Three Arrested in San Antonio Health Care Fraud Investigation

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InvestigationFocused on Fraudulent Medicare and Medicaid Billing Scheme
In San Antonio today, federal and stateauthorities arrested 38–year-old Andey Gray, of San Antonio, owner of CrownConsulting and Billing, as well as 54–year-old Michael Farris and 47–year-oldSherry Trouten, of Castroville, Texas, directors of Tejas Ambulance, Inc.(Tejas) in connection with an estimated $2.5 million fraudulent Medicare andMedicaid billing scheme, announced United States Attorney Robert Pitman, FBISan Antonio Division Special Agent in Charge, Armando Fernandez, HHS-OIG DallasRegional Office Special Agent in Charge Mike Fields, and Texas Attorney GeneralGreg Abbott.
The defendants are charged in a 13-countfederal grand jury indictment returned on Wednesday and unsealed today. Theindictment charges the defendants with 10 counts of health care fraud and twocounts of theft or embezzlement in connection with health care fraud. Inaddition, Farris is charged with one count of making a false statement.
According to the indictment, Farris andTrouten worked for different ambulance companies—Farris, as director of MedinaValley Emergency Medical Services (Medina Valley), director of Tejas, andinterim director for Community Emergency Medical Services, Inc. (Community);Trouten, as an administrator for Community, bookkeeper for Medina Valley, andbusiness manager for Tejas. Gray, through his business, processed medicalclaims for Medina Valley, Community, and Tejas.
The indictment alleges that in March2011, Farris and Trouten began surreptitiously diverting Medina Valley andCommunity incoming calls for service to Tejas Ambulance. Because TejasAmbulance was not an authorized Medicare or Medicaid provider, the defendantsbegan using numbers assigned to other entities, including Medina Valley andCommunity, to fraudulently submit claims for ambulance services eitherperformed by Tejas, or not even performed at all. The indictment furtheralleges that the defendants then embezzled those Medicare and Medicaid fundsfrom Medina Valley and Community, diverting them to Tejas Ambulance andultimately, to themselves. As a result of the defendants’ scheme, Medicare andMedicaid paid just under $600,000 for claims that were not qualified forreimbursement from Medicare and Medicaid.
Upon conviction, the defendants face upto 10 years in federal prison per health care fraud related count. Farris isalso subject to a maximum of five years in federal prison upon conviction ofthe false statement charge.
This case was investigated by the TexasAttorney General’s Medicaid Fraud Control Unit together with the Federal Bureauof Investigation, U.S. Department of Health and Human Services Office ofInspector General, and the U.S. Department of Labor, Employee Benefits SecurityAdministration. Special Assistant United States Attorney Kimberly Johnson isprosecuting this case on behalf of the government.
An indictment is merely a charge andshould not be considered as evidence of guilt. The defendants are presumedinnocent until proven guilty in a court of law.