A Chula Vista couple who took part in a scheme that defrauded pregnant women and bilked the state's Medi-Cal program out of more than $1 million were sentenced Tuesday to federal prison terms.
Earlier this year, Melissa Alvarez Torres, 33, and Jose Luis Olmos Hernandez, 36, pleaded guilty to charges of conspiracy to commit health care fraud and wire fraud for selling bogus insurance to pregnant women living in Mexico.
Sign up for our Breaking newsletter to get the most urgent news stories in your inbox.
On Tuesday, Alvarez received a 33-month term, while Olmos was sentenced to 40 months. Olmos received a longer sentence due to what prosecutors described in court documents as a "thinly veiled threat" to a woman who confronted him and an attempt to deter her from reporting what she knew to authorities.
“The defendants were driven by greed and devised an elaborate scheme to defraud the state and make a quick buck,” FBI Special Agent in Charge Suzanne Turner is quoted as saying in a news release. “Today, they found out the cost of their scheme."
As part of their sentence, Alvarez and Olmos agreed to pay more than $1.5 million in restitution to both the state of California and the individual victims.
The defendants posted advertisements on Facebook for their purported private insurance company called Seguros Americanos Embarazo — or American Pregnancy Insurance — and claimed policies purchased through their company would allow women to legally give birth in the United States, prosecutors said.
According to court documents, many of the women were first-time mothers who sought coverage through the company because they had high-risk pregnancies and considered U.S. hospitals to be safer.
Victims were charged between $1,200 to $3,000 per pregnancy, the U.S. Attorney's office said.
Once they secured the women's personal information, prosecutors said, the defendants unwittingly signed them up for Medi-Cal benefits, despite the fact that the women were not eligible because they weren't California residents.
Prosecutors said Alvarez impersonated dozens of women when calling the Medi-Cal Access Program — or MCAP — customer service telephone line to get their applications approved.
According to court documents, many of the women reported having no intention of signing up for government-funded benefits because they knew doing so would violate the conditions of their work or tourist visas.
When one of the women confronted Olmos about the insurance, he sent her a picture of her visa and told her, "Let me remind you that you can lose your visa, ma'am," court documents state.
Prosecutors allege the defendants got at least $425,000 through the scheme, which was used to buy multiple properties in Mexico, including two homes in the Mexicali area and a beachfront property in Nayarit.
They were arrested in September of last year at their home in Chula Vista.
"These defendants exploited families at their most vulnerable and defrauded our vital public health programs to line their pockets," Acting U.S. Attorney Randy Grossman said.