South Texas Doctor Jailed for 25 Years Over Multimillion‑Dollar Scam

A federal court has sentenced Dr Osama Balhir Nahas, a South Texas physician, to 25 years in prison for orchestrating a multimillion‑dollar healthcare fraud that involved kickbacks, bogus billing and unnecessary procedures, the US Attorney's Office for the Southern District of Texas has confirmed.

Millions Fraudulently Billed

Federal prosecutors allege that from 2016 to 2017, Dr Nahas and his employee, Isabel Moreno Pruneda, billed Medicare and private insurers for millions of dollars in sham medical services. Patients were subjected to unnecessary diagnostic tests and treatments, while a significant portion of the proceeds was funnelled back to Pruneda and others as kickbacks.

The fraud encompassed a range of schemes, including billing for non-existent patient visits, inflating charges for services never provided, and falsifying diagnostic procedures. Investigators uncovered a systematic operation designed solely to exploit government and private insurance systems.

Uncovering the Scheme

The scheme prompted a joint investigation by the Department of Justice, the FBI, and the Department of Health and Human Services' Office of Inspector General. The authorities described the case as part of a broader crackdown on healthcare fraud, which has cost US taxpayers billions.

Court documents reveal how Nahas and Pruneda used detailed, falsified records to justify extensive billing. In one instance, supposedly routine consultations and tests were billed at thousands of dollars each. Patients often reported a lack of follow-up or confusion over procedures they never ordered.

Long Prison Term and Financial Penalties

Dr Osama Nahas, who was convicted in March 2024 of healthcare fraud and related charges, faces a potential sentence of up to 25 years in prison and substantial restitution. However, formal sentencing and the amount of any financial penalties have not yet been finalised.

Pruneda, described in court as Nahas's primary accomplice, received an additional two years to her initial sentence for identity fraud. Both are barred from practising medicine or handling medical billing in the future.

Impact on Patients and the Medical Community

Victims of the fraud included elderly and chronically ill patients, who not only suffered medically unnecessary interventions but also endured significant emotional distress. One victim described feeling violated after discovering they had been billed for invasive tests they never saw performed.

Medical professionals and public health advocates have responded by highlighting the wider threat posed by such schemes, warning that fraud undermines trust in the healthcare system and drives up insurance premiums and public healthcare costs.

Federal Crackdown Continues

This sentencing follows a wave of similar prosecutions: In May, Dr Jorge Zamora‑Quezada, a Texas rheumatologist, was given a 10‑year sentence for orchestrating a $118 million (approximately £86 million) fraud involving false diagnoses and unnecessary treatments.

Separately, in South Texas, a former pharmacist, John Ageudo Rodriguez, along with clinic doctors, pleaded guilty and were recently sentenced for participating in a $110 million (approximately £80 million) kickback scheme targeting Medicare and other federal programmes. Rodriguez received a five-year prison sentence, while his co-defendants received sentences ranging from 30 to 46 months.

Officials say this case highlights the importance of rigorous oversight, effective reporting mechanisms, and collaboration across law enforcement agencies in holding medical professionals accountable.

What This Means Going Forward

With patient trust and public funds at stake, authorities urge ongoing vigilance. Government bodies remind all medical providers to follow strict billing standards, maintain thorough patient documentation, and report any suspicious referral patterns or financial arrangements.

This case sends a clear message: medical fraud will be met with severe consequences, and the justice system is ready to act decisively to protect patients and taxpayers alike.