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The final suspect in a massive healthcare fraud case was sentenced on Wednesday to a little more than four years in federal prison.
Jesus Virlar-Cadena, a 52-year-old San Antonio resident, pleaded guilty on June 4, 2019 to his role in a scheme that involved $150 million in false and fraudulent Medicare claims for hospice and other healthcare services.
The three other suspects — Rodney Mesquias, 53, of San Antonio, Henry McInnis, 52, of Harlingen, and Francisco Pena — went to trial in Brownsville federal court in October 2019 and were found guilty.
Mesquias is serving a 20-year sentence while McInnis is serving a 15-year sentence. Pena died in custody prior to his sentencing and the government later moved to dismiss all of the charges against him due to his death, court records reflect.
U.S. District Judge Rolando Olvera, who sentenced Virlar, also ordered him to pay $9 million in restitution and ordered a forfeiture of $9 million.
He had served as medical director of the Merida Group, a large company with dozens of locations throughout the state, from 2009 to 2018.
He was a physician, but his license was later suspended by the Texas Medical Board, according to a news release from the U.S. Attorney’s Office for the Southern District of Texas.
The short of the scheme was the men were enrolling patients with conditions such as Alzheimers or dementia or people with limited mental capacity who lived in group homes, nursing homes and in housing projects into hospice care.
“In some instances, Merida Group marketers falsely told patients they had less than six months to live,” the release stated. “They also sent chaplains to the patients based on the false pretense they were near death.”
To pull this off and bill Medicare, the Merida Group hired Virlar and other medical doctors but made payment of their fees contingent on an agreement to certify people for hospice care who did not need that care.
“In addition to regular medical director payments, Virlar received luxury trips, bottle service at exclusive nightclubs and other perks in exchange for his certification of unnecessary hospice patients,” the release stated.
Virlar personally certified more than $18 million in unnecessary hospice service as part of the overall $150 million conspiracy.