Couple gets prison in insurance scam targeting Mexican pregnant women [The San Diego Union-Tribune]

For many women living in Mexico preparing to give birth, it almost sounded too good to be true.

A Chula Vista couple was offering pregnant visa holders private health insurance that would allow them to deliver their babies in the U.S. and access high-quality pre-natal and post-natal care.

Nearly 300 women accepted, only to later learn it was a scam.

Prosecutors say the couple — Melissa Alvarez Torres and Jose Luis Olmos Hernandez — took the womens' payments of $1,200 to $3,000 each and instead fraudulently signed them up for a state maternity care program offered only to eligible employed, middle-income California residents.

On Tuesday, Alvarez and Olmos were sentenced in San Diego federal court to 33 months and 40 months, respectively. They have agreed to pay the state about $1.1 million in restitution, as well as forfeit about $424,000 — the amount they pocketed from victims in profits.

The couple lived lavishly while operating the scheme, prosecutors said, buying two homes in the Mexicali area and a beach house in Nayarit.

Prosecutors said the couple was familiar with California's maternity care program, known as MCAP, which is administered by the California Department of Health Care Services. They had used it for the last two of their four children.

According to a government sentencing memorandum, the couple advertised American Pregnancy Insurance on Facebook, often receiving referrals from other families. The scam, which began in 2016, targeted women who already held visas allowing them to work in or visit the United States.

The couple then filled out applications for MCAP on behalf of the women, using the womens' personal identifying information. The couple falsified employment documents to show eligibility and claimed the women lived in California when they did not. Alvarez also impersonated many of the women in phone calls to program administrators.

Several women confronted the couple upon learning the insurance was a government program that they weren't eligible for — and that their unwitting participation put them at risk of losing their visas.

When one woman demanded a refund, Olmos sent her a picture of her visa and told her, "Let me remind you that you can lose your visa, ma'am," according to court documents. The woman took the retort as a threat, but she reported the fraud to authorities anyway, prosecutors said.

Other women posted comments on the Facebook page, warning others that the insurance was not as advertised.

"In response, Alvarez and Olmos doubled down, responding dismissively that such comments were 'without foundation' and that their product was legitimate," Assistant U.S. Attorneys Lisa Sanniti and Jeffrey Hill wrote in their sentencing document. "Even when the victims asked Alvarez and Olmos why they were being contacted by investigators, Alvarez and Olmos pressed on undeterred."

The couple continued to file fraudulent applications through the summer of 2020 shortly before their arrest that September at the $2,600-per-month Chula Vista townhouse they were renting.

"There was no indication they were going to stop," Hill said.

The investigation — by California Department of Health Care Services, the FBI and U.S. Attorney's Office — was sparked by complaints from some women and also by red flags that administrators began to notice in the applications. Some of the same address kept popping up, as well as a particular fax machine from Mexico and similar employment paperwork, Hill said.

They each pleaded guilty to one count of wire fraud conspiracy in July.

While many of the women gave birth in the U.S., some did not after their applications were denied. One called into the sentencing hearing this week and told the judge that she paid the couple but ended up giving birth in Mexico after her MCAP application was flagged as possibly fraudulent, prosecutors said. During delivery, her daughter's skull was crushed, and the newborn had to undergo surgery to prevent chronic seizures.

She acknowledged that the injury wasn't a direct result of the scheme, but claimed it was a consequence.

Both Alvarez, a U.S. citizen, and Olmos, a lawful permanent resident, have been in custody since their arrest. In a letter to the judge, Alvarez offered apologies and said she was ready to pay for her mistakes and contribute to society.

Olmos' attorney said he was also remorseful: "He was tempted to participate in this offense for monetary reasons as well as the misguided belief that he was helping Mexican women get access to safe medical services in the United States, and did not fully appreciate the harm and financial loss he had caused," his attorney, Jennifer Coon, wrote in a sentencing document.

The attorney added that the home in Nayarit is owned not by the couple but by other family members, that one Mexicali home is being rented out to cover the mortgage and another is in foreclosure.

This story originally appeared in San Diego Union-Tribune.

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