Chula Vista couple admits fraud scheme targeting pregnant women in Mexico | #phishing | #scams


A Chula Vista couple admitted Monday to a fraud scheme that targeted pregnant women in Mexico and led to more than $1 million in losses to California’s Medi-Cal system, San Diego federal prosecutors said.

Melissa Alvarez Torres, 33, and Jose Luis Olmos Hernandez, 36, each pleaded guilty to conspiracy to commit health care fraud and wire fraud. They each face up to 20 years in federal prison when they are sentenced in October by U.S. District Judge Gonzalo Curiel, the San Diego U.S. Attorney’s Office said.

The couple has agreed to pay $1.5 million in restitution to the state and the women. Their defense attorneys declined comment Monday afternoon.

The scheme centered on pregnant Mexican women who had tourist or work visas allowing them to enter into the United States.

According to authorities and court documents, the couple advertised pregnancy insurance services on Facebook. They told victims they could provide private medical insurance to cover their maternity needs at a low cost so they could give birth in the U.S.

But it wasn’t private insurance. It was Medi-Cal, specifically the Medi-Cal Access Program for pregnant middle-income Californians without enough health insurance to cover maternity costs. The women did not live in California and were not eligible for it. They were unaware the couple was trying to get them fraudulently obtained government-funded insurance.

Federal prosecutors said the couple completed applications for insurance for the women, but those applications were filled with falsehoods. The supporting documents they supplied, such as letters from purported employers, were also faked.

Also, the couple told the women to pay a fake insurance premium between $1,200 to $3,000, much of which the pair pocketed, according to a charging document laying out an overview of the conspiracy.

Between January 2016 through September 2020, the couple submitted more than 250 fraudulent applications for the insurance. Most were approved.

Prosecutors said insurance program paid out more than $1 million to cover the pregnancy-related medical expenses in the fraud case. Federal funds cover about 88 percent of the Medi-Cal Access Program, and the state pays 12 percent, according to court documents.

According to a sworn affidavit from one of the case investigators, one woman was still pregnant when she realized that the insurance provided to her was Medi-Cal, not the private insurance she thought she had purchased. She called to report that she had been a victim of fraud, and had the baby in Mexico.

In 2018, a state investigator looking into suspicious applications to the program went knocking on doors in Imperial County to verify residences. Those efforts led to a call from a woman targeted in the scheme, and she provided information.

window.fbAsyncInit = function() { FB.init({

appId : '125832154430708',

xfbml : true, version : 'v2.9' }); };

(function(d, s, id){ var js, fjs = d.getElementsByTagName(s)[0]; if (d.getElementById(id)) {return;} js = d.createElement(s); js.id = id; js.src = "https://connect.facebook.net/en_US/sdk.js"; fjs.parentNode.insertBefore(js, fjs); }(document, 'script', 'facebook-jssdk'));



Original Source link

Leave a Reply

Your email address will not be published. Required fields are marked *

− six = one