Texas U.S. Attorney: Two Charged With $12 Million Health Care Fraud Scheme

DALLAS, Texas, Nov. 21 -- The U.S. Attorney for the Northern District of Texas, Leigha Simonton, issued the following news release on Nov. 20, 2023:

Two individuals were charged with submitting fraudulent claims for corticosteroid injections and other services that were not performed and unlawfully distributing hydrocodone, announced U.S. Attorney for the Northern District of Texas Leigha Simonton.

Drs. Desi Barroga, 51, and Deno Barroga, 51, were indicted on November 14th on one count each of conspiracy to commit healthcare fraud, five counts each of healthcare fraud, and one count each of unlawful distribution of a controlled substance. The defendants were arrested November 16th, and made their initial appearances Friday morning.

According to court documents, the defendants operated a pain management clinic in Dallas where patients received prescriptions for high doses of hydrocodone, oxycodone, and morphine. Patients submitted to a short office visit each month and would receive their prescriptions. As part of those monthly visits, the defendants would submit fraudulent claims to the patients' insurance companies representing that the patients received dozens of corticosteroid injections, when in fact, the patients received few injections or none. The doctors would place a needle on the patient's body without actually piercing the skin to mimic an injection. If patients actually received any injections they would generally receive only a small amount. In many instances the defendants falsely represented that they provided over eighty injections to the patient on a single date of service. Fake medical records were also created to falsely reflect that injections were performed.

The doctors billed health care benefit programs over $50 million and were paid approximately $12 million for these fraudulent services.

An indictment is merely an allegation of criminal conduct, not evidence. Both defendants are presumed innocent until proven guilty in a court of law.

If convicted, they face up to up to ten years in federal prison for each count of health care fraud and conspiracy to commit health care fraud. They face up to twenty years for the unlawful distribution of a controlled substance counts. They will also be required to forfeit any proceeds or property traceable to the commission of the offenses of which they're convicted.

The U.S. Department of Labor, Office of Inspector General, U.S Department of Labor, Employee Benefits Security Administration, U.S Office of Personnel Management, Office of the Inspector General, Drug Enforcement Administration Dallas Field Division Diversion Group, Texas Department of Insurance - Fraud Unit - Austin and Ft. Worth Field Office conducted the investigation. Assistant U.S. Attorney Renee Hunter is prosecuting the case.

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Original text here: https://www.justice.gov/usao-ndtx/pr/two-charged-12-million-health-care-fraud-scheme