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Texas Department of Insurance
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December 6, 2021

TDI sergeant recognized for helping with $120 million health care fraud case

Gabriel Torres Sgt. Gabriel Torres of the Texas Department of Insurance (TDI) Fraud Unit won national recognition for helping investigate a North Texas nurse practitioner who filed millions of dollars of fake insurance claims for services he didn’t provide.

The National Health Care Anti-Fraud Association chose the case of United States vs. Trivikram Reddy for its Special Investigation Resource and Intelligence System Investigation of the Year Award. Torres was on the multi-agency team that investigated and prosecuted the case.

Reddy was a licensed nurse practitioner operating out of medical clinics he owned in Ellis County. He fraudulently billed more than $120 million in insurance and Medicare claims for services that patients didn’t receive and at higher rates than allowed.

“He also treated patients for weight loss services that weren’t covered by insurance. So, he would bill their insurance for other services they didn’t receive,” Torres said. “It was layers and layers of fraud.”

After catching wind of the investigation, Reddy wired more than $58 million to a bank account in India. He pleaded guilty to wire fraud in October 2020 after a nearly two-year investigation by the TDI Fraud Unit, FBI, the Texas Office of the Attorney General (OAG), and others.

Reddy was sentenced to 20 years in prison and ordered to pay more than $52 million in restitution. The FBI is trying to recover the money from Reddy’s frozen Indian bank accounts.

Torres was working on the case for the OAG before he joined the Fraud Unit’s Dallas field office. He helped with more than 30 witness and patient interviews, evidence seizures, and court proceedings.

Fraud Unit Chief Investigator Chris Davis said insurance fraud affects everyone, not just the victims of the scam.

“Insurance fraud affects everyone and contributes to the cost of insurance,” he said. “We take our role in finding and penalizing those who commit fraud very seriously.”

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Last updated: 12/6/2021