2 people charged in connection with health care fraud scheme, officials say

11-count indictment unsealed Friday

A gavel
A gavel (WDIV)

SAN ANTONIO – Two people have been charged in connection with a health care fraud scheme by a federal grand jury in San Antonio, according to the U.S. Attorney’s Office for the Western District of Texas.

Officials said authorities arrested a former employee of medical services provider Kindred Home Health for her alleged role in prescription fraud and home health kickback schemes.

An 11-count indictment unsealed on Friday charges former Kindred Home Health employee Amber Price, 37, and Christopher Cruz, 46, owner of a medical marketing business, CP Cruz Management Group, LLC (Cruz), with one count of conspiracy to violate the federal anti-kickback law.

Officials said Price is also charged with four counts of soliciting and receiving illegal kickbacks; one count of conspiracy to commit health care fraud; and five counts of health care fraud and aiding and abetting health care fraud.

From June 2014 to April 2019, Price allegedly created fraudulent prescriptions that were submitted for payment to federal health care benefit programs, including Medicare, Medicaid, FEHBP, TRICARE and other private insurance companies, according to the indictment.

The indictment also alleged Price and Cruz solicited and received monies from various pharmacies and laboratories to increase their volume of signed prescriptions, lab analysis and other billable procedures, officials said.

Price allegedly used actual hospital patient information she obtained to create fraudulent prescription forms, officials said. To facilitate her scheme, Price allegedly forged physician’s signatures on prescription forms or used pre-signed or photo copied prescription forms, officials said.

Price and Cruz allegedly accepted financial kickbacks paid by pharmacies on a per-prescription basis once they received payment from the insurance companies. During the alleged scheme, officials said Price was paid over $250,000 in kickbacks by multiple different marketers.

Charges of conspiracy to violate the federal anti-kickback law and soliciting and receiving illegal kickbacks call for up to five years in federal prison upon conviction, officials said.

Charges related to health care fraud call for up to 10 years in federal prison upon conviction.