“Twelve Los Angeles-Area Residents Accused of Attempting to Bilk Medicare of $22 Million Arrested as Part of Nationwide Crackdown”

May 15, 2013

The Federal Bureau of Investigation (FBI) on May 14, 2013 released the following:

“LOS ANGELES— Twelve Los Angeles-area residents—including California’s second-largest biller for chiropractic services, a physician’s assistant, and owners of durable medical equipment (DME) and ambulance companies—were taken into custody today in relation to seven criminal cases that allege they cumulatively submitted more than $22 million in false billings to Medicare.

The charges filed in Los Angeles are part of a nationwide “takedown” by Medicare Fraud Strike Force operations in eight cities that led to charges against 89 individuals for their alleged participation in schemes to collectively submit about $223 million in fraudulent claims to Medicare.

The dozen defendants taken into custody are among 13 people charged in Los Angeles in cases that allege health care fraud. The 12 either were arrested this morning or self-surrendered to authorities after learning that they had been charged in federal court. All those defendants are scheduled to be arraigned this afternoon. A 13th defendant is a fugitive.

Dr. Houshang Pavehzadeh, of the Sylmar Physician Medical Group, allegedly billed Medicare more than $1.7 million for chiropractic treatments he never performed. During the scheme, which ran from 2005 through 2012, Dr. Pavehzadeh, 40, of Agoura Hills, became the second-largest Medicare biller in California for chiropractic services—even though he was not in the United States when some of the alleged services were performed. In addition to being charged with health care fraud, Pavehzadeh is charged with aggravated identity theft related to Medicare beneficiaries whose information he used to bill Medicare as a part of the scheme. When investigators tried to conduct an audit of Pavehzadeh’s claims, he falsely reported to the Los Angeles Police Department that he had been carjacked and that patient files requested by the auditors had been stolen from his car. Pavehzadeh surrendered this morning, and he is scheduled to be arraigned with other Los Angeles-area defendants this afternoon in the Roybal Federal Building.

Nine defendants affiliated with DME companies were also charged in five separate indictments.

Olufunke Fadojutimi, 41, of Carson, a registered nurse; Ayodeji Temitayo Fatunmbi, 41, formerly of Carson and now believed to be residing in Nigeria; and Maritza Velazquez, 40, of Las Vegas, were charged with health care fraud. The scheme allegedly revolved around Lutemi Medical Supplies, a DME company Fadojutimi owned and where Fatunmbi and Velazquez worked. According to the indictment in this case, Lutemi billed Medicare more than $8.3 million in claims, primarily for medically unnecessary power wheelchairs. Fadojutimi and Fatunmbi allegedly laundered Medicare funds in order to purchase fraudulent prescriptions for those power wheelchairs and pay illegal kickbacks to recruit Medicare beneficiaries. Fadojutimi was arrested this morning in Los Angeles, while Velazquez was arrested in Las Vegas. Fatunmbi is currently a fugitive being sought by federal authorities.

Susanna Artsruni, 45, of North Hollywood, and Erasmus Kotey, 76, of Montebello, a licensed physician’s assistant, allegedly worked together to commit health care fraud out of a medical clinic on Vermont Avenue where they both worked. Kotey allegedly prescribed medically unnecessary DME, including power wheelchairs, for Medicare beneficiaries. Many of those power wheelchair prescriptions were then used by Artsruni’s DME company, Midvalley Medical Supply, to support fraudulent claims to Medicare. In only four months, the clinic and Midvalley billed Medicare more than $525,000 for these fraudulent claims. Artsruni has previously been convicted of health care fraud and was on pre-trial supervision at the time she allegedly laundered some of the proceeds of this fraud. Artsruni was arrested this morning, while Kotey self-surrendered.

Three other DME cases were also charged, alleging fraudulent Medicare billing for medically unnecessary power wheelchairs that were sometimes never even delivered. In one case, Akinola Afolabi, 53, of Long Beach, the owner of Emmanuel Medical Supply, allegedly submitted more than $2.6 million in false and fraudulent billing to Medicare. In another case, Queen Anieze-Smith, 52, of Encino, and Abdul King-Garba, 47, of Westwood, the owners and operators of ITC Medical Supply, allegedly submitted more than $1.8 million in false and fraudulent billing to Medicare. In the third case, Clement Etim Aghedo, 53, of Fontana, the owner of Ace Medical Supply Company, allegedly submitted more than $1.8 in false and fraudulent claims to Medicare. Afolabi, Anieze-Smith, and King-Garba were all arrested this morning, while Aghedo self-surrendered.

In the seventh case brought as part of today’s takedown, three defendants affiliated with Gardena-based ProMed Medical Transportation, an ambulance company, were charged with submitting more than $5.9 million in false claims to Medicare between 2008 and 2011. ProMed’s owner, Yaroslav Proshak, 45, of Valley Village; general manager Sharetta Wallace, 35, of Inglewood; and office manager and biller Sergey Mumjian, 40, of West Hollywood, submitted claims for medically unnecessary transportation services and then created fake documentation purporting to support those claims. Proshak, Wallace, and Mumjian were arrested this morning.

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

The Los Angeles cases announced today are being investigated by a Medicare Fraud Strike Force team, which is composed of agents and investigators with the Federal Bureau of Investigation; the Department of Health and Human Services, Office of Inspector General; IRS-Criminal Investigation; and Medicaid Fraud Control Units, including the California Department of Justice. The cases are being prosecuted by attorneys from the United States Attorney’s Office and the Fraud Section of the Justice Department’s Criminal Division.

An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty.

The charge of health care fraud carries a statutory maximum penalty of 10 years in federal prison. Money laundering carries a potential penalty of 20 years in prison. Aggravated identity theft carries a mandatory two-year prison term.”

————————————————————–

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.


5 Are Charged in Alleged Schemes at Agency on Housing

June 6, 2012

The New York Times on June 5, 2012 released the following:

“By JOSEPH GOLDSTEIN

By the time Wendell B. Walters, a former top official at a New York City agency that builds affordable housing, pleaded guilty to accepting bribes in March, he was known to be cooperating with the F.B.I. and federal prosecutors.

On Tuesday, details of what Mr. Walters has so far told the authorities began to emerge, as federal prosecutors in Brooklyn charged five more people in bribery and kickback schemes involving the city’s Department of Housing Preservation and Development, where Mr. Walters was an assistant commissioner until last year.

The charges provide further details about the $2.5 million in bribes and other benefits Mr. Walters has pleaded guilty to accepting, and also assert that he was not the only corrupt official with oversight of the city’s affordable housing program.

A criminal complaint charged one Brooklyn contractor, Panayiotis Papanicolaou, who had received contracts for several Department of Housing Preservation and Development projects, with paying $12,390 to send Mr. Walters on a honeymoon trip to Greece. A real estate developer, William B. Clarke, subsidized $50,000 worth of renovations to Mr. Walters’s home, according to a second criminal complaint, which charges that Mr. Walters promised to help Mr. Clarke’s company secure subsidies for an affordable housing project in the Bronx in return.

Prosecutors also charged a current department official, Michael Provenzano, 49, with receiving a $10,000 annual retainer between 2004 to 2009 from a contractor who wanted inside information from the agency. Mr. Provenzano supervised the inspectors who visit work sites and began providing the contractor with paperwork from the agency’s site inspections, prosecutors said.

This allowed the contractor to tailor his payrolls to match what the housing agency had observed at the job sites, prosecutors said. In fact, prosecutors said, laborers at the contractor’s job sites were routinely paid less than the required prevailing wage, and the remaining money was used to hire illegal immigrants.

Prosecutors also charged a housing official who left the agency earlier this year, Luis Adorno, 48, with participating in a kickback scheme.

The five criminal complaints unsealed against the various defendants on Tuesday in Federal District Court in Brooklyn do not mention Mr. Walters by name. But several of the complaints mention a cooperating witness who appears to be Mr. Walters; the witness is described as someone who began working at the housing agency in 1998 and rose to the level of assistant commissioner before pleading guilty this year.

“Instead of fulfilling their charge to create affordable housing for deserving New Yorkers, these defendants looked for ways to line their own pockets,” the United States attorney in Brooklyn, Loretta E. Lynch, said in a statement. The five defendants were in court on Tuesday afternoon and entered pleas of not guilty, Robert Nardoza, a spokesman for the United States attorney’s office, said.”

————————————————————–

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.


Eight Los Angeles-Area Residents Charged in an Alleged Medicare Fraud

May 2, 2012

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

“Eight Los Angeles-Area Residents Charged in Nationwide Medicare Fraud Strike Force Takedown

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

LOS ANGELES—Eight Los Angeles-area residents, including two doctors, were charged today for their roles in schemes to submit more than $14 million in false billing to Medicare, announced the Departments of Justice and Health and Human Services (HHS).

The charges in Los Angeles 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 United States 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.”

“Medicare fraud drains vital resources and harms consumers across the nation,” said United States Attorney André Birotte Jr. “The problem is national in scope and it calls out for the type of coordinated national response that today’s crackdown represents. This office is dedicated to working with all our partners, both locally and nationally, to protect this important public program that serves our elderly and disabled.”

“As today’s strike force operation demonstrates, health care fraud is not limited to just one or two types of health care providers,” said Glenn R. Ferry, Special Agent in Charge for the Los Angeles Region of HHS’s Office of Inspector General (OIG). “Whether it is a physician, a business owner, or any other provider, OIG and our law enforcement partners are committed to pursuing those that attempt to steal precious dollars from the Medicare program.”

According to court documents filed in the Central District of California, two Orange County doctors and two of their co-schemers were charged for allegedly submitting nearly $5.7 million in false claims to Medicare for durable medical equipment (DME). Specifically, the defendants billed Medicare for enteral nutrition, a liquid nutritional supplement. Medicare will only pay for enteral nutrition if a patient has a feeding tube. According to the indictment, Dr. Augustus Ohemeng, 62, of Buena Park, and Dr. George Tarryk, 72, of Seal Beach, wrote fraudulent prescriptions for enteral nutrition for patients who did not have feeding tubes. Co-defendant George Samuel Laing, 41, of Sylmar, who managed the clinic where Tarryk and Ohemeng practiced, allegedly received kickbacks in exchange for referring the prescriptions to Ivy Medical Supply, owned by co-defendant Emmanuel Chidueme, 59, of Mira Loma. Ivy then fraudulently billed Medicare for the enteral nutrition, even though it was not medically necessary and was not delivered to patients in the quantities billed to Medicare. Ohemeng, Tarryk, Laing, and Chidueme were arrested this morning and are scheduled to make their initial appearances before a U.S. Magistrate Judge this afternoon.

“The charges announced today emphasize disturbing health care fraud trends, including the arrest of physicians, that exploit federal health care meant for those in need,” said Steven Martinez, Assistant Director in Charge of the FBI’s Los Angeles Field Office. “The cases charged in Southern California and around the U.S. indicate the staggering amount of fraud adversely affecting the U.S. economy and illustrate the need for the continued focus on protecting federally funded health care programs.”

In a separate case, two defendants were arrested on charges related to their DME company, Latay Medical Services, which allegedly submitted more than $8 million in fraudulent billings to Medicare for power wheelchairs, orthotics, and hospital beds that were either not provided or were medically unnecessary. The indictment charges Latay’s owner, Bolademi Adetola, 46, of Harbor City, and Latay employee Yuri Martin Lopez, 46, of Lawndale, with obtaining fraudulent prescriptions for the DME, creating fake documentation to make it seem as though the DME had been delivered when it had not, and delivering DME less expensive than that listed on Latay’s Medicare claims.

Two additional defendants are scheduled to self-surrender today on charges related to Greatcare Home Health Inc., a home health agency that received more than $5.4 million from Medicare for skilled nursing and physical therapy services that were often either never performed or performed by unlicensed individuals. Greatcare’s owner, Hee Jung Mun, also paid illegal kickbacks to doctors, individuals known as marketers, and patients themselves in order to recruit Medicare beneficiaries. Mun, along with three other Greatcare employees, have already pleaded guilty to the fraud and are awaiting sentencing before U.S. District Judge Dean D. Pregerson. Yeong Ja Lee, 50, of Mid-City, is scheduled to make her initial court appearance this afternoon on charges that she visited and provided services to patients without a license and created false documentation for Greatcare and one of its referring doctors. Sang Whan Ahn, 60, of Koreatown, is also scheduled to appear on charges that she acted as a marketer, accepting kickbacks in exchange for referring patients to Greatcare.

As a part of the operation, members of the strike force in Los Angeles also executed three search warrants today.

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 Central District of California, the Southern District of Florida, the Eastern District of Michigan, the Southern District of Texas, the Middle District of Louisiana, the Northern District of Illinois, and the Middle District of Florida; and agents from the Federal Bureau of Investigation, HHS-OIG, and state and local Medicaid Fraud Control Units, including the California Department of Justice and Los Angeles Sheriff’s Department’s Health Authority Law Enforcement Task Force.

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

To learn more about HEAT, go to: http://www.stopmedicarefraud.gov.

CONTACT:
Assistant United States Attorney Kristen A. Williams
Major Frauds Section
(213) 894-0526

Special Assistant United States Attorney Grant Gelberg
Major Frauds Section
(213) 894-2872

Assistant United States Attorney Consuelo S. Woodhead
Major Frauds Section
(213) 894-3987″

————————————————————–

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.


Federal Prosecutors Charge John Heary, an Ohio Chiropractor, in an Alleged $1M Medicare and Private Insurance Fraud Case

April 5, 2012

The Republic on April 4, 2012 released the following:

“Federal prosecutors charge Ohio chiropractor in $1M Medicare and private insurance fraud case

THE ASSOCIATED PRESS

CLEVELAND — A northeast Ohio chiropractor has been charged with defrauding Medicare and private insurers out of more than $1 million, including orders for unneeded medical equipment and free dinner offers if patients would assist the alleged scheme.

Federal prosecutors in Cleveland announced the indictment Tuesday against 37-year-old John Heary, who most recently lived in Lodi (LOH’-dy) and had a practice in Medina (meh-DY’-nuh).

He was charged with 55 counts including health care fraud and paying kickbacks.

He allegedly offered patients the dinners or waived co-payments if they would come to his office and clear the way for the alleged billing fraud.

Heary’s attorney, Joseph Morse, declined comment Wednesday.”

US v. John Heary – Federal Criminal Indictment

18 U.S.C. § 1341 – Mail Fraud

18 U.S.C. § 1347 – Health Care Fraud

42 U.S.C. § 1320A-7B – Illegal Kickbacks

————————————————————–

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 Crimes Watch 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 and OFAC SDN Sanctions Removal.

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.


FBI sting nabs 13 in alleged kickback scheme

December 2, 2011

The Boston Globe on December 1, 2011 released the following:

“By Todd Wallack

The US government yesterday charged 13 corporate executives, lawyers, and penny stock promoters with agreeing to pay illegal kickbacks, the result of a yearlong FBI sting operation run out of Massachusetts.

As part of the sting, an undercover FBI agent pretended to work for a local office of a New York hedge fund in an unnamed Boston suburb, according to government documents. The agent then approached both companies and intermediaries, offering to arrange for his fund to invest up to $5 million in the firms – under the condition that the companies secretly kick much of the money back to him.

Authorities said the agent met with about 30 individuals in the Boston area office from October 2010 through August 2011.

The government filed criminal charges against executives of two Massachusetts companies: Michael Lee, 51, of Hingham, chief executive of ZipGlobal Holdings Inc., a former telecommunications firm in Hingham now focused on lighting products; and Paul Desjourdy, 50, of Medfield, chief executive of Symbollon Corp./Symbollon Pharmaceuticals Inc., a specialty biotechnology firm in Medfield. Both were charged with mail fraud and conspiracy to commit securities fraud.

Eleven other defendants from across the country were charged with fraud, including Edward Henderson, 69, of Lincoln, R.I. Henderson, who helps firms obtain financing, allegedly arranged for the agent posing as a hedge fund representative to meet Desjourdy in hopes of receiving a portion of the kickback.

The Securities and Exchange Commission also filed civil charges against Lee, Desjourdy, and Henderson, alleging they manipulated trading in microcap stocks – shares of companies with a small market value that are typically traded over the counter, rather than on better-known exchanges such as Nasdaq Stock Market or the New York Stock Exchange.

Lee’s attorney, Thomas Brant, said his client was “shocked and devastated’’ by the charges, but declined to comment further. Desjourdy’s lawyer declined to comment. Henderson’s attorney could not be reached.

As result of the investigation, the SEC suspended trading of Symbollon, ZipGlobal, and five other thinly traded public companies. ZipGlobal last traded at 3 cents a share before being suspended. Symbollon last traded for less than a penny a share.

David Bergers, director of the SEC’s Boston office, said it is important to thwart kickback schemes – even involving small companies – because they can hurt investors. A tainted hedge fund investment could artificially drive up a firm’s stock price, forcing other investors to pay more for shares or misleading them about the company’s potential.

“Although the stock price for these companies may be low, the damage can be very high,’’ Bergers said.

US Attorney Carmen Ortiz said the case was novel because FBI agents were able to partner with the SEC to use undercover strategies more common to drug and public corruption cases than securities.

“It’s really important that the markets operate in a fair and honest fashion,’’ Ortiz said. “We hope it serves a deterrent factor so that others will not engage in this kind of criminal activity.’’”

————————————————————–

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 Crimes Watch 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 and OFAC SDN Sanctions Removal.

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