Acting U.S. Attorney Abe Martinez announced Friday the owner of Penitas Family Pharmacy, aka “Riverside Pharmacy,” pleaded guilty to defrauding Blue Cross Blue Shield of Texas.
Forty-five-year-old Omar Espericueta of Palmhurst submitted over $1.7 million in fraudulent clams through his pharmacy to Blue Cross Blue Shield of Texas for expensive scar creams and pain patches, according to the indictment.
Forty-seven-year-old Oscar Elizondo of Pharr also pleaded guilty in connection with the scheme. Elizondo was hired by Espericueta to target employees with health insurance through Blue Cross. Elizondo and other marketers solicited employees with drinks, meals and “free” prescription scar creams and pain patches.
The co-conspirators then submitted hundreds of unnecessary, fraudulent claims to Blue Cross, utilizing the employees’ insurance information. Some employees saw a physician that was selected by Espericueta to sign fraudulent prescriptions. The physician received prescription pain medication and “cash loans” that were never repaid.
Some of the employees received creams and patches, with multiple refills that they never requested.
Elizondo and Espericueta face a maximum 10-year prison sentence and $250,000 fine.