McALLEN, Texas - Seven people have been charged in connection with a multi-million dollar health care fraud and kickback scheme.
A federal grand jury returned a 15-count indictment charging the seven with conspiracy to commit health care fraud, health care fraud, conspiracy to pay and receive illegal kickbacks, and conspiracy to commit money laundering.
51-year-old John Ageudo Rodriguez, 40-year-old Mohammad Imtiaz Chowdhury, his father 71-year-old Dr. Tajul Shams Chowdhury, and 51-year-old Alex Flores Jr., all of McAllen; 50-year-old Hector DeLaCruz, Jr. of Edinburg; 35-year-old Araceli Gaona of Mission; and 38-year-old Erika Hernandez Salinas of Donna have all been charged for their parts in the scheme.
The US Attorney's Office says that Rodriguez was the owner of Pharr Family Pharmacy, which from May 2014 to September 2016, allegedly billed various federal health care programs more than $110 million, including claims that were false, fraudulent, and the result of illegal kickbacks.
According to the indictment, Mohammad Chowdhury, Flores and DeLaCruz were purported marketers for the pharmacy who were the conduits for several million dollars in kickbacks relating to the referral of prescriptions for high-reimbursing compound drugs to the pharmacy. In numerous instances, the marketers allegedly received kickbacks from Rodriguez, which they shared with referring physicians.
Dr. Chowdhury, a physician with the Center for Pain Management in Edinburg, allegedly paid kickbacks to his father for referring prescriptions to the pharmacy, including prescriptions for high-reimbursing compound drugs not medically necessary or what patients wanted.
Gaona and Salinas, employees at the practice, are charged with conspiring to pay and receive kickbacks and conspiracy to commit money laundering in connection with their alleged receipt of kickbacks to help coordinate the flow of prescriptions from the medical clinic to the pharmacy.
The indictment alleges Rodriguez and his co-conspirators also targeted specific health care benefit programs known to pay high reimbursements for compound drugs, such as Federal Employee’s Compensation Program, TRICARE, Medicare, and various private insurance plans.
As part of the scheme, Rodriguez allegedly provided marketers with pre-filled prescription pads intended to be given to physicians. The charges allege these included compound drugs and other prescription items that would yield the highest possible reimbursement without regard to medical necessity.
If convicted of health care fraud and conspiracy to commit health care fraud, they face up to 10 years in prison and a maximum $250,000 possible fine. The penalty for conspiracy to pay and receive illegal kickbacks is five years with a $25,000 maximum fine. Those charged and convicted of conspiracy to commit money laundering face up to 20 years in prison and a fine of up to $500,000.