EL PASO, Texas (KFOX14/CBS4) — Two men surrendered to the FBI in El Paso last week after being criminally charged for an alleged fraud scheme involving pass-through healthcare billing.
According to court documents, Jose Huerta, 58, was the Chief Executive Officer for two Long-Term Acute Care hospitals located in El Paso.
Israel Navarro, 47, owned one of the hospitals and was financially connected to the other.
An indictment filed on June 25 alleges that Huerta and Navarro conspired together and with others to knowingly devise a scheme to engage in illegal pass-through billing of urine drug tests (UDTs).
Huerta’s and Navarro’s hospitals allegedly submitted false insurance claims to Blue Cross Blue Shield, indicating in those claims that the individuals tested were patients in their hospitals when they were not.
The claims further indicated that UDT samples were taken from the patients and forwarded to a lab in the Dallas area. None of this was true. Over a six-month period, Huerta and Navarro submitted $16 million dollars in claims for the laboratory testing of UDTs.
The actual loss to Blue Cross Blue Shield attributed to Huerta’s and Navarro’s alleged fraud scheme totals more than $12 million.
Navarro, who resides in Puerto Rico and in the Dallas area, voluntarily surrendered to the FBI El Paso and made his initial appearance on July 22.
A federal magistrate released Navarro on a $150,000 bond.
Huerta surrendered to FBI El Paso on July 23, made his initial appearance July 24, and was released on a $50,000 bond.
They are each charged with one count of conspiracy to commit wire fraud, one count of wire fraud, and one count of conspiracy to commit mail fraud. If convicted, they face up to 20 years in prison and a $250,000 fine for each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
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