Mexican Man Sentenced to 14 Years in Federal Prison for Leading a $6.85M Healthcare Fraud Scheme

DEL RIO, Texas - A Legal Permanent Resident cardholder from Mexico was sentenced in a federal court in Del Rio to 168 months in prison for healthcare fraud, announced U.S. Attorney for the Western District of Texas, Justin R. Simmons.

According to court documents, in 2008, Orlando Omar Garcia-Moya, 54, of Piedras Negras, founded an ambulance company known as Fleet Ambulance Service Inc., which operated in and around Brackettville. As part of a fraud conspiracy involving Garcia-Moya and two of his employees, Oscar Gutierrez and Melody Ann Villarreal, the three conspirators fraudulently billed Medicare and Medicaid for services and received reimbursement they were not authorized or entitled to receive.

Garcia-Moya, Gutierrez Jr. and Villarreal fraudulently created run sheets for patients that were not transported, transported patients in personal vehicles or in vehicles not approved for appropriate medical transfers, and used "ghost employees" in the run sheets.

From 2008 to 2012, Fleet Ambulance billed Medicare, Medicaid, and Managed Care Organizations (MCOs) more than $12.3 million. Medicare and Medicaid paid a total of $4,741,601.73. From Jan. 1, 2013, to April 2016, Fleet Ambulance billed Medicare, Medicaid and MCOs more than $5.6 million. Medicare and Medicaid paid a total of $2,142,491.12. The total amount paid out by Medicare and Medicaid as a result of the fraud was $6,856,186.85.

Garcia-Moya, Gutierrez Jr. and Villarreal were named in a 13-count indictment on Aug. 21, 2019. On March 2, 2022, Garcia-Moya opted for a bench trial and was found guilty on all 13 counts of the indictment. Gutierrez Jr. and Villarreal each pled guilty and were sentenced on March 1, 2023, to 60 months and 48 months in federal prison, respectively. During the sentencing hearing Thursday, Chief U.S. District Judge Alia Moses also ordered Garcia-Moya to pay $6,856,186.85 in restitution.

U.S. Health and Human Services and the Office of Inspector General - Medicaid Fraud Control investigated the case.

Assistant U.S. Attorney Justin Chung prosecuted the case.

###