Brenda Rodriguez, 57, of Harris County, Texas, was convicted of participating in an $11 million Medicare fraud scheme in which fraudulent medical documents were sold to home-health agencies in and around Houston.
Rodriguez, the owner and operator of a purported medical clinic, QC Medical Clinic, was convicted on Jan. 24, by a federal jury of one count of conspiracy to commit healthcare fraud and three counts of healthcare fraud.
The conviction was announced by Assistant Attorney General Brian A. Benczkowski of the Criminal Division and U.S. Attorney Ryan Patrick of the Southern District of Texas.
According to the evidence presented at trial, from October 2012 through August 2015, Rodriguez and others conspired to defraud Medicare by selling Plans of Care, and other medical documents signed by a doctor, through QC Medical Clinic to various home-health services.
The evidence at trial showed that home-health agencies billed Medicare for home health services that were not medically necessary and in many instances, not provided. The scheme resulted in approximately $11 million in false and fraudulent claims for home-health services billed to Medicare.
The case is ongoing, with three others having pleaded guilty or been convicted based on their roles in a larger fraudulent scheme that included QC Medical. John Ramirez, M.D., was convicted of conspiracy to commit healthcare fraud and healthcare fraud for his role at a related purported clinic and is awaiting sentencing.
Rodriguez is expected to be sentenced on April 29. The case was investigated by the FBI, and was brought as part of the Medicare Fraud Strike Force. The case is being prosecuted by Trial Attorney Scott Armstrong of the Criminal Division’s Fraud Section and Assistant U.S. Attorneys Tina Ansari and Thomas Heyward Carter.
Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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