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2 Texas medical workers indicted for fraud against adult daycare patients

Justice Department Reporters Records
Posted at 9:43 PM, Sep 10, 2022
and last updated 2022-09-10 22:43:39-04

MCALLEN, Texas — Two Texans were indicted for fraud for their roles in a healthcare scheme exploiting adult daycare patients.

The Department of Justice reported Dr. Osama Balhir Nahas of McAllen and Isabel Moreno Pruneda of Edinburg were taken into custody on Aug. after being accused of charging around $3.5 million to Medicare for services not needed or not provided to multiple patients.

Authorities said the 67-year-old Dr. Nahas, as a physician and owner of Crosspoint Medical Clinic, paid kickbacks to different adult daycare companies in the scheme while claiming to provide the medical services they charged.

Pruneda was an employee at the clinic and is also accused of forging patient signatures on consent forms for multiple lab tests, authorities said.

Authorities accused the pair of performing various unnecessary medical tests and procedures and ordered unneeded and expensive prescribed medications for these patients, who were allegedly disabled or elderly and could not provide informed consent.

Authorities also said marketers paid the two kickbacks in exchange for ordering lab tests that the patients didn't want and excluded the patients' primary care doctors before or after their examinations, according to the charges.

Both are charged with seven counts of healthcare fraud and conspiracy to commit said fraud. Authorities said all carry a possible sentence of 10 years. They also received one count of conspiracy to receive illegal remunerations which carries a potential sentence of five years.

According to authorities Nahas and Pruneda are additionally charged with aggravated identity theft, a sentence that carries a minimum sentence of two years in federal prison.

All convictions carry maximum fines of $250,000, said authorities.