Trevino Guilty of Insurance Fraud
Written by Post Public Information Representative, Feb 17, 2012, 0 Comments
Courtesy Monica Garcia,
The Office of District Attorney Isidro R. Alaniz reports that Firefighter Ricardo Trevino has entered a guilty plea in the 341st District Court. Trevino, whose criminal trial began on Monday of this week, is the owner of Chiro Health Clinic and was charged with having defrauded Blue Cross and Blue Shield Insurance Company of close to two hundred thousand dollars in fraudulent claims.
According to prosecutors, patients of Chiro Health Clinic would provide insurance information to clinic staff and initial blank paperwork upon their initial visit. Testimony this week, revealed that although patients would not return or would only be seen a handful of times, there was documentation and billing that demonstrated multiple visits and services rendered.
On Wednesday, a City Utilities worker testified about his visit to Chiro Health Clinic. From the witness stand, he stated that his wife phoned him on his cellular and asked that he not seek treatment at the clinic. He agreed and stated that he left Chiro Health Clinic prior to being evaluated for treatment. According to his testimony, he was required to initial documents by clinic staff before they would return his insurance card. He said that he was never evaluated nor did he receive any sort of treatment. Evidence showed, however, that the clinic submitted documentation seeking payment from Blue Cross and Blue Shield for one-hundred-twenty-two services or treatments rendered to that witness.
Also, testimony from a firefighter revealed that he had visited the clinic once in 2007 and was denied treatment due to the fact that his injuries were work related. Prior to leaving that initial visit, though, he was asked to initial a blank document multiple times. Evidence showed that despite his testimony of not having received treatment in 2007, the clinic sought reimbursement from Blue Cross and Blue Shield for twenty visits by that witness.
On Tuesday, during the first day of testimony, a medical billing agent who had worked at the clinic testified that sixty percent of the billing that took place was legitimate and that “forty percent was fabricated”. She testified that Trevino’s management style was “tyrannical” and that she argued with him about the fraudulent claims because she was “uncomfortable with it”. She testified that Trevino instructed her to use Dr. David Hall’s ID number for billing purposes and said that the doctor never gave her the authority to use his ID number. She said, “We would get into heated discussions over it”, but the end result was “to just do it or not come to work”.
The billing agent also testified, “Whenever we were slow, Nena would take a chart that had forms pre-initialed by the patients. We would check them off and bill them”.
Prosecutors had submitted a list of seventy-nine witnesses to the court and 583 exhibits. With such an overwhelming amount of evidence, the defendant chose to end the trail today and entered a guilty plea shortly before lunch.
Trevino pled guilty to one count of insurance fraud, which took place between January 1, 2007 and January 30, 2008. It is a first degree felony for which he owes approximately $154,000 in restitution. He will be sentenced by the Honorable Judge Elma Salinas Ender on September 6, 2012 at 9:00a.m.
District Attorney Isidro R. Alaniz said, “The State is very pleased with the guilty plea. This case was about accountability”.
