Couple indicted for Medicare fraud

By John McPhaul

Ramón Crespo Zamora and Carmen Pagán Domínguez, a married couple, have been indicted by a federal grand jury for committing Medicare fraud for almost $400,000, W. Stephen Muldrow, United States Attorney for the District of Puerto Rico, announced Tuesday.

The couple were arrested by law enforcement officers from the U.S. Department of Health and Human Services (HHS) and the U.S. Postal Inspection Service.

The grand jury issued two separate indictments against Crespo Zamora and Pagán Domínguez. The crimes charged are health care fraud, aggravated identity theft, conspiracy to commit health care fraud, obstruction of a criminal investigation related to health crimes and conspiracy to mail fraud, prosecutor Muldrow said in a written statement. .

According to the first accusation, from November 2015 to May 2020, the defendants were enriched by presenting 1,002 false and fraudulent claims for non-invasive cardiovascular studies to Medicare, in the amount of $259,147.

Cardiology Medical Group and Cardiology Medical Services, both owned by Pagán Domínguez, obtained $132,312 for fraudulent claims. Crespo Zamora is a cardiovascular technician for the companies.

The couple billed Medicare for non-invasive cardiovascular studies allegedly performed by two cardiologists even though the services were not provided by those doctors.

“Submitting false claims to federal health care benefit programs is unacceptable and a waste of taxpayer funds,” Muldrow said. “Today’s [Tuesday] arrests show the strong commitment of the Department of Justice and its law enforcement partners to protect public funds and safeguard the well-being of Medicare and Medicaid beneficiaries.”

If Pagán Domínguez and Crespo Zamora are found guilty, they face maximum sentences of up to 10 years in prison on charges related to health care fraud, conspiracy to commit health care fraud, and conspiracy to mail fraud; up to five years in prison for obstruction of a criminal investigation related to crimes against health; and a mandatory prison term of two consecutive years for aggravated identity theft.

The public is urged to report suspected cases of health care fraud to the HHS Office of Inspector General hotline at 1-800-HHS-TIPS (1-800-447-8477) or fraud / report-fraud /index.asp.

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