Two El Paso hospital CEOs are facing hefty charges after being indicted on June 25 for allegedly orchestrating a fraudulent healthcare scheme, a situation that unwound last week when they turned themselves in to the FBI. The U.S. Attorney's Office for the Western District of Texas announced that Jose Huerta, 58, and Israel Navarro, 47, were caught in the crosshairs of a federal investigation after submitting $16 million in false insurance claims for urine drug tests that never actually happened.
The scheme, as outlined in the indictment, had Huerta and Navarro's hospitals billing for lab tests on non-patient urine samples which were then, according to the claim, sent to a lab in Dallas that was also complicit in the fraudulent activities; nonetheless, the tests were never done and the supposed patients were not admitted to their hospitals, causing Blue Cross Blue Shield a loss of over $12 million, an indictment filed last month argued that these acts were part of a conspiracy to engage in illegal pass-through billing for urine drug tests (UDTs). The accused faced the music as Navarro, residing both in Puerto Rico and the Dallas area, surrendered to the FBI in El Paso on July 22, and Huerta followed suit one day later.
Upon their respective appearances in court, both CEOs were released on bond; Navarro's price for temporary freedom was set at $150,000, while Huerta's bond was determined at $50,000. Their charges rack up to one count of conspiracy to commit wire fraud, one count of wire fraud, and one count of conspiracy to commit mail fraud, crimes which carry a potential sentence of up to 20 years behind bars and a quarter-million-dollar fine for each count, although sentences will ultimately rest in the hands of a federal district court judge who will weigh the U.S. Sentencing Guidelines along with other statutory factors.
The announcement by U.S. Attorney Justin R. Simmons of the Western District of Texas confirms that the FBI and Texas Department of Insurance are piecing together the investigation, while Assistant U.S. Attorney Debra Kanof shoulders the prosecution of the case, though it is crucial to remember that indictments are mere allegations and not convictions; until a jury decides their fate, Huerta and Navarro remain innocent, maintaining their constitutional right to be presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
