Prison time for healthcare employees in multimillion dollar adult daycare fraud scheme

McALLEN, Texas – A doctor and clinic employee have been sentenced following their convictions for receiving illegal kickbacks after ordering unnecessary lab tests and prescriptions, announced U.S. Attorney Nicholas J. Ganjei. A federal jury found Dr. Osama Nahas, 70, McAllen, and Isabel Pruneda, 54, Edinburg, guilty March 1, 2024, of conspiracy to commit healthcare fraud, healthcare fraud and conspiracy to violate the Anti-Kickback Statute following a two-week trial. Pruneda was also convicted for aggravated identity theft. Chief U.S. District Judge Randy Crane has now imposed a 120-month-term of imprisonment for Nahas, while Pruneda received 97 months. Both must also serve three years of supervised release following their sentences. At the hearing, the court characterized Nahas and Pruneda as “predators” who exploited elderly, disabled and otherwise vulnerable patients at adult day care centers. Both were also ordered to pay over $3.1 million in restitution to Medicare. “Medical professionals have a solemn obligation to heal the sick and infirm, not to subject them to unnecessary treatments solely for the sake of making a quick buck,” said Ganjei. “The defendants here abused their unique position of trust and shamelessly took advantage of particularly vulnerable victims. Now they will have several years in prison to reflect on their actions.” Nahas, the owner and physician at Crosspoint Medical Clinic in Edinburg, traveled to adult day care centers across the Rio Grande Valley ordering unnecessary lab tests and prescriptions on behalf of elderly and vulnerable clients. Pruneda, a medical assistant at Crosspoint, helped carry out the scheme by fording patient signatures on consent forms and misappropriating expensive medications, including pain creams. Pruneda would strip patient information and packaging from the creams to hand them out as “goodie bags” in an effort to encourage patients to agree to testing. From January 2016 through December 2017, Nahas and Pruneda ordered unnecessary prescriptions and lab work, resulting in millions in losses. They directed those prescriptions and tests to specific companies in exchange for kickbacks. In June 2018, law enforcement executed a search warrant at Crosspoint and seized hundreds of thousands in stolen medications. Nahas and Pruneda also paid bribes-disguised as “rent” payments-to adult day care owners to gain access to their facilities. Witnesses testified that both accepted kickbacks for referrals, often labeling them as “rent” agreements. Evidence also revealed that both received tens of thousands of dollars in kickbacks from January 2016 to December 2017. Nahas was permitted to remain on bond and voluntarily surrender, while Pruneda will remain in custody pending transfer to a Federal Bureau of Prisons facility to be determined in the near future. The FBI, Department of Health and Human Services – Office of Inspector General, Texas Attorney General’s Medicaid Fraud Control Unit and Texas Health and Human Services - OIG conducted the investigation