A couple admitted to cheating the California public health system of more than a million dollars on Monday through a false private insurance scheme targeted at pregnant Mexican women looking to give birth in the United States.
  • A couple advertised private insurance to pregnant Mexican women promising they could give birth legally in the US and have their hospital bills covered.
  • Melissa Álvarez Torres and José Luis Olmos Hernández then used the women’s personal information and falsified documents to file claims with the Medi-Cal Access Program, and receive cash payments.
  • In a plea deal, the two agreed to pay back the state and victims $1.5 million (around R23 million) in restitution.
  • For more stories go to www.BusinessInsider.co.za.

A couple admitted to cheating the California public health system of more than a million dollars on Monday through a false private insurance scheme targeted at pregnant Mexican women looking to give birth in the United States, reported the San Diego Union-Tribune.

Melissa Álvarez Torres and José Luis Olmos Hernández, both California residents, advertised in the Facebook group “Seguros Americanos Embarazo (American Pregnancy Insurance),” promising that their insurance would allow women to give birth legally in the states and have their hospital bills covered.

According to court documents seen by Insider, many of the women who signed up had high-risk pregnancies, and were looking for insurance to cover the potentially costly birth, or to give birth in US hospitals, which are perceived to be safer. The majority of the victims held B1/2 visas – temporary non-immigrant visas for tourism or business purposes.

After the women paid insurance premiums, ranging between $1,200 (R16,800) and $3,000 (R42,000), according to court documents, the couple filed their claims with the Medi-Cal Access Program, a California programme that helps low-income women access affordable maternity care. Because the women signed up by Torres and Hernandez were not actually US residents, they did not actually qualify for the care.

To get the claims through, the couple used the women’s personal information to sign up to the government programme without their knowledge. They also submitted doctored tax and employment documents, falsely identifying them as California residents.

In all, Torres and Hernández submitted around 250 false applications, according to court documents.

The couple pleaded guilty to conspiracy to commit health care fraud and wire fraud. The couple agreed to pay back the state and individual victims $1.5 million (R23 million) in restitution, reported the San Diego Union-Tribune.

Torres and Hernández each face up to 20 years in federal prison, and are scheduled to be sentenced in October.

Melissa Alvarez Torres’ lawyer did not respond immediately to Insider’s request for comment.

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