A
corporate executive has been ordered to serve 20 years in prison after
his conviction related to falsely telling thousands of patients with
long-term incurable diseases, such as Alzheimers and dementia, they had
less than six months to live and subsequently enrolling them in hospice
programs.
A federal jury in McAllen, Texas, convicted Rodney Mesquias, 48, of
San Antonio, Texas. The one-month trial in November 2019 was one of the
first criminal hospice fraud prosecutions the Department of Justice has
presented to a federal jury.
Today, U.S. District Court Judge Rolanda Olvera ordered Mesquias to
serve a total of 240 months in federal prison and to pay $120 million in
restitution.
“Mesquias funded his lavish lifestyle by exploiting patients with
long-term, incurable diseases by enrolling them in expensive but
unnecessary hospice services,” said Acting Assistant Attorney General
Brian C. Rabbitt of the Justice Department’s Criminal Division. “This
significant sentence represents the department’s continued commitment to
pursue those who orchestrate and commit healthcare fraud schemes.”
“Financial healthcare fraud is abhorrent enough, but to fraudulently
diagnose patients with dementia or Alzheimer’s is the pinnacle of
medical cruelness to both the patient and their family,” said U.S.
Attorney Ryan K. Patrick of the Southern District of Texas. “They
falsely gave patients life ending diagnosis and they will pay the price
with years behinds bars.”
“Families seek to give comfort and support to their ailing loved ones
when all other medical options are gone,” said Special Agent in Charge
Christopher Combs of the FBI’s San Antonio Division. “It is
unconscionable and evil to prey upon the most vulnerable in our
community to commit fraud against government-funded programs. The FBI is
committed to protecting our communities from those who may not have the
strength to protect themselves.”
“Mesquias’ scheme included paying kickbacks to physicians and
fraudulently enrolling vulnerable beneficiaries in hospice care that
prevented them from accessing curative care – all done to steal millions
of dollars from Medicare to fund lavish personal spending,” said
Special Agent in Charge Miranda L. Bennett of the U.S. Department of
Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas
Region. “This victimization is intolerable, and our investigators and
law enforcement partners will continue to work hard to bring such
criminals to justice and to protect those relying on federal health care
programs.”
Mesquias and his co-conspirator Henry McInnis, 48, were both
convicted of one count each of conspiracy to commit health care fraud,
conspiracy to commit money laundering and conspiracy to obstruct justice
as well as six counts of health care fraud. Mesquias was separately
convicted on one count of conspiracy to pay and receive kickbacks.
From 2009 to 2018, Mesquias orchestrated a scheme that involved $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.
According to evidence presented at trial, Mesquias and the Merida
Group adopted a strategy to market their hospice programs as providing
medical benefits “you don’t have to die to use.” They also aggressively
enrolled patients with long-term incurable diseases, such as Alzheimers
and dementia, and limited mental capacity who lived at group homes,
nursing homes and in housing projects.
In some instances, Merida Group marketers falsely told patients they
had less than six months to live and sent chaplains to lie to the
patients. They also discussed last rites and preparation for their
imminent death.
Hospice services require patients to be suffering from a terminal
illness expected to result in death within six months. Not only were
patients not in such circumstances, they were walking, driving, working
and even coaching athletic sporting events in some instances. However,
Mesquias and others kept patients on services for multiple years in
order to increase revenue.
Placing patients on such palliative hospice care meant they were
unable to obtain medical coverage for curative medical services.
Mesquias also fired employees who refused to go along with the fraud.
He often directed them not to “[expletive] with his patients or
[expletive] with his money” by discharging patients from services. One
co-conspirator said with respect to hospice patients “the way you make
money is by keeping them alive as long as possible.” This included
engaging in surgical and other medical interventions that were designed
to extend life through the use of medical technologies, according to
trial testimony.
The evidence further established Mesquias obstructed justice by
causing the creation of false and fictitious medical records. Further,
Mesquias produced them to a federal grand jury in order to attempt to
avoid indictment. The records added false diagnostic information, making
it appear that patients were dying when, in fact, they were not.
Mesquias also was convicted in connection with laundering the
proceeds of the fraud. The jury found they used monies 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 sporting events and a security detail and
bottle service at high-end Las Vegas nightclubs. Mesquias also treated
physicians to lavish parties at these elite nightclubs, providing them
with tens of thousands of dollars in alcohol and other perks in exchange
for medically unnecessary patient referrals.
McInnis will be sentenced at a later date. Two other co-conspirators have pleaded guilty and are awaiting sentencing.
The Department of Health and Human Service – Office of Inspector
General (DHHS-OIG); FBI and Texas Health and Human Services Commission
conducted the investigation. Assistant Chief Jacob Foster and Trial
Attorney Kevin Lowell of the Criminal Division’s Fraud Section and
Assistant U.S. Attorney Andrew Swartz of the Southern District of Texas
are prosecuting the case.
The Fraud Section leads the Health Care Fraud Strike Force. Since its
inception in March 2007, the Health Care 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, DHHS Centers for Medicare &
Medicaid Services, working in conjunction with the DHHS-OIG, are taking
steps to increase accountability and decrease the presence of fraudulent
providers.
The year 2020 marks the 150th anniversary of the Department of Justice. Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.
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