McALLEN, Texas – A McAllen area insurance agent has been indicted on multiple counts of mail fraud and aggravated identity theft arising from a scheme to defraud several private insurance companies offering Medicare Advantage plans and other insurance products, United States Attorney Kenneth Magidson announced today.

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San Juana Lopez, 59, of Edinburg, Texas, was charged with five counts of mail fraud and three counts of aggravated identity theft in a federal indictment, returned under seal Tuesday, Jan. 24, 2012. The indictment was unsealed this morning upon her arrest by federal agents at her residence and she is expected to make an initial appearance in federal court later this morning before U.S. Magistrate Judge Dorina Ramos.

According to the indictment, from 2007 through 2008, Lopez worked for a San Antonio, Texas, insurance agency, selling Medicare Advantage insurance plans. These plans provide Medicare beneficiaries with the option to receive their benefits through a wide variety of private managed care plans, rather than through the traditional Medicare program. The indictment alleges Lopez obtained identifiers of beneficiaries through a variety of illegal means and used the identifiers to enroll the beneficiaries in a Medicare Advantage plan offered by Care Improvement Plus – a Baltimore, Md., insurance company – without the authorization or knowledge of the beneficiaries. Lopez received thousands in commissions as a result of the false enrollments.

The indictment further alleges that only a few days after being suspended by Care Improvement Plus, Lopez entered into a sales agent agreement with United Funeral Directors Benefit Life Insurance Company (United), of Richardson, Texas, which offered pre-need funeral contracts allowing insured individuals to pre-plan and pre-fund funeral expenses. According to the indictment, soon after becoming an agent for United, Lopez began enrolling numerous individuals in United’s pre-need funeral insurance policy without their authorization or knowledge. The indictment alleges Lopez used bank account information belonging to unsuspecting United clients, whom she had previously enrolled, to make premium payments on the false policies. Lopez received thousands of dollars in commissions from United in connection with the alleged fraud.

Each count of mail fraud carries a sentence of up to 20 years in federal prison without parole and a $250,000 fine upon conviction. Lopez also faces a mandatory two-year prison term for each count of aggravated identity theft which must be served consecutive to any prison sentence imposed on the underlying charges.

The investigation leading to the charges was conducted by the U.S. Department of Health and Human Services–Office of Inspector General and the U.S. Secret Service. Assistant United States Attorney Greg Saikin is prosecuting the case.

An indictment is a formal accusation of criminal conduct, not evidence.
A defendant is presumed innocent unless convicted through due process of law.

In the State of the Union address, President Obama promised a fresh investigation into mortgage abuses that led to the financial meltdown. The goal, he said, is to “hold accountable those who broke the law, speed assistance to homeowners and help turn the page on an era of recklessness that hurt so many Americans.”

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Could this be it, finally? An investigation that results in clarity, big fines and maybe even jail time?

There is good reason to be skeptical. To date, federal civil suits over mortgage wrongdoing have been narrowly focused and, at best, ended with settlements and fines that are a fraction of the profits made during the bubble. There have been no criminal prosecutions against major players. Justice Department officials say that it reflects the difficulty of proving fraud — and not a lack of prosecutorial zeal. That is hard to swallow, given the scale of the crisis and the evidence of wrongdoing from private litigation, academic research and other sources.

This new investigation could be the real thing. Eric Schneiderman, the New York State attorney general, will be a co-chairman of the group, and he has refused to support a settlement being worked out between big banks most responsible for foreclosure abuses and federal agencies and some state attorneys general.

He rightly objected to the fact that in exchange for providing some $20 billion worth of mortgage relief — mainly by reducing the principal on homeowners’ loans — the banks wanted release from legal claims that have never been fully investigated, including those related to potential tax, trust and securities violations in mortgage loans.

In the past year, the Obama administration has pushed back against Mr. Schneiderman, even as other attorneys general also left the settlement talks. By choosing him now to help run the investigation, the president appears to be embracing the call for a much broader inquiry that, properly executed, could result in a far bigger settlement.

For now, the administration is saying that the new investigation and the settlement talks will both proceed. It would be better to settle with the banks only after officials have a full picture of any and all violations.

There are reasons to be wary. Some of the federal officials who will also be involved with the investigation — including Eric Holder Jr., the United States attorney general, and Lanny Breuer, the leader of the Justice Department’s criminal division, who will be a co-chairman — have not distinguished themselves in the pursuit of mortgage fraud.

To win and retain public trust, both the administration and all the group’s co-chairmen — there are also four other officials from the Justice Department, the Securities and Exchange Commission and the Internal Revenue Service — must agree on several steps immediately.

The administration must ensure that the group has ample resources. The co-chairmen must hire a tough-as-nails prosecutor with a successful track record in financial fraud to drive the investigation forward. And the group must move quickly and vigorously, issuing subpoenas and filing cases. It is not starting from scratch; various agencies have all had separate investigations under way.

President Obama’s credibility is on the line. To restore public faith in the financial system, nothing less than a full investigation and full accountability will do.