CORPUS CHRISTI – A Corpus Christi-area physician has been charged in a 14-count indictment for a scheme to defraud Medicare and Medicaid through fraudulent billings, according to Texas Attorney General Greg Abbott, U.S. Attorney Kenneth Magidson, the FBI and Health and the Human Services Office of Inspector General.??
Dr. Roque Joel Ramirez, 48, of Robstown and the owner of Health Resolutions, Inc., has been charged for sending false and fraudulent billings to Medicare and Medicaid. The indictment against Dr. Ramirez was returned by a Nueces County grand jury on Oct. 9. The charges include nine counts of health care fraud, three counts of mail fraud and two counts of aggravated identity theft. Agents and officers of the Coastal Bend Healthcare Fraud Task Force arrested Dr. Ramirez on October 11.??
The indictment alleges that Dr. Ramirez, who has been a Texas licensed practitioner since 1997, engaged in a scheme to defraud Medicare and Medicaid through fraudulent billings for physician services that he did not provide. The indictment alleges that from May 2008, and continuing through December 2011, Dr. Ramirez submitted approximately 4,970 false and fraudulent bills to Medicare and Medicaid totaling over $1.4 million dollars. The indictment alleges that Dr. Ramirez billed for medical services he claimed to have personally provided to patients who had died prior to the dates of his claimed services, and that he also billed for medical services he claimed to have personally provided to patients in Texas on days when he was overseas or in another state. The indictment alleges Dr. Ramirez billed for medical services that would have required him to have personally worked more than 24 hours in a single day. The aggravated identity theft charges accuse Dr. Ramirez of using the Medicare identification numbers of former patients to bill for medical services he claimed to have personally provided to them after they had died.
??Each of the nine counts of health care fraud carries a maximum punishment of 10 years in federal prison without the possibility of parole and a $250,000 fine upon conviction. Each of the three counts of mail fraud carries a maximum punishment of 20 years in federal prison without the possibility of parole and a $250,000 fine upon conviction. The two counts of aggravated identity theft each carry a mandatory two-year additional prison term which must be served consecutively to any prison sentence imposed for a conviction on any of the other crimes charged.??
The investigation leading to the charges was conducted by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services-Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit. These agencies are partners of the Coastal Bend Healthcare Fraud Task Force. ??
Assistant United States Attorney Robert Thorpe and Special Assistant United States Attorney Rex Beasley are prosecuting the case.