The former medical director of a Texas hospice company was sentenced to 50 months in prison for his role in a scheme that submitted more than $150 million in false claims to Medicare.
Jesus Virlar-Cadena, MD, 52, of San Antonio, was also ordered to pay $9 million in restitution and forfeit $9 million, according to a Sept. 27 Justice Department news release.
From 2009 to 2018, Mr. Virlar-Cadena served as medical director for the Merida Group, which operated dozens of locations throughout Texas, according to the release. He was a physician, but the Texas Medical Board later suspended his medical license.
The Merida Group enrolled patients with long-term incurable diseases and limited mental capacity who lived in group homes, nursing homes and housing projects into their hospice program, according to the release. The company's marketers in some instances falsely told patients that they had less than six months to live.
The company hired Mr. Virlar-Cadena and other medical directors to bill Medicare for these services, according to the release. Payment of their medical director fees were contingent upon an agreement to certify unqualified patients for hospice. He certified more than $18 million in unnecessary services as part of the scheme.
Three others were convicted for their roles in the scheme in October 2019, the release said.