San Antonio’s grimy healthcare landscape was hit by a double whammy of fraud as Nancy Almaguer, 42, and Christopher Felix Montoya, 47, were handed down prison sentences for their roles in health care fraud schemes that bilked public and private insurance programs out of over half a million dollars.
Montoya, the licensed physician’s assistant and owner of TPC Family Care and Medical Clinics in San Antonio and Laredo, was sentenced to 36 months in federal prison. His co-conspirator, Almaguer, was given an 18-month sentence. The duo began their kickback scheme in September 2018, referring lab testing requests to specific laboratories in exchange for a percentage of the receipts.
In addition to their jail time, Montoya was ordered to pay $849,865.93 in restitution, while Almaguer faces a fine of $137,792.10 and must repay $52,603.62 in restitution. The kickback scheme, which continued until June 2019, resulted in more than $500,000 in fraudulent billings.
Montoya’s fraud didn’t end there. He also pleaded guilty to conspiracy to receive health care kickbacks from a California-based pharmacy for writing prescriptions for compounded medication. TRICARE was billed nearly $8.83 million for these prescriptions, with TRICARE paying out over $6.69 million.
U.S. Attorney Ashley C. Hoff emphasized the importance of kickback regulations in protecting federal insurance programs and ensuring only medically necessary procedures are performed. FBI Special Agent in Charge Christopher Combs pointed out that health care fraud costs billions annually, driving up medical costs for all Americans.
This case was investigated by a coalition of agencies including the FBI, Texas Attorney General’s Office, U.S. Department of Health and Human Services, Defense Criminal Investigation Service, and others. Assistant U.S. Attorneys Justin Chung, William R. Harris, and Antonio Franco led the prosecution on behalf of the government.
RELATED: Houston Pharmacist Nermin El-Hadik Pleads Guilty to $5M Kickback Scheme
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Key Facts
- State: Texas
- Agency: DOJ USAO
- Category: Fraud & Financial Crimes
- Source: Official Source ↗
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