Medicaid Fraud Control Unit. Trial Attorney
Kevin Lowell and Assistant Chief Jacob Foster of the Criminal Division’s Fraud
Section and SDTX Assistant U.S. Attorney Andrew Swartz are prosecuting the
case.
The Fraud Section leads the Medicare Fraud Strike Force.
Since its inception in March 2007, the Medicare Fraud Strike Force, which
maintains 15 strike forces operating in 24 districts, has charged more than
4,200 defendants who have collectively billed the Medicare program for nearly
$19 billion. In addition, the HHS Centers for Medicare & Medicaid Services,
working in conjunction with the HHS-OIG, are taking steps to increase
accountability and decrease the presence of fraudulent providers.
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