Local Dentist and Orthodonist Wife Charged with Defrauding Medicaid

January 25, 2010 - A federal indictment charging a Laredo dentist and his orthodontist wife with 17 counts of health care fraud has been unsealed, United States Attorney Tim Johnson and Texas Attorney General Greg Abbott announced today. Both defendants, who were arrested yesterday without incident, appeared before United States Magistrate Judge Diana Saldana today. During that hearing the issue of bond was raised. The court has taken the matter under advisement and the defendants were ordered to remain in custody pending her decision.

Carlos Armin Morales-Ryan, 33, and his wife, Nelia Patricia Garcia-Morales, 30, are the owners and operators of Orthogenesis International Centre, a Laredo dentistry and orthodontics business. The indictment alleges that from January 2005 to at least July 2008, the defendants fraudulently submitted claims to the Texas Medicaid program for payment for dental and orthodontic services they did not and could not have rendered because they were not in their offices, in the state of Texas or in the continental United States on the dates and times claimed. Physical presence of the provider is a prerequisite under applicable Texas law and Medicaid regulations for a claim to be submitted and paid for services rendered to a Medicaid beneficiary. The defendants are accused of executing the scheme and defrauding the Medicaid program of a total of $768,215.

Texas Medicaid is a health care program funded in part by the federal government through payroll taxes and in part by the State of Texas.

Each count of health care fraud carries a maximum sentence of 10 years imprisonment without parole and a maximum fine of $250,000 upon conviction.

The investigation leading to the charges was jointly conducted by the FBI, Department of Health and Human Services Office of the Inspector General and the Texas Attorney General Medicaid Fraud Control Unit. The case is being prosecuted by Assistant United States Attorneys Don J. Young and Michael Elliot.

An indictment is a formal accusation of criminal conduct, not evidence.

Both defendants are presumed innocent unless and until convicted through due process of law.