For his part in a conspiracy that entailed filing over $150 million in false and fraudulent claims to Medicare for hospice and other medical services, a hospice medical director was given a four-year and two-month prison sentence on Wednesday.
According to court records, 52-year-old Jesus Virlar-Cadena worked as the medical director of the Merida Group, a significant healthcare organization with several facilities throughout Texas, from 2009 to 2018.
Evidence at the trial of co-defendants Rodney Mesquias, Henry McInnis, and Francisco Pena showed that the Merida Group marketed their hospice programs through a group of companies known as the Merida Group.
With their fraudulent money, the criminals purchased expensive cars, including a Porsche, clothes from Louis Vuitton, and San Antonio Spurs premium seating tickets, according to the release.
It also stated physicians were given parties at elite nightclubs and bribed with other luxuries in exchange for referrals for patients who did not need medical help.
Peña also said as a cooperating witness that “the way you make money is by keeping them alive as long as possible,” according to trial testimony.
They enrolled people with chronic, incurable illnesses, including Alzheimer’s and dementia, and those with poor mental health who resided in group homes, nursing homes, and housing projects.
Marketers for the Merida Group occasionally misled patients into believing they had fewer than six months to live.
On the false premise that the patients were close to death, they also despatched chaplains to the patients.
In order to bill Medicare for these services, officials stated that the Merida Group hired Virlar and other medical directors, but made payment of their medical director fees contingent upon an agreement to certify unqualified patients for hospice.
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.
In exchange for these illegal kickbacks, Virlar himself certified over $18 million in unnecessary hospice services as part of the over $150 million conspiracy.
Mesquias was sentenced to 20 years in prison and McInnis got a 15-year prison sentence. Pena died before sentencing.
Principal Assistant Chief Jacob Foster, former Trial Attorney Kevin Lowell of the Criminal Division’s Fraud Section, and Assistant U.S. Attorney Andrew Swartz for the Southern District of Texas prosecuted the case.