On June 6, Lt. Mike Ramirez, an investigator with Medicaid Provider Integrity, received the U.S. Department of Health and Human Services Inspector General’s Award for Excellence in Fighting Fraud, Waste, and Abuse. The award was presented during a ceremony in Washington.
Ramirez was recognized for his role in a joint investigation that returned more than $120 million to the treasury and resulted in five convictions. The case was the U.S. Department of Justice’s largest hospice investigation. It was conducted by the Rio Grande Valley Health Care Fraud Task Force, which includes Ramirez along with personnel from the U.S. Attorney’s Office, FBI, U.S. HHS-OIG, Texas Attorney General Medicaid Fraud Control Unit, and other agencies.
The investigation found dozens of companies were part of the scheme that improperly enrolled Texas Medicaid patients in hospice care programs after paying kickbacks to providers and lying to clients about having terminal illnesses with less than six months to live. The scheme also barred clients from seeking medical care for some conditions as hospice patients.