An investigation by Texas Attorney General Ken Paxton’s Medicaid Fraud Control Unit has secured a 60-month federal prison sentence for Rene Fernandez Gaviola, a Houston dentist involved in a $6.9 million fraud scheme. Gaviola will also serve three years of supervised release and has been ordered to pay $4,908,957 in restitution to Medicaid, along with a personal money judgment of $2,996,092.
“Fraudulent schemes like the one perpetrated by Mr. Gaviola undermine our health care system and maliciously exploit funding that comes from hardworking taxpayers,” said Attorney General Paxton. “We will always work tirelessly to bring to justice any individuals who steal money from public programs.”
Gaviola pled guilty to one count of Conspiracy to Commit Health Care Fraud, five counts of Health Care Fraud, one count of Conspiracy to Pay and Receive Health Care Kickbacks, three counts of Payment of Health Care Kickbacks, and six counts of Money Laundering. Gaviola and his co-conspirators paid kickbacks to marketers who referred child Medicaid beneficiaries. Gaviola then fraudulently billed Medicaid for services not rendered and used unlicensed individuals to practice dentistry.
The investigation was conducted by Sergeant Alfred Paige, Investigative Auditor Mai Tang, and Captain Alex Chancia of Attorney General Paxton’s Medicaid Fraud Control Unit in cooperation with the FBI and the Department of Health and Human Services’ Office of Inspector General. The case was prosecuted by the U.S. Attorney’s Office for the Southern District of Texas.
Since 2021, the MFCU has recovered more than $612 million in settlements, judgments, and restitution for Texas taxpayers. The MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $20,944,200 for fiscal year 2023. The remaining 25 percent, totaling $6,981,395 is funded by the State of Texas. For every dollar of state funding over the last three years, the OAG’s MFCU has recovered more than 49 dollars for taxpayers.