The Texas Department of Insurance’s Fraud Unit contributed to investigations landing nearly $58 million in court-ordered restitution last year.

According to TDI, more than 20 TDI investigators stationed around the state looked into over 350 insurance fraud allegations with a goal of focusing on cases with the biggest possible impact.

“If we recoup restitution for insurance companies and consumers, hopefully that causes less of an increase in premiums,” said Kyson Johnson, a TDI lawyer, in a statement. “Those companies and consumers are no longer exposed to the fraud.”

One investigation helped stop Dallas doctors Desi and Deno Barroga, TDI said. Barroga, 51, and Barroga, 51, were indicted in November 2023 and pleaded guilty in May 2024 to one count each of conspiracy to commit healthcare fraud. The two had been overprescribing opioids and falsely billing health plans by millions of dollars.

“These doctors exploited drug users’ vulnerabilities, requiring them to submit to monthly visits in exchange for controlled substance prescriptions, then billing their insurance providers for services the patients did not need nor receive,” said U.S. Attorney Leigha Simonton in September 2024. “In a bizarre attempt to cover up their crimes, the defendants feigned giving injections without actually piercing the patients’ skin.”

Information collected by a TDI investigator helped the FBI and other agencies build a criminal case, the TDI noted. The doctors pleaded guilty and were sentenced to prison. A U.S. district judge ordered them to pay $9 million in restitution. Both men also were required to give up their medical licenses

The TDI advises consumers to report fraud at: https://www.tdi.texas.gov/fraud.

Source: Texas Department of Insurance.

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