An Edinburg physician and one of his employees were arrested by federal agents Friday on multiple charges of health care fraud, conspiracy to receive illegal remuneration and aggravated identity theft.
A federal grand jury handed up a 15-count indictment against Dr. Osama Balhir Nahas, 67, and his employee, Isabel Moreno Pruneda, 50, on Tuesday, according to a news release from the U.S. Attorney’s Office. The indictment has yet to be unsealed.
The pair are accused of participating in a conspiracy that resulted in some $3.5 million in fraudulent claims billed to Medicare via Nahas’ medical practice at Crosspoint Medical Clinic in Edinburg.
“Nahas allegedly paid kickbacks to various adult day care companies to gain Medicare beneficiary information under the guise of providing medical services,” the news release states.
“Nahas, Pruneda and other co-conspirators used their access to adult day care facilities to perform a variety of unnecessary medical tests and procedures and order prescriptions for expensive medications that were not needed,” it further states.
The alleged scheme targeted elderly and disabled patients, many of whom already had primary care physicians who were unaware of the examinations Nahas and his co-conspirators were conducting on them.
Both the doctor and Pruneda also allegedly accepted kickbacks from “marketers” who ordered laboratory tests and prescriptions that weren’t needed or wanted by the patients. In furtherance of the scheme, Pruneda allegedly...
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