A San Diego mother and daughter are accused of turning Medicare into a personal revenue stream, with federal authorities alleging they conducted a billing scheme that sought nearly $9.5 million from the program. According to court documents, the daughter provided patient care while using her mother’s provider credentials, including during a period when the mother was in prison. Their arrests are part of a larger federal crackdown on health care fraud that includes many agencies and jurisdictions.
FBI San Diego agents arrested Blanca Cardenas and her daughter, Raquel Pasillas, earlier this month. According to court documents cited by the agency, Pasillas filed Medicare claims using Cardenas’ provider number while he was detained. The FBI stated that the collaborative investigation with the HHS Office of Inspector General falls under the Department of Justice’s 2026 National Health Care Fraud Takedown. According to HealthExec, this nationwide enforcement effort has accused hundreds of individuals and suspected fraud totaling more than $6.5 billion.
Public records connect the two ladies to local medical and business operations. Blanca E. Cardenas is listed as a federal provider with a National Provider Identifier and a San Diego practice address, according to the NPI register at NPIViewer. BizProfile reports that California business records show a Chula Vista limited liability company with both women as proprietors. According to San Diego Superior Court, county court dockets reveal the same identities in a 2024 civil fraud case, giving investigators an existing paper trail related to billing activity.
According to federal filings and investigator summaries, a billing system was used to route patient services and payment claims through the mother’s provider number, allowing Medicare to pay even when Cardenas was not providing care. Prosecutors allege that the arrangement allowed a single provider credential to represent two individuals. “Those who commit health care fraud cause real harm because they divert critical resources away from programs designed to help some of our most vulnerable community members,” FBI San Diego Special Agent in Charge Mark Remily stated in the agency’s post. The investigation is still ongoing, with agents and prosecutors scrutinizing comprehensive billing files and questioning witnesses to determine how much of the roughly $9.5 million in fraudulent Medicare claims were paid.
Federal health care fraud cases like these frequently result in a combination of potential criminal charges, such as conspiracy and health care fraud, as well as civil and administrative procedures like asset forfeiture and suspension of Medicare billing privileges. According to HealthExec, the Justice Department’s national takedown documents state that enforcement usually includes cash and luxury asset seizures, as well as administrative suspensions while criminal investigations are pending.
The Southern District of California’s prosecutors will decide whether to seek official grand jury indictments. If indictments are returned, the matter will proceed to federal court for arraignment and pretrial scheduling, during which Cardenas’s and Pasillas’s attorneys will have their first formal opportunity to reply to the claims.
The case comes in the midst of an intense federal campaign targeting Medicare and durable medical device billing in the San Diego area. Recent FBI San Diego and HHS-OIG investigations resulted in multiple multimillion-dollar charges. One San Diego-area case this spring resulted in a guilty plea for roughly $51 million in fake Medicare claims, demonstrating how substantial the alleged rewards may be when fraudulent billing goes undetected.
Local suppliers say the recent arrests reflect an increasingly sophisticated use of data analytics and cross-agency collaboration to identify billing trends that deviate from the norm. Federal officials will release further information as the Cardenas and Pasillas case progresses through the legal system. For now, the arrests and subsequent court papers provide insight into how investigators are combining local records with national claims data to pursue alleged Medicare fraud in Southern California.
Leave a Reply