Texas Adult Day Care Healthcare Fraud: Doctor and Employee Sentenced After Kickback Scheme

Federal prosecutors in the Southern District of Texas have secured substantial prison sentences for two healthcare employees convicted in a multimillion-dollar fraud scheme that targeted elderly and vulnerable patients at adult day care facilities. A federal jury found Dr. Osama Nahas and clinic employee Isabel Pruneda guilty of conspiracy to commit healthcare fraud, healthcare fraud, and conspiracy to violate the Anti-Kickback Statute after a jury trial. As a result, Nahas received a 10-year prison term while Pruneda was sentenced to over 8 years, and both will serve three years of supervised release following their incarceration. In addition, the court ordered them to pay more than $3.1 million in restitution to Medicare to help compensate for the financial harm caused by their conduct.

Investigators determined that the defendants exploited their positions for financial gain by ordering unnecessary lab tests and prescriptions for patients at adult day care centers in the Rio Grande Valley. Nahas, a physician and clinic owner, allegedly traveled to these facilities to prescribe unneeded services, while Pruneda aided the scheme by forging patient signatures and misusing expensive medications to induce compliance. Prosecutors further revealed that the defendants paid bribes—disguised as “rent” payments—to the day care owners in exchange for access to patients, funneling lucrative kickbacks from companies that profited from the unnecessary services. The case was the product of a coordinated investigation by the FBI, HHS-OIG, the Texas Attorney General’s Medicaid Fraud Control Unit, and other partners, underscoring the federal government’s sustained focus on prosecuting health care fraud and enforcing anti-kickback laws.