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Doctor Faces New Charges After Continuing To File Claims For Dead Patients

20 August 2015No Comments

elder abuseAccording to federal investigators, a McAllen area doctor accused in June of filing fraudulent Medicare claims involving deceased patients, is facing new charges after he continued to file false claims. The U.S District Attorney’s Office announced that Dr. Eduardo Carrillo, age 42, must surrender to authorities following his hearing scheduled before the U.S Magistrate Judge Dorina Ramos, where he will be formally charged with six new counts of healthcare fraud.

Carrillo was first indicted by a federal grand jury in June, on three counts of illegal remunerations, two counts of aggravated identity theft, and one count of false statement. Court documents show, a week later, Carrillo was given a $50,000 bond and released under certain conditions, including not violating federal, state, or local law. A motion was filed, accusing Carrillo of submitting six fraudulent bills for services he provided between July 2 through 15, to patients whose death certificates show they had died in 2013 and 2014.  According to documents, he also filed at least eight new fraudulent claims involving Medicare beneficiaries who told investigators they did not receive any services from Carrillo. It is also documented that he filed the dozen new claims to a billing company on or before July 17 less than one month after his release from jail. His first set of charges involved 34 deceased patients and a scheme to solicit cash kickbacks from other agencies.

South Texas Health Care Fraud Takedown

His assistant Martha Uribe Medrano, 47, was also charged in June after investigators said they learned the duo had received about $3,000 in exchange for 13 to 15 Medicare patient referrals to home healthcare agencies. Carrillo was one of 16 arrested in June across South Texas in a nationwide crackdown targeting federal insurance fraud. Federal and state authorities investigated six cases billed as the “South Texas Health Care Fraud Takedown,” which represented $7 million in federal insurance payments that prosecutors said resulted from false billings and kickbacks by healthcare providers across the region.

Insurance companies, or insurers, have certain duties towards their policyholders, including the duty of good faith and fair dealing. For example, when a policyholder files a claim with his or her insurance company, the insurer is obligated to conduct a full and reasonable investigation into the claim. If the insurance company arbitrarily denies the claim, delays payment, or decides to pay the policyholder less than the full value of benefits owed under the policy, the insurer may be liable for the tort of bad faith. Insurance bad faith is a legal term describing a tort claim that an insured may have against an insurance company for its misconduct. In other words, when an insurance company fails to uphold the duties it owes to policyholders, the insurance company has committed a bad faith act. If you have been the victim of an insurance bad faith act, consult a Texas insurance bad faith attorney immediately.

If you or a loved one has been victimized by bad faiths acts by an insurance company, contact a Texas insurance bad faith attorney today. You may be entitled to financial compensation for punitive damages and attorney fees, in addition to compensation owed to you under your insurance contract. With the help of a qualified Texas insurance bad faith lawyer, you can protect your legal rights and ensure that your insurance claim is handled professionally and appropriately.

 

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