Federal Court Sentences Texas Healthcare Company Owner For Healthcare Fraud, Wire Fraud and Identity Theft
WASHINGTON, DC – The U.S. District Court for the Western District of Texas has sentenced Rafael Enrique Rodriguez – manager and owner of 210 Workers LLC, and registered agent of Alta Vista Healthcare Group LLC in San Antonio, Texas – after his conviction on six counts of healthcare fraud, five counts of wire fraud and one count of aggravated identity theft in June 2019.
On December 2, 2019, U.S. District Judge David Ezra sentenced the healthcare company owner to seven years in prison for scheming to defraud the Federal Employees' Compensation Act (FECA) program. FECA is a federal healthcare benefit program that provides workers' compensation benefits to federal employees. In addition to the prison term, Senior U.S. District Judge David A. Ezra ordered that Rodriguez pay $6,032,126.69 in restitution to the government, and placed on supervised release for a period of three years after completing his prison term. Judge Ezra ordered that Rodriguez surrender to federal authorities on January 16, 2020, to begin serving his federal prison term.
A federal investigation found Rodriguez billed the program using codes that indicated a qualified professional provided physical therapy and treatment services when, in fact, unlicensed technicians performed the services. Between October 22, 2012, and December 14, 2016, Rodriguez fraudulently billed the program for more than $8.4 million and received more than $6.3 million. Investigators also determined Rodriguez used the identity of a licensed physical therapist to obtain provider registration with the program without the permission of the therapist.
The U.S. Postal Service Office of the Inspector General led the investigation, while the Department of Labor's Office of Worker's Compensation Programs (OWCP) and Office of the Inspector General assisted with the investigation. OWCP's Division of Federal Employees' Compensation (DFEC) provided critical billing evidence that established Rodriguez's improper use of the codes.
"The U.S. Department of Labor recognizes the efforts of the Office of the Inspector General community and federal agencies involved, and will continue to identify potential medical provider fraud and stop abuse of the Federal Employees' Compensation Act program," said Division of Federal Employees' Compensation Director Antonio Rios. "These fraud detection efforts continue to be a high priority for us."
DFEC provides wage replacement benefits, medical benefits, vocational rehabilitation, and other benefits to federal workers who sustain work-related injury or illness. In recent years, DFEC has strengthened its efforts to identify fraud in all areas of its operations.
The Office of Workers' Compensation Programs protects the interests of workers who are injured or become ill on the job, their families, and their employers by evaluating claims, promptly paying benefits, and helping injured workers return to work as quickly as possible.
The mission of the Department of Labor is to foster, promote, and develop the welfare of the wage earners, job seekers, and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights.