Former Owner of Los Angeles Medical Clinic Management Company Mikran “Mike” Meguerian Indicted by a Federal Grand Jury Alleging a $13 Million Medicare Fraud Scheme

October 1, 2013

The Federal Bureau of Investigation on September 30, 2013 released the following:

“WASHINGTON—The former owner of a Los Angeles medical clinic management company has been indicted for his role in a $13 million scheme to defraud Medicare.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney André Birotte, Jr. of the Central District of California, and Assistant Director in Charge Bill L. Lewis of the FBI’s Los Angeles Field Office made the announcement.

Mikran “Mike” Meguerian, 36, of Glendale, California, was indicted in the Central District of California on one count of conspiracy to commit health care fraud and five counts of health care fraud, each of which carries a maximum penalty of 10 years in prison upon conviction. Meguerian was arrested on September 26, 2013, and the indictment was unsealed following his initial appearance in federal court on September 27, 2013.

According to court documents, Meguerian owned Med Serve Management, a medical clinic management company located in Van Nuys, California. From approximately 2006 through February 2009, he allegedly engaged in a conspiracy to commit health care fraud, in part through the operation of Med Serve. According to court documents, Meguerian oversaw several medical clinics that generated prescriptions and other medical documents for medically unnecessary power wheelchairs and other durable medical equipment (DME). Meguerian and his co-conspirators then sold the prescriptions to DME supply companies, knowing that the prescriptions were fraudulent. Court documents allege that, based on these fraudulent prescriptions, the DME supply companies then submitted false and fraudulent claims to Medicare.

Court documents allege that fraudulent prescriptions from Meguerian’s clinics were instrumental in generating approximately $13.6 million in fraudulent claims to Medicare, and Medicare paid approximately $7.6 on those claims.

The charges and allegations contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

The case was investigated by the FBI and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. This case is being prosecuted by Trial Attorneys Fred Medick and Blanca Quintero of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

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To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Former Owner of Los Angeles Equipment Supply Company Valery Bogomolny Indicted by a Federal Grand Jury Alleging a $4 Million Medicare Fraud Scheme

October 1, 2013

The Federal Bureau of Investigation on September 30, 2013 released the following:

“WASHINGTON—A former owner of a Los Angeles medical equipment supply company has been indicted for allegedly engaging in a $4 million Medicare fraud scheme.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney André Birotte, Jr. of the Central District of California, Special Agent in Charge Glenn R. Ferry of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), and Assistant Director in Charge Bill L. Lewis of the FBI’s Los Angeles Field Office made the announcement.

Valery Bogomolny, 41, of Los Angeles, California, was indicted in the Central District of California on six counts of health care fraud, each of which carries a maximum penalty of 10 years in prison upon conviction. Bogomolny was taken into custody on September 27, 2013, and the indictment was unsealed following his initial appearance in federal court that afternoon.

According to court documents, Bogomolny was the owner and president of Royal Medical Supply, a durable medical equipment (DME) supply company located in Los Angeles. From approximately January 2006 through October 2009, he allegedly engaged in a scheme to commit health care fraud through the operation of Royal by providing medically unnecessary power wheelchairs and other DME to Medicare beneficiaries and submitting false and fraudulent claims to Medicare. Court documents allege that Bogomolny knew the prescriptions and medical documents were fraudulent and that some of the beneficiaries did not receive the DME, yet he certified to Medicare with the submission of each claim that the DME was received and was medically necessary.

Bogomolny, through Royal, allegedly submitted approximately $4 million in fraudulent claims to Medicare for power wheelchairs and related services, and Medicare paid Royal approximately $2.7 million on those claims.

The charges and allegations contained in the indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty.

The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. This case is being prosecuted by Trial Attorney Fred Medick of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

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To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


“Walmart Pleads Guilty to Federal Environmental Crimes, Admits Civil Violations, and Will Pay More Than $81 Million”

May 29, 2013

The Federal Bureau of Investigation (FBI) on May 28, 2013 released the following press release:

“Retailer Admits Violating Criminal and Civil Laws Designed to Protect Water Quality and to Ensure Proper Handling of Hazardous Wastes and Pesticides

WASHINGTON—Walmart Stores Inc. pleaded guilty today in cases filed by federal prosecutors in Los Angeles and San Francisco to six counts of violating the Clean Water Act by illegally handling and disposing of hazardous materials at its retail stores across the United States. The Bentonville, Arkansas-based company also pleaded guilty today in Kansas City, Missouri, to violating the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) by failing to properly handle pesticides that had been returned by customers at its stores across the country.

As a result of the three criminal cases brought by the Justice Department, as well as a related civil case filed by the U.S. Environmental Protection Agency (EPA), Walmart will pay approximately $81.6 million for its unlawful conduct. Coupled with previous actions brought by the states of California and Missouri for the same conduct, Walmart will pay a combined total of more than $110 million to resolve cases alleging violations of federal and state environmental laws.

According to documents filed in U.S. District Court in San Francisco, from a date unknown until January 2006, Walmart did not have a program in place and failed to train its employees on proper hazardous waste management and disposal practices at the store level. As a result, hazardous wastes were either discarded improperly at the store level—including being put into municipal trash bins or, if a liquid, poured into the local sewer system—or they were improperly transported without proper safety documentation to one of six product return centers located throughout the United States.

“By improperly handling hazardous waste, pesticides, and other materials in violation of federal laws, Walmart put the public and the environment at risk and gained an unfair economic advantage over other companies,” said Ignacia S. Moreno, Assistant Attorney General for the Justice Department’s Environment and Natural Resources Division. “Today, Walmart acknowledged responsibility for violations of federal laws and will pay significant fines and penalties, which will, in part, fund important environmental projects in the communities impacted by the violations and help prevent future harm to the environment.”

“Federal laws that address the proper handling, storage, and disposal of hazardous wastes exist to safeguard our environment and protect the public from harm,” said André Birotte, Jr., the U.S. Attorney for the Central District of California. “Retailers like Walmart that generate hazardous waste have a duty to legally and safely dispose of that hazardous waste, and dumping it down the sink was neither legal nor safe. The case against Walmart is designed to ensure compliance with our nation’s environmental laws now and in the future.”

“As one of the largest retailers in the United States, Walmart is responsible not only for the stock on its shelves but also for the significant amount of hazardous materials that result from damaged products returned by customers,” said Melinda Haag, U.S. Attorney for the Northern District of California. “The crimes in these cases stem from Walmart’s failure to comply with the regulations designed to ensure the proper handling, storage, and disposal of those hazardous materials and waste. With its guilty plea today, Walmart is in a position to be an industry leader by ensuring that not only Walmart but all retail stores properly handle their waste.”

“This tough financial penalty holds Walmart accountable for its reckless and illegal business practices that threatened both the public and the environment,” said Tammy Dickinson, U.S. Attorney for the Western District of Missouri. “Truckloads of hazardous products, including more than two million pounds of pesticides, were improperly handled under Walmart’s contract. Today’s criminal fine should send a message to companies of all sizes that they will be held accountable to follow federal environmental laws. Additionally, Walmart’s community service payment will fund important environmental projects in Missouri to help prevent such abuses in the future.”

“The FBI holds all companies, regardless of size, to the same standards,” said FBI Special Agent in Charge David J. Johnson of the San Francisco Field Office. “We will continue to work closely with our law enforcement partners to ensure there is a level playing field for all businesses and that everyone follows the rules.”

“Today, Walmart is taking responsibility for violating laws that protect people from hazardous wastes and chemicals,” said Cynthia Giles, assistant administrator for EPA’s Office of Enforcement and Compliance Assurance. “Walmart is committing to safe handling of hazardous wastes at all of its facilities nationwide, an action that will benefit communities across the country.”

Walmart owns more than 4,000 stores nationwide that sell thousands of products which are flammable, corrosive, reactive, toxic, or otherwise hazardous under federal law. The products that contain hazardous materials include pesticides, solvents, detergents, paints, aerosols, and cleaners. Once discarded, these products are considered hazardous waste under federal law.

Walmart pleaded guilty this morning in San Francisco to six misdemeanor counts of negligently violating the Clean Water Act. The six criminal charges were filed by the U.S. Attorney’s Office in Los Angeles and San Francisco (each office filed three charges), and the two cases were consolidated in the Northern District of California, where the guilty pleas were formally entered before U.S. Magistrate Judge Joseph C. Spero. As part of a plea agreement filed in California, Walmart was sentenced to pay a $40 million criminal fine and an additional $20 million that will fund various community service projects, including opening a $6 million Retail Compliance Assistance Center that will help retail stores across the nation learn how to properly handle hazardous waste.

In the third criminal case resolved today, Walmart pleaded guilty in the Western District of Missouri to violating FIFRA. According to a plea agreement filed in Kansas City, beginning in 2006, Walmart began sending certain damaged household products, including regulated solid and liquid pesticides, from its six return centers to Greenleaf LLC, a recycling facility located in Neosho, Missouri, where the products were processed for reuse and resale. Because Walmart employees failed to provide adequate oversight of the pesticides sent to Greenleaf, regulated pesticides were mixed together and offered for sale to customers without the required registration, ingredients, or use information, which constitutes a violation of FIFRA. Between July 2006 and February 2008, Walmart trucked more than two million pounds of regulated pesticides and additional household products from its various return centers to Greenleaf. In November 2008, Greenleaf was also convicted of a FIFRA violation and paid a criminal penalty of $200,000 in 2009.

Pursuant to the plea agreement filed in Missouri and accepted today by U.S. District Judge John T. Maughmer, Walmart agreed to pay a criminal fine of $11 million and to pay another $3 million to the Missouri Department of Natural Resources, which will go to that agency’s Hazardous Waste Program and will be used to fund further inspections and education on pesticide regulations for regulators, the regulated community, and the public. In addition, Walmart has already spent more than $3.4 million to properly remove and dispose of all hazardous material from Greenleaf’s facility.

In conjunction with today’s guilty pleas in the three criminal cases, Walmart has agreed to pay a $7.628 million civil penalty that will resolve civil violations of FIFRA and Resource Conservation and Recovery Act (RCRA). In addition to the civil penalties, Walmart is required to implement a comprehensive, nationwide environmental compliance agreement to manage hazardous waste generated at its stores. The agreement includes requirements to ensure adequate environmental personnel and training at all levels of the company, proper identification and management of hazardous wastes, and the development and implementation of Environmental Management Systems at its stores and return centers. Compliance with this agreement is a condition of probation imposed in the criminal cases.

The criminal cases announced today are a result of investigations conducted by the FBI and the EPA, which received substantial assistance from the California Department of Substance and Toxics Control, and the Missouri Department of Natural Resources.

In Missouri, the case was prosecuted by Deputy U.S. Attorney Gene Porter and ENRD Senior Trial Attorney Jennifer Whitfield of the Environmental Crimes Section of the Environment and Natural Resources Division. In California, the cases were prosecuted in Los Angeles by Assistant U.S. Attorney Joseph O. Johns and in San Francisco by Assistant U.S. Attorney Stacey Geis.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

————————————————————–

To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Three Coachella Valley Residents Arrested for Alleged Detroit-Area Ponzi Scheme After Successful Joint Operations with Cathedral City and Palm Springs Police

September 15, 2012

The Federal Bureau of Investigation (FBI) on September 14, 2012 released the following:

“Three individuals wanted on federal fraud charges alleging they victimized hundreds while operating an alleged $25 million investment scheme were arrested in the Coachella Valley, announced Timothy Delaney, Special Agent in Charge of the FBI’s Los Angeles Field Office.

Mr. Delaney made the announcement on behalf of the FBI’s Detroit Field Office, the Cathedral City Police Department, and the Palms Springs Police Department.

An indictment filed in March 2012 in the Eastern District of Michigan charged five defendants with conspiracy to commit wire fraud for their alleged roles in an investment scheme where hundreds of victims were allegedly defrauded of millions of dollars. Three of the defendants are Coachella Valley residents. Agents with the FBI’s Palm Springs Resident Agency, part of the FBI’s Los Angeles Division, assisted the FBI’s Detroit Field Office in locating the three Coachella Valley-based defendants following the indictment. Agents in Palm Springs requested assistance from the Cathedral City (California) and Palm Springs (California) Police Departments in locating and apprehending the fugitives.

Ronald Lee Brito, 61, and Bonnie Brito, 66, both of Rancho Mirage, California, were taken into custody on August 10, 2010, by officers with the Cathedral City Police Department after a safely executed vehicle-stop in Cathedral City.

Thomas Winston Moore, 68, of Palm Springs, California, was arrested at his residence on September 8 by officers with the Palm Springs Police Department.

The 64-count indictment alleges defendants participated in the Ponzi scheme between 2005 and 2012 and outlines an investment scheme where victims were promised lucrative returns on their investments in, among other things, valuable minerals extracted from a gold mine in Arizona. The indictment alleges the defendants used various corporate names, including Infinity Trading, LLC; GetMoni.com; and PJM

Kingman Mine to lure approximately 500 investors. The government has stated that the scheme brought in investments totaling more than $25 million.

Ronald and Bonnie Brito had an initial appearance in California and in the Eastern District of Michigan once they were returned to Detroit. Ronald Brito was remanded to federal custody and Bonnie Brito was released on bond.

Thomas Moore had an initial appearance in U.S. District Court in Riverside on Monday, September 10, and was remanded to federal custody pending removal to Detroit.

This investigation is being conducted by the FBI’s Detroit Field Office and will be prosecuted by the United States Attorney’s Office in the Eastern District of Michigan.

The fugitive investigation involving defendants Ronald Brito, Bonnie Brito, and Thomas Winston Moore was conducted by officers with the Cathedral City Police Department; Palm Springs Police Department; and agents with the FBI in Palm Springs and Detroit. The United States Attorney’s Office in Los Angeles (Central District of California) provided considerable assistance during the California portion of this investigation.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

Federal Mail Fraud Crimes

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To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Feds attack California’s medical marijuana trade-again

June 7, 2012

Chicago Tribune on June 6, 2012 released the following:

“LOS ANGELES (Reuters) – Federal authorities opened the latest front in their war on California’s massive medical marijuana industry this week, filing property forfeiture lawsuits in a bid to shut down three dispensaries and sending warning letters to 34 people.

The moves by the U.S. Attorney’s Office in Los Angeles are the latest in an ongoing crackdown on what federal prosecutors say is a flourishing network of illegal cannabis suppliers operating across California under the cover of the state’s medical marijuana law.

Authorities have now targeted more than 220 dispensaries — deemed “marijuana stores” by prosecutors — or indoor cultivation houses in the seven-county Central District of California alone, U.S. Attorney’s spokesman Thom Mrozek said.

Most have been closed or are facing eviction or have been the subject to additional federal law enforcement actions, he said. The Central District of California represents the largest federal law enforcement jurisdiction in the country.

“Because there are so many in our district we could not go after all of them at once, so we’ve developed a strategy based on geographical areas,” Mrozek said. “We’re methodically going through our district.”

The forfeiture lawsuits were filed on Monday in U.S. District Court in Los Angeles against a pair of buildings in the Los Angeles suburb of Santa Fe Springs, one of which houses two dispensaries.

Letters were also sent to 34 other property owners or store operators in the Los Angeles area giving them 14 days to come into compliance with federal law or face civil or criminal actions.

The drive by federal prosecutors to shut down dispensaries has caused friction between the U.S. government and California, which in 1996 became the first state to decriminalize medical marijuana. Sixteen states and the District of Columbia have followed suit.

The possession or sale of marijuana is illegal under federal law, which does not have an exemption for medical purposes.

California Attorney General Kamala Harris, in a November interview with the New York Times, said the federal campaign had “only increased uncertainty about how Californians can legitimately comply with state law.”

Harris also said federal authorities were “ill equipped to be the decision makers as to which providers are violating the law.”

But Mrozek said federal prosecutors believed that the dispensaries were operating outside of California law, which he said permits only primary caregivers to dispense marijuana and bars sale of the drug for profit.

“Our position is that they are in violation of federal law, but also in violation of state law because they are operating as for-profit enterprises and they are not functioning as a primary caregiver,” he said.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

————————————————————–

To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Twenty-Two Detroit-Area Residents Charged in Nationwide Medicare Fraud Strike Force Takedown

May 3, 2012

The Federal Bureau of Investigation (FBI) on May 2, 2012 released the following:

Total of 107 Defendants Charged in Seven Cities for Approximately $452 Million in False Billing

DETROIT—Twenty-two Detroit-area residents were charged today for their roles in psychotherapy, home health care, and infusion therapy schemes to submit more than $58 million in false billing to Medicare, announced the Departments of Justice and Health and Human Services. Including these charges, Medicare Fraud Strike Force operations in Detroit have charged a total of 164 individuals in cases involving approximately $244 million in fraudulent billings to Medicare.

The charges in Detroit are part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that led to charges against 107 individuals for their alleged participation in schemes to collectively submit more than $452 million in fraudulent claims to Medicare. This takedown involved the highest amount of false Medicare billing in a single takedown in strike force history.

“The results we are announcing today are at the heart of an administration-wide commitment to protecting American taxpayers from health care fraud, which can drive up costs and threaten the strength and integrity of our health care system,” said Attorney General Eric Holder. “We are determined to bring to justice those who violate our laws and defraud the Medicare program for personal gain. As today’s takedown reflects, our ongoing fight against health care fraud has never been more coordinated and effective.”

United States Attorney for the Eastern District of Michigan Barbara L. McQuade stated, “A disturbing new trend we are seeing is the exploitation of adults in foster care. Providers bill Medicare for home health and psychotherapy services for disabled adults that are unnecessary or not provided.”

“Those who seek to steal from Medicare and exploit the system will be vigorously pursued and brought to justice,” stated Special Agent in Charge of the FBI’s Detroit Division Andrew G. Arena. “These arrests are the result of a tremendous amount of hard work by FBI and HHS-OIG agents.”

“Today’s indictments and arrests in the areas of home health care, psychotherapy, or infusion therapy fraud demonstrate that HHS-OIG agents will untangle even the most complex fraud schemes and hold those responsible accountable for their criminal actions,” said Lamont Pugh III, Special Agent in Charge of the Department of Health & Human Services Office of Inspector General for the Chicago Region, which includes Detroit. “Through collaboration with our law enforcement partners, HHS-OIG will bring to justice those who waste Medicare’s limited resources and prevent the most vulnerable members of our society from receiving vital health care services.”

Court documents unsealed today in the Eastern District of Michigan charge defendants including owners and operators of companies, social workers, office employees, and patient recruiters with submitting fraudulent claims for services that were never rendered. Eighteen of the defendants were either arrested this morning or will be self surrendering this week and four defendants remain at large. In addition, law enforcement agents today executed search warrants at nine locations and seizure warrants of 14 bank accounts related to the alleged fraud schemes. The following charges were unsealed:

United States v. Rahman, et al.

Five individuals were charged in a superseding indictment with conspiracy to commit health care fraud for their roles in a $13.8 million scheme to defraud Medicare by submitting fraudulent claims for home health care services. One of the defendants was also charged with conspiracy to pay or receive kickbacks to refer Medicare beneficiaries for the fraudulent services. The indictment alleges that the fraudulent claims were submitted by four home health agencies operating in Livonia, Michigan: Physicians Choice Home Health Care, LLC; First Care Home Health Care, LLC; Quantum Home Care, Inc.; and Moonlite Home Care, Inc.

The defendants charged in the superseding indictment are: Bilal Akbar, 49, formerly of Canton, Michigan; Joann Terrell, 49, of Detroit; Madhur Thawani, 27, of Auburn Hills, Michigan; Shahzad Mirza, 41, of Canton, Michigan; and Ankit Patel, 27, of Plymouth, Michigan.

United States v. Mehmood, et al.

Two individuals were charged in a superseding indictment with conspiracy to commit health care fraud for their roles in a $33 million scheme to defraud Medicare by submitting fraudulent claims for home health care services, as well as conspiracy to pay or receive illegal kickbacks. The indictment alleges that the fraudulent claims were submitted by four home health agencies operating in Ypsilanti, Michigan and Detroit, Michigan: Access Care Home Care, Inc.; Patient Care Home Care, Inc.; Hands On Healing Home Care, Inc.; All State Home Care, Inc.

The defendants charged in the superseding indictment are: Badar Ahmadani, 45, of Ypsilanti Michigan and Falusic Ashford, 47 of Detroit, Michigan.

United States v. Sharma, et al.

Four individuals were charged in an indictment with conspiracy to commit health care fraud for their roles in a $23 million scheme to defraud Medicare by submitting fraudulent claims for home health care services and psychotherapy services. Three of the individuals were also charged with conspiring to pay or receive illegal kickbacks. The indictment alleges that the fraudulent claims were submitted by three home health agencies and an adult day care center. The home health agencies operating in Madison Heights, Michigan and Sterling Heights, Michigan are: Reliance Home Care, LLC; First Choice Home Health Care Services, Inc.; and Associates in Home Care, Inc. The adult day care center operating in Detroit Michigan is Haven Adult Day Care Center, LLC.

The defendants charged in the indictment are: Sachin Sharma, 36, of Shelby Township, Michigan; Dana Sharma, 29, of Shelby Township, Michigan; Abdul Malik Al- Jumail, aka “Tony,” 52, of Brownstown, Michigan; and Felicar Williams, 49, of Dearborn, Michigan.

United States v. English, et al.

Six individuals were charged in an indictment with conspiracy to commit health care fraud for their roles in a $2.8 million scheme to defraud Medicare by submitting fraudulent claims for psychotherapy services. Two of the defendants are also charged with additional health care fraud counts. The indictment alleges that the fraudulent claims were submitted by an adult day care center operating in Flint, Michigan: New Century Adult Day Program Services, LLC.

The defendants charged in the indictment are: Glenn English, 52, of Detroit, Michigan; Gregory Lawrence, 54, of Detroit, Michigan; Richard Hogan, 65, of Flint, Michigan; Donald Berry, 65, of Detroit, Michigan; Felicia Marsh, 44, of Detroit, Michigan; and Jamie Moreau, 34, of Davison, Michigan.

United States v. Thompson, et al.

Two individuals were charged in an indictment with conspiracy to commit health care fraud and additional counts of health care fraud for their roles in a $20 million scheme to defraud Medicare by submitting fraudulent claims for psychotherapy services. The indictment alleges that the fraudulent claims were submitted by two psychotherapy clinics and an adult day care center operating in Detroit, Michigan: TGW Medical, Inc.; Caldwell Thompson Manor, Inc. And P&C Adult Day Care Center, LLC.

The defendants charged in the indictment are: Louisa Thompson, 62, of Detroit, Michigan and Checarol Robinson, 41, of New Baltimore, Michigan.

United States v. Edwards, et al.

Two individuals were charged in an indictment with conspiracy to commit health care fraud and additional counts of health care fraud for their roles in a $3 million scheme to defraud Medicare by submitting fraudulent claims for psychotherapy services. The indictment alleges that the fraudulent claims were submitted by a psychotherapy clinic operating in Southfield, Michigan and Detroit, Michigan: Funderburg Clinical and Community Services, Inc.

The defendants charged in the indictment are: Sanyani Edwards, 32, of Taylor, Michigan and Angel Williams, 27, of Southfield, Michigan.

United States v. Raymond Arias

Raymond Arias, 40, of Troy, Michigan was charged in an indictment with six counts of health care fraud for his leading role in a $12.5 million scheme to defraud Medicare by submitting fraudulent claims for infusion therapy treatments. The fraudulent claims were submitted by Arias’s clinic Elite Wellness, LLC, operating in Westland, Michigan.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The cases announced today are being prosecuted and investigated by Medicare Fraud Strike Force teams comprised of attorneys from the Fraud Section of the Justice Department’s Criminal Division and from the U.S. Attorney’s Offices for the Southern District of Florida, the Eastern District of Michigan, the Southern District of Texas, the Central District of California, the Middle District of Louisiana; the Northern District of Illinois, and the Middle District of Florida; and agents from the FBI, HHS-OIG, and state Medicaid Fraud Control Units.

The cases in the Eastern District of Michigan are being prosecuted by Assistant Chief Gejaa T. Gobena and Trial Attorneys Catherine K. Dick and William G. Kanellis of the Criminal Division’s Fraud Section, and Assistant United States Attorney Philip Ross of the U.S. Attorney’s Office for the Eastern District of Michigan.

An indictment is merely a charge and defendants are presumed innocent until proven guilty.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

Federal Mail Fraud Crimes

————————————————————–

To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Fifty-Nine South Florida Residents Charged as Part of Nationwide Coordinated Takedown by Medicare Fraud Strike Force Operations

May 3, 2012

The Federal Bureau of Investigation (FBI) on May 2, 2012 released the following:

107 Individuals Charged Nationally for Submitting Approximately $452 Million in Fraudulent Billing; South Florida Responsible for more than $137 Million in False Billings

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); and Henry Gutierrez, Postal Inspector in Charge, U.S. Postal Inspection Service, Miami Division, announced that 59 South Florida residents were charged for their alleged participation in various schemes to defraud Medicare out of more than $137 million. The charges in South Florida are part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that resulted in charges against 107 individuals, including doctors, nurses and other licensed professionals, for their alleged participation in Medicare fraud schemes involving approximately $452 million in false billing. This coordinated takedown involved the highest amount of false Medicare billings in a single takedown in strike force history.

The joint Department of Justice and HHS Medicare Fraud Strike Force is a multi-agency team of federal, state, and local investigators designed to combat Medicare fraud. Approximately 400 law enforcement agents from the FBI, HHS-OIG, multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in the national takedown.

U.S. Attorney Wifredo A. Ferrer stated, “The Medicare program is a valuable and limited trust fund to provide much needed services for the poor, the elderly and the sick. Among the dozens of fraudsters charged in South Florida in this operation are clinic owners, nurses, therapists, patient recruiters, pharmacy owners, accountants, former social workers, and even beneficiaries, all of whom stole precious health care dollars through a variety of schemes. These get rich quick schemes at the expense of the most vulnerable in our society are unacceptable. We will continue to fight health care fraud on all fronts: we will prosecute each link in the fraud chain and each evolving fraud scheme.”

“The results we are announcing today are at the heart of an administration-wide commitment to protecting American taxpayers from health care fraud, which can drive up costs and threaten the strength and integrity of our health care system,” said Attorney General Eric Holder. “We are determined to bring to justice those who violate our laws and defraud the Medicare program for personal gain. As today’s takedown reflects, our ongoing fight against health care fraud has never been more coordinated and effective.”

“More than half of those charged in a record setting health care fraud takedown today were from the Miami area. The local fraud totaled more than $137 million. Sadly, in Miami, multi-million-dollar health care fraud cases are no longer shocking in their magnitude or frequency,” said John V. Gillies, Special Agent in Charge of the FBI’s Miami Office. “Here’s my message clear and simple: you can run, but as evidenced by today’s nationwide takedown, you can’t hide.”

“Medicare fraud diverts precious resources from those who are eligible and need it most,” said Christopher B. Dennis, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General’s region covering Florida. “Today’s action should send a strong message that we will continue to track the evidence to ensure that those involved are held accountable.”

U.S. Postal Inspector in Charge Henry Gutierrez stated, “Medicare fraud is an assault on resources for our most needy and vulnerable citizens. This joint effort by the South Florida law enforcement community demonstrates that those who engage in these illegal schemes will be prosecuted to the full extent of the law.”

The South Florida defendants are accused of various health care fraud-related crimes, including conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home health care, mental health services, and physical and occupational therapy. According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes never provided. In many cases, court documents allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare for services that were medically unnecessary or never provided.

Specifically, the South Florida cases announced as part of the nationwide Medicare Fraud Strike Force takedown include:

U.S. v. Odalys Fernandez, Kelvin Soto, Yumidia Naranjo, Jose Guerra, Yanuris Lima, and Servando Raya, Case No. 12-20230-CR-Ungaro

In this six-defendant case, two registered nurses employed by Ideal Home Health (Odalys Fernandez and Kelvin Soto) are charged with conspiracy to commit health care fraud for purportedly providing services, such as skilled nursing and physical therapy, to homebound beneficiaries. In fact, however, the services were either medically unnecessary or were never provided. As part of the scheme, the defendants falsified medical paperwork to make it appear as if they had provided the services. Four other defendants (Yumidia Naranjo, Jose Guerra, Yanuris Lima, and Servando Raya) are alleged to be patient recruiters who paid Medicare beneficiaries so they would serve as patients at Ideal Home Health. Ideal, in turn, submitted more than $40 million in false billings to Medicare. This case is being prosecuted by Assistant U.S. Attorney Daniel Bernstein.

U.S. v. Eulises Escalona, Case No. 12-20293-CR-Lenard

This indictment charges Eulises Escalona with one count of conspiracy to commit health care fraud, one count of conspiracy to defraud the United States and to receive and pay health care kickbacks, and five counts of payment of health care kickbacks stemming from a $42 million home health care fraud scheme. According to the indictment, Escalona owned and operated Willsand Home Health, Inc. (Willsand), a home health agency that purportedly provided home health and physical therapy services to eligible Medicare beneficiaries. In fact, however, from January 2006 through November 2009, Escalona and others paid kickbacks to Medicare beneficiaries to induce them to become patients at Willsand regardless of medical need and to falsely attest that they had received the purported services. In addition, Escalona and others paid kickbacks to patient recruiters and to doctors who signed fraudulent prescriptions and plans of care (POCs) for unnecessary home health services for patients at Willsand. To execute the scheme, Escalona and others falsified patient files and POCs to make it appear as if the patients had qualified for and actually received home health services. In this way, Willsand allegedly submitted approximately $42 million in false claims to Medicare for services it claimed to have provided to approximately 622 beneficiaries. This case is being prosecuted by Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section.

U.S. v. Rodolfo Nieto, Jr., Case No. 12-20290-CR-Altonaga

This indictment charges Rodolfo Nieto, Jr., owner and operator of Ronat Home Health Care, Inc. (Ronat), with one count of conspiracy to defraud the United States and to receive and pay health care kickbacks and three counts of receipt of kickbacks for his participation in a $60 million home health care fraud scheme. According to the indictment, from January 2006 through November 2009, Nieto accepted kickbacks in return for recruiting Medicare beneficiaries for placement at Nany Home Health, Inc. (Nany). Nieto allegedly caused Nany to submit claims to Medicare for home health services, including insulin injections and physical therapy, purportedly provided through Ronat. According to the indictment, Nany submitted approximately $60 million in false claims to the Medicare program for services that it purportedly provided to approximately 1474 beneficiaries. This case is being prosecuted by Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section.

U.S. v. Maggie Leon, Yuderkis Pena Garcia and Eduardo Vilau, Case No. 12-20274-CR-Seitz

In this case, defendants Maggie Leon, Yuderkis Pena Garcia, and Eduardo Vilau, owners of Leon Medical and Leah Medical, were charged with conspiracy to commit health care fraud and health care fraud for submitting false claims to private insurance companies that were Medicare Advantage contractors under Part C of the Medicare program. As alleged in the indictment, the defendants submitted approximately $1,826,000 in false claims for expensive cancer and HIV injections that were not medically necessary and were not actually provided to the Medicare beneficiaries. In addition, the indictment alleges that the defendants conspired to pay kickbacks to Medicare beneficiaries so that they would serve as patients at Leah and Leon. This case is being prosecuted by Assistant U.S. Attorney Christopher J. Clark.

U.S. v. Ricardo Martinez, Case No. 12-20316-CR-Martinez

This indictment charges defendant Ricardo Martinez with health care fraud and paying kickbacks to patients. The indictment alleges that the defendant paid kickbacks and bribes to beneficiaries so that they would serve as patients at Rima Medical. The indictment further alleges that Martinez, through Rima Medical, submitted approximately $1,706,701 in false claims for expensive cancer and HIV injections to private insurance companies that were Medicare Advantage contractors under Part C of the Medicare program. This case is being prosecuted by Assistant U.S. Attorney Christopher J. Clark.

U.S. v. Yaquelin Colls, Pedro Colls, and Jesus Fernandez, Case No. 12-20315-CR-Seitz

This indictment charges defendants Yaquelin Colls, Pedro Colls, and Jesus Fernandez with conspiracy to commit health care fraud, substantive health care fraud, conspiracy to pay health care kickbacks, and substantive charges of paying kickbacks. More specifically, the indictment alleges that the defendants owned and operated Ma Medical and Therapy Services, Inc. (Ma Medical), and caused the submission of $972,068 in false medical claims for expensive cancer and HIV injections to a private insurance company that was a Medicare Advantage provider under Part C of the Medicare program. In a similar scheme, the defendants submitted $55,642 in false claims to another private insurance company under Part C of the Medicare program through a second clinic, Healthy Touch Rehab Center Inc. (Healthy Touch), which they also owned and operated at the same address as Ma Medical. The indictment further alleges that the defendants conspired to pay kickbacks and bribes to beneficiaries so that they would serve as patients at Ma Medical and Healthy Touch. This case is being prosecuted by Assistant U.S. Attorney Christopher J. Clark.

U.S. v. Roberto L. Valdes Gonzalez, Francisca Gema Valdez, Gilberto Faure, and Alberto Sotolongo, Case No. 12-20275-CR-Moore

In this case, defendants Jose L. Valdes Gonzalez, a/k/a “Roberto Gonzalez,” Alberto Sotolongo, a/k/a “Ruben,” Gilberto Faure, and Francisca Gema Valdes were charged with conspiracy to commit health care fraud and substantive counts of health care fraud in connection with the operation of Ilva Pharmacy, Inc. More specifically, the indictment alleges that between 2009 and 2011, the defendants caused Ilva Pharmacy to submit approximately $1.3 million in false claims for prescription drugs that were not provided to Medicare and private insurance companies that were Medicare Advantage contractors under Part D of the Medicare program. The indictment additionally charges Gonzalez and Sotolongo with offering and paying kickbacks to Medicare beneficiaries to induce them to serve as patients at Ilva Pharmacy. This case is being prosecuted by Assistant U.S. Attorney John Couriel.

U.S. v. Alina De Armas, Case No. 12-20282-CR-Zloch

In this case, defendant Alina De Armas is charged with health care fraud and with paying kickbacks to patients. The information alleges that De Armas offered and paid kickbacks to Medicare beneficiaries to induce them to serve as patients at Ultratech Medical Supplies, Inc., d/b/a Guines Pharmacy. In this way, from 2007 through 2011, De Armas caused the submission through Guines Pharmacy of approximately $3.6 million in false claims for prescription drugs to Medicare and private insurance companies that were Medicare Advantage contractors under Part D of the Medicare program. This case is being prosecuted by Assistant U.S. Attorney John Couriel.

U.S. v. Isaura Bou-Melendez and Gricel Font, Case No. 12-20113-CR-MGC

In this case, Isaura Bou-Melendez and Gricel Font are charged with conspiracy to commit health care fraud. Bou and Font, licensed therapists, owned and operated a comprehensive outpatient rehabilitation facility, Font & Bou Rehab Associates, Inc. The information alleges that from January 2006 through February 2010, Font and Bou allegedly submitted approximately $6.9 million in false claims to Medicare for physical and occupational therapy services that were not medically necessary or not provided as claimed. This case is being prosecuted by Assistant U.S. Attorney Jon Juenger.

U.S. v. Maritza Claudia Fernanda Lorza Ramirez, and James Arley Velasco Gonzalez, Case No. 12-60090-CR-KMW

This indictment charges defendants Maritza Lorza Ramirez and James Velasco Gonzalez with conspiracy to commit money laundering and substantive counts of money laundering. More specifically, the indictment alleges that between January 2006 and December 2010, Lorza and Velasco laundered approximately $3 million in health care fraud proceeds for several companies using their own corporations, including Celebration Home Services, Inc., 4 All Your Needs, Inc., VPP Staffing, Inc, and Work Force Innovations, Inc. This case is being prosecuted by Assistant U.S. Attorney Jon Juenger.

U.S. v. Orlando Conrado Piedra Jr., Case No. 12-60091-CR-KMW

This indictment charges Orlando Piedra, an accountant, with conspiracy to commit money laundering and substantive counts of money laundering. More specifically, the indictment alleges that between June 2007 and September 2009, Piedra laundered approximately $500,000 in health care fraud proceeds for several companies through his own company, Media Health Consultants, Inc. This case is being prosecuted by Assistant U.S. Attorney Jon Juenger.

U.S. v. Armando “Manny” Gonzalez, John Thoen, Wondera Eason, Paul Thomas Layman, Alexandra Haynes, Serena Joslin, Ivon Perez, Daniel Martinez, Raymond Rivero, Case No. 12-20291-CR-Altonaga

Armando “Manny” Gonzalez, John Thoen, Wondera Eason, Paul Thomas Layman, Alexandra Haynes, and Serena Joslin are charged with one count of conspiracy to commit health care fraud through a company called Health Care Solutions Network (HCSN). Additionally, defendants Gonzalez, Daniel Martinez, Raymond Rivero, and Ivon Perez are charged with conspiracy to receive and pay health care kickbacks; defendants Martinez, Rivero, and Perez are charged with substantive counts of soliciting and receiving health care kickbacks; defendants Gonzalez and Thoen are charged with one count of conspiracy to commit money laundering; and defendant Gonzalez is charged with substantive counts of money laundering. More specifically, the indictment alleges that between November 2004 and March 2011, Gonzalez, Thoen, Eason, Layman, Haynes, and Joslin conspired to submit approximately $63 million in false claims to Medicare and Medicaid for mental health services that were neither necessary nor provided. The indictment also alleges that Gonzalez conspired with owners of Assisted Living Facilities (ALFs), including Martinez, Rivero, and Perez to pay and receive health care kickbacks in exchange for referring Medicare beneficiaries to HCSN. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Sarah Da Silva Keller, Case No. 12-20289-CR-Cooke

Sarah Da Silva Keller is charged with one count of conspiracy to commit health care fraud. More specifically, the criminal information alleges that between April 2006 and February 2008, Keller conspired with others at HCSN to submit false claims to Medicare for mental health services that were neither medically necessary nor provided. The information further alleges that HCSN submitted approximately $63 million in false claims to Medicare. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Alba Serrano, Case No. 12-20285-CR-Seitz

Alba Serrano is charged with one count of conspiracy to commit health care fraud. The criminal information alleges that Serrano, the owner of Elsa’s House of the Elderly, a Miami-Dade ALF, referred residents from her ALF to American Therapeutic Corporation (ATC) in exchange for kickbacks. ATC was a Community Mental Health Center (CMHC) that submitted false claims for intensive mental health services, called Partial Hospitalization Program, based on Serrano’s Medicare beneficiary referrals. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Bobby Ramnarine, Case No. 12-20288-CR-Middlebrooks

Bobby Ramnarine is charged with one count of conspiracy to commit health care fraud. The criminal information alleges that Ramnarine, the owner of Elmina’s ALF, in Broward County, recruited residents from Elmina’s to become patients at ATC in exchange for kickbacks. ATC submitted false claims for PHP services based on Ramnarine’s Medicare beneficiary referrals. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Giuseppe Pellerito, Case No. 12-20292-CR-Cooke

In this case, defendant Giuseppe Pellerito is charged with conspiracy to receive health care kickbacks and substantive counts of receiving kickbacks. The indictment alleges that Pellerito, the owner of Florida Sober House (FSH), received kickbacks for recruiting residents from FSH to become patients at ATC. ATC, in turn, submitted false claims for PHP based on Pellerito’s referrals. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Hassan Collins, Case No. 12-20286-CR-Moore

Hassan Collins is charged with one count of conspiracy to pay and receive health care kickbacks. According to the criminal information, Collins was the owner of New Way Recovery Inc. (NWR), which operated several halfway houses in Broward County. Collins allegedly received kickbacks for recruiting Medicare beneficiaries who resided at NWR to become patients at ATC. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Jean Luc Veraguas, Case No. 12-20287-CR-Moreno

Jean-Luc Veraguas is charged with one count of conspiracy to commit health care fraud. The criminal information alleges that Veraguas was the owner of Neu Ways Inc., which operated several halfway houses in Broward County. Veraguas allegedly referred residents at his houses to ATC in exchange for kickbacks. This case is being prosecuted by Trial Attorney Steven Kim of the Criminal Division’s Fraud Section.

U.S. v. Pablo Orama, Vivian Augustine, a/k/a Vivian Salazar, Ariane Marchioro Amorim, Jose Orelvis Ortega, Marlen Diosdada Garcia, Ivon Perez, Marianela Terrero, Jose Abreu-Gonzalez, Elba M. Caicedo, Carlos A. Herrera, Marisela Sherwood, Nancy Diaz, Daymi Fuentes Gil, Olga Martinez Rodriguez, Yuria Perez Rivero, and Joel Loyola, Case No. 12-20265-CR-Middlebrooks(s)

In this case, 16 defendants are charged with conspiracy to pay and receive health care kickbacks and substantive counts of paying and receiving kickbacks in connection with a federal health care program. According to the indictment, defendant Pablo Orama was the owner of Superstar Home Health, a Miami-Dade County home health agency that purportedly provided skilled nursing services and physical therapy to homebound Medicare beneficiaries. Vivian Augustine and Ariane Amorim were employees of the company. Jose Orelvis Ortega, Marlen Garcia, Ivon Perez, Marianela Terrero, Jose Abreu-Gonzalez, Elba Caicedo, Carlos Herrera, Marisela Sherwood, and Nancy Diaz were recruiters who offered money to Medicare beneficiaries in return for their agreement to serve as patients at Superstar. Defendants Daymi Fuentes Gil, Olga Rodriguez, Yuria Rivero, and Joel Loyola were Medicare beneficiaries who accepted kickbacks in return for agreeing to serve as patients at Superstar. This case is being prosecuted by Assistant U.S. Attorney Eric E. Morales.

U.S. v. Jorge Luis Reyes and Waldo Gonzalez, Case No. 12-14030-CR-Moore

This indictment charges Jorge Luis Reyes and Waldo Gonzalez, owners of a medical clinic that purported to treat HIV-positive Medicare beneficiaries at locations in Miami-Dade and St. Lucie Counties. According to the indictment, between November 2005 and January 2009, the defendants submitted approximately $15,201,162 in fraudulent claims to Medicare for treatment that was not provided, and in many cases would not have been medically necessary. The majority of the fraudulent claims (more than $13.6 million) were submitted to private insurance companies that were a Medicare Advantage contractor under Part C of the Medicare program. This case is being prosecuted by Assistant U.S. Attorney Marc Osborne.

U.S. v. Manotte Bazile, Case No. 12-20284-CR-Lenard

Defendant Manotte Bazile, a former social worker and licensed intern at Biscayne Milieu, was charged with health care fraud conspiracy for purportedly treating patients who did not qualify for PHP treatment. This case is part of larger indictment involving of Biscayne Milieu, a CMHC that was involved in the submission of $57 million in false claims to Medicare for purportedly providing PHP services to Medicare beneficiaries who did not qualify for or receive the treatments that were billed to Medicare. In this case, Bazile assisted non-U.S. citizen patients by completing immigration forms on their behalf that falsely indicated that the patients suffered from mental illnesses, thereby fraudulently enabling the patients to avoid taking the citizenship test. This case is being prosecuted by Assistant U.S. Attorney Alicia Shick.

U.S. v. Roselyn Nicole Charles, Case No. 12-20283-CR-Ungaro

Defendant Roselyn Nicole Charles, a former patient recruiter at Biscayne Milieu, was charged with conspiracy to pay health care fraud kickbacks. More specifically, the criminal information alleges that Charles recruited patients to participate in Biscayne Milieu’s PHP in exchange for kickbacks. These patients, who did not qualify for PHP treatment, were promised assistance with their U.S. citizenship applications in exchange for their participation in Biscayne Milieu’s PHP. This case is part of larger indictment of Biscayne Milieu, a CMHC that was involved in the submission of more than $57 million in false claims to Medicare for purportedly providing PHP services to Medicare beneficiaries who did not qualify for PHP treatment or receive the treatments that were billed to Medicare. This case is being prosecuted by Assistant U.S. Attorney Alicia Shick.

The cases announced today are being prosecuted and investigated by Medicare Fraud Strike Force teams comprised of attorneys from the Fraud Section of the Justice Department’s Criminal Division and from the U.S. Attorney’s Offices for the Southern District of Florida, the Eastern District of Michigan, the Southern District of Texas, the Central District of California, the Middle District of Louisiana; the Northern District of Illinois, and the Middle District of Florida; and agents from the FBI, HHS-OIG, and state Medicaid Fraud Control Units.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. Miami was the first Strike force city in the nation, and the model for others that followed.

An indictment or information is only an accusation and defendants are presumed innocent until proven guilty.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at http://www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at http://www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.”

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Douglas McNabb – McNabb Associates, P.C.’s
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