Case Summaries

2024 National Health Care Fraud Enforcement Action
Summary of Criminal Charges

Cases Filed in Federal Court

Southern District of Alabama

Brian Cotugno, of Auburn, Georgia, and James Matthew Thorton “Bo” Potter, of Santa Rosa Beach, Florida, were charged by information and indictment, respectively, with purchasing and selling Medicare beneficiary identification numbers (“BINs”) in connection with their role in a nearly $20 million over-the-counter (“OTC”) COVID-19 test fraud scheme. As alleged, Cotugno sold hundreds of thousands of BINs and other personal data to labs around the country, including to two laboratories co-owned by Potter based in Birmingham, Alabama and Spanish Fort, Alabama. The BINs were used to bill Medicare tens of millions of dollars for OTC COVID-19 test kits, many of which had not been requested by the beneficiaries. The case is being prosecuted by Assistant U.S. Attorney Christopher Bodnar of the U.S. Attorney’s Office for the Southern District of Alabama. Assistant U.S. Attorney Gina Vann is handling asset forfeiture.

District of Arizona

Alexandra Gehrke, 38, and Jeffrey King, 49, of Scottsdale, Arizona, were charged by indictment with various counts of conspiracy, health care fraud, receiving kickbacks, and money laundering in connection with an alleged scheme to fraudulently bill Medicare $900 million for highly expensive amniotic allografts. The defendants targeted elderly Medicare patients, many of whom were terminally ill in hospice care, through their companies—Apex Mobile Medical LLC, Apex Medical LLC, Viking Medical Consultants LLC, and APX Mobile Medical LLC. The defendants caused unnecessary and extremely expensive amniotic grafts to be applied to these vulnerable patients’ wounds indiscriminately, without coordination with the patients’ treating physicians, without proper treatment for infection, to superficial wounds that did not need this treatment, and in sizes excessively larger than the wound. In just sixteen months, Medicare paid the defendants more than $600 million as a result of their fraud scheme, paying on average more than a million dollars per patient for these unnecessary grafts. The defendants received more than $330 million in illegal kickbacks from the graft distributor in exchange for purchasing, ordering, and arranging for the purchasing of the grafts billed to Medicare. Significant assets were seized upon the defendants’ arrests, including luxury vehicles, gold, and bank accounts totaling more than $70 million. The case is being prosecuted by Trial Attorney Shane Butland of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Carlos Ching, 55, of Phoenix, Arizona, is charged by information with conspiracy to commit health care fraud in connection with the APX scheme. As alleged in the information, Ching was paid by APX to apply medically unnecessary allografts to Medicare patients that were procured through kickbacks and bribes. Between June 2023 and January 2024, APX fraudulently billed Medicare over $87 million for allografts applied by Ching. Medicare paid APX over $65 million based on those false and fraudulent claims. And from January 2024 through March 2024, Ching, through his company H3 Medical Clinic LLC, billed Medicare over $5 million for allografts that he procured through kickbacks and bribes and applied to Medicare beneficiaries without medical necessity. Medicare paid over $4 million based on those false and fraudulent claims. The case is being prosecuted by Trial Attorney Shane Butland of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Bethany Jameson, 53, of Gilbert, Arizona, is charged by information with conspiracy to commit wire fraud in connection with the APX scheme. As alleged in the information, Jameson was paid by Apex Mobile Medical and APX to apply medically unnecessary allografts to Medicare beneficiaries that were procured through kickbacks and bribes. Between November 2022 and August 2023, Apex Mobile Medical and APX billed Medicare over $71 million for allografts applied by Jameson. Medicare paid over $49 million based on those false and fraudulent claims. The case is being prosecuted by Trial Attorney Shane Butland of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Rita Anagho, 52, of San Tan Valley, Arizona, was charged by indictment with conspiracy to commit health care fraud, health care fraud, money laundering, and obstruction of justice in connection with an alleged $69 million scheme involving a substance abuse treatment clinic in Arizona. As alleged in the indictment, Anagho owned Tusa Integrated Clinic LLC (“Tusa”), an outpatient treatment center, which was purportedly in the business of providing addiction treatment services for persons suffering from alcohol and drug addiction. Tusa enrolled as a provider with Arizona’s Medicaid agency, Arizona Health Care Cost Containment System, and submitted false and fraudulent claims for services that were not provided, were not provided as billed, were so substandard that they failed to serve a treatment purpose, were not used as part of or integrated into any treatment plan, and were medically unnecessary. Anagho also instructed former Tusa employees to create false therapy notes for sessions they did not conduct in 2023 after she was served with a subpoena for Tusa’s records as part of the government’s investigation of this fraud. The case is being prosecuted by Assistant Chief James Hayes and Trial Attorney Sarah Edwards of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Adam Mutwol, 45, of Tempe, Arizona, and Daud Koleosho, 44, of Gilbert, Arizona, were charged by separate informations with conspiracy to commit health care fraud in connection with an alleged $57 million substance abuse treatment fraud scheme. As alleged in the informations, Mutwol and Koleosho owned Community Hope Wellness Center LLC (“CHWC”), an outpatient treatment center, which was purportedly in the business of providing addiction treatment services for persons suffering from alcohol and drug addiction. CHWC enrolled as a provider with Arizona Medicaid. To obtain and retain patients for CHWC whose insurance could be billed for substance abuse treatment services, Mutwol and Koleosho offered and paid kickbacks and bribes to owners of residences that housed substance abuse treatment patients, in exchange for these residence owners referring patients for treatment to CHWC. Mutwol and Koleosho submitted $57 million of false and fraudulent claims to Arizona Medicaid for treatment services that were not provided, were not provided as billed, were not provided by qualified personnel, were so substandard that they failed to serve a treatment purpose, were not used or integrated into any treatment plan, and were medically unnecessary. The case is being prosecuted by Trial Attorney S. Babu Kaza of the Midwest Strike Force, Assistant Chief James Hayes of the National Rapid Response Strike Force, and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.

Central District of California

Kyrollos Mekail, 36, of Moreno Valley, California, was charged by information with two counts of health care fraud in connection with an alleged scheme to fraudulently bill Medicaid of California (“Medi-Cal”) $307 million for medications that were medically unnecessary and in many instances not provided, and that were obtained through illegal kickbacks. Mekail was the pharmacist and owner of MONTE VP LLC d/b/a Monte Vista Pharmacy, a pharmacy located in Montclair, California. Medi-Cal generally required providers to obtain prior authorization before billing for certain medications, including medications that contained inexpensive generic ingredients but were manufactured in unique dosages, combinations, or package quantities, and were not included in the applicable maximum price lists that capped Medi-Cal reimbursements (“non-contracted, generic drugs”). However, as of January 2022, Medi-Cal temporarily suspended the prior authorization requirement. Beginning in May 2022, Mekail paid kickbacks to co-schemers for prescriptions for certain non-contracted, generic drugs (the “Fraud Scheme Medications”), for which Monte Vista could bill Medi-Cal. Other co-schemer medical providers were paid to write prescriptions for the Fraud Scheme Medications using the names and personal information of Medi-Cal patients provided by other co-schemers. Mekail then submitted false and fraudulent claims to Medi-Cal for purportedly dispensing the Fraud Scheme Medications knowing that the medications were medically unnecessary and in many instances were not provided, and that the prescriptions were obtained through kickbacks. In total, Mekail submitted and caused the submission of approximately $306,521,392 in false and fraudulent claims to Medi-Cal for purportedly dispensing the Fraud Scheme Medications, of which Medi-Cal paid approximately $204,032,151. In November 2023, the government seized approximately $108,683,368 in assets tied to the alleged scheme. The case is being prosecuted by Assistant Chief Niall M. O’Donnell and Trial Attorney Siobhan M. Namazi of the Los Angeles Strike Force and Assistant U.S. Attorney Roger A. Hsieh of the Central District of California. Assistant U.S. Attorney James E. Dochterman is handling asset forfeiture.
Monica Boniadi, 53, of Laguna Niguel, California, was charged by information with health care fraud in connection with a scheme to bill private insurers for the cost of dental services that she did not perform. According to the information, Boniadi, a licensed dentist, billed insurers for the cost of providing fillings to patients when Boniadi actually provided a resin restoration that reimbursed less, leading to a total actual loss of $142,677. The case is being prosecuted by Assistant Chief Niall M. O’Donnell of the Los Angeles Strike Force and Assistant U.S. Attorney Benjamin R. Barron of the U.S. Attorney’s Office for the Central District of California.

Northern District of California

Riley Levy, 30, of Peoria, Arizona, was charged by information with conspiracy to distribute controlled substances in connection with his role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the information, in the course and scope of his work for Done Health, P.C. and Done Global Inc. (“Done”), Levy, Done’s Executive Leader, Operations and Strategy, conspired to distribute Adderall and other stimulants by means of the Internet that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Deputy Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney’s Office for the Northern District of California are prosecuting the case.
Christopher Lucchese, 58, of Plano, Texas, was charged by information with conspiracy to defraud the United States and distribute controlled substances in connection with his role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the information, in the course and scope of his work for Done Health, P.C. and Done Global Inc., Lucchese, a medical doctor, issued prescriptions for Adderall and other stimulants that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney’s Office for the Northern District of California are prosecuting the case.
Yina Cruz, 37, of Glenwood, New Jersey, was charged by information with conspiracy to defraud the United States and distribute controlled substances in connection with her role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the information, in the course and scope of her work for Done Health, P.C. and Done Global Inc., Cruz, a nurse practitioner, issued prescriptions for Adderall and other stimulants, including to Medicare and Medicaid beneficiaries, that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney’s Office for the Northern District of California are prosecuting the case.
Katrina Pratcher, 70, of Altadena, California, was charged by information with conspiracy to defraud the United States and distribute controlled substances in connection with her role in an unlawful scheme to distribute Adderall and other stimulants. As alleged, in the course and scope of her work for Done Health, P.C. and Done Global Inc., Pratcher, a nurse practitioner, issued prescriptions for Adderall and other stimulants, including to Medicare and Medicaid beneficiaries, that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney’s Office for the Northern District of California are prosecuting the case.

Southern District of California

Cindy Justice, 69, and Ashleigh Davis, 40, both of Melbourne, Florida, were charged by indictment with conspiracy to commit health care fraud and pay unlawful remuneration. Cindy Justice was the owner and president of PureScience Rx, a compounding pharmacy located in Poway, California. Ashleigh Davis was the Operations Manager at PureScience Rx and was a licensed pharmacy technician. As alleged in the indictment, the defendants conspired to execute a scheme to defraud Medicare in connection with medically unnecessary and exorbitantly priced compound prescriptions supposedly for a “foot bath” treatment. The defendants were paid a total of $4.6 million by Medicare. The case is being prosecuted by Assistant U.S. Attorney Valerie H. Chu of the U.S. Attorney’s Office in the Southern District of California.
Casimiro Bojorquez, 42, of North Hills, California, was charged by complaint with conspiracy to solicit and receive illegal remunerations for referrals to clinical treatment facilities. According to the complaint, Bojorquez brought patients to substance abuse treatment facilities in exchange for payments. In December 2019, Bojorquez texted a co-conspirator, referring to potential patients, “Might have 2 for u ima go see them tonight.” The co-conspirator, who owned a treatment facility in Fallbrook, California, replied: “Yay sweet.” In April 2020, as Bojorquez was bringing a patient to the facility, he texted, “Stopping at Starbucks in Oceanside but we’re close to the facility Back on the road....” The facility’s owner responded, “Ok cool. I left an envelope for u.” Inside of this envelope was a $5,000.00 check from the facility. Bojorquez later texted, “Touchdown” when he arrived with the patient. Between October 24, 2018, and January 22, 2024, the facility paid Bojorquez approximately $176,000 in kickbacks for the referral of patients. The case is being prosecuted by Assistant U.S. Attorney Valerie H. Chu of the U.S. Attorney’s Office in the Southern District of California.
Jose Angel Portilla, 52, of Tijuana, Mexico, and Kathie Silva, 45, of Chula Vista, California, were charged by indictment with conspiracy to commit health care fraud and pay unlawful remunerations, as well as with health care fraud, in connection with a scheme to defraud Medicare by making false and fraudulent claims for durable medical equipment (“DME”) products. Beginning no later than in or about 2016, and continuing through in or about 2022, Portilla and Silva conspired with each other and with others to defraud Medicare by operating, managing, and hiring call centers located in Mexico. These centers were filled with agents who attempted to locate and contact Medicare beneficiaries living in the United States. The defendants and their co-conspirators created call scripts for the call center agents to attempt to persuade Medicare beneficiaries to agree to accept one or more DME products. Silva located, contracted with, and paid telemedicine companies to get doctors’ signatures on orders for the DME products. DME products were orthotic braces, including spinal and knee braces and any additional medical equipment. The case is being prosecuted by Assistant U.S. Attorney Valerie H. Chu of the U.S. Attorney’s Office in the Southern District of California.

District of Connecticut

Shawn Tyson, 54, of Bloomfield, Connecticut, was charged by information with one count of health care fraud in connection with a scheme to defraud the Connecticut Medicaid program of $670,963. As alleged in the information, Tyson, a licensed alcohol and drug abuse counselor, and another individual engaged in a scheme to submit fraudulent claims for psychotherapy services that were either not rendered at all, or which falsely represented the identity of the provider who purportedly rendered the service. The case is being prosecuted by Assistant U.S. Attorney David Sheldon of the U.S. Attorney’s Office for the District of Connecticut.

Middle District of Florida

Ma Gracia Cadet, 53, of Kissimmee, Florida, was charged by information with conspiracy to commit health care fraud in connection with an alleged scheme to fraudulently obtain over $9.3 million in Medicare funds. According to the information, Cadet, the owner of durable medical equipment (“DME”) companies KGA Medical Supply LLC and Sapphire Medical Supply LLC, caused the submission of false and fraudulent claims to Medicare for DME that was medically unnecessary and ineligible for reimbursement by Medicare. Cadet offered and paid illegal kickbacks to her co-conspirators at purported telemedicine companies in exchange for signed doctors’ orders for medically unnecessary orthotic braces that were ultimately billed to Medicare. The case is being prosecuted by Trial Attorney Jessica A. Massey of the Florida Strike Force.
Eva LeBeau, 65, of Clearwater, Florida, and Lori Lebrecht, 60, of Largo, Florida, were charged by indictment with conspiracy to defraud the United States and to pay and receive illegal health care kickbacks, as well as with paying illegal health care kickbacks to patient recruiters, all in connection with an alleged scheme to refer Medicare beneficiaries to Prestigious Senior Home Health Care, Inc. (“Prestigious”) and to submit false and fraudulent claims totaling over $2 million for home health services. LeBeau owned Prestigious and Lebrecht was Prestigious’ Director of Nursing. The indictment alleges that LeBeau and Lebrecht conspired to pay, and paid, patient recruiters per patient referral that Prestigious to billed to Medicare. Medicare paid approximately $1.3 million based on the false and fraudulent claims. The case is being prosecuted by Trial Attorneys Reginald Cuyler Jr. and Charles D. Strauss of the Florida Strike Force.
Robert Desselle, 46, of Sarasota, Florida was charged by indictment with conspiracy to defraud the United States and to pay and receive health care kickbacks, and with paying illegal health care kickbacks, in connection with a scheme to pay illegal health care kickbacks to patient recruiters in exchange for referring Medicare beneficiaries. The alleged scheme involved Desselle, through his company Desselle’s Sky High Enterprise, LLC, paying marketers on a per-patient basis to recruit Medicare beneficiaries for cancer genetic testing (“CGx”) tests which were not medically necessary. As a result of the charged scheme, Medicare paid approximately $4.5 million on CGx claims billed for these beneficiaries. The case is being prosecuted by Trial Attorney Charles D. Strauss of the Florida Strike Force.

Marques Elijah Green, 29, of Windermere, Florida, was charged by information with conspiracy to commit health care fraud in connection with an alleged scheme to fraudulently obtain over $3.4 million in Medicare funds. According to the information, Green, owner of durable medical equipment (“DME”) companies Onyx Medical Supply LLC and AquaMed Supply LLC, caused the submission of false and fraudulent claims to Medicare for DME that was medically unnecessary and ineligible for reimbursement by Medicare. Green offered and paid kickbacks to his co-conspirators at purported telemedicine companies in exchange for signed doctor’s orders for medically unnecessary orthotic braces that were ultimately billed to Medicare. The case is being prosecuted by Trial Attorney Jessica A. Massey of the Florida Strike Force.

Lisa Williams, 56, of Lithia, Florida, was charged by indictment with six counts of tampering with a consumer product and six counts of obtaining a controlled substance by fraud in connection with her unlawfully acquiring and tampering with fentanyl infusion bags at a hospital. The case is being prosecuted by Assistant U.S. Attorney Greg Pizzo of the U.S. Attorney’s Office for the Middle District of Florida.

Lawrence Waldman, 57, of Miami, Florida, was charged by indictment with conspiracy to defraud the United States and to solicit and receive illegal kickbacks and bribes, as well as with illegal monetary transactions, in connection with a scheme to submit false and fraudulent claims to Medicare. As alleged in the indictment, Waldman worked for ASAP Lab, LLC as a sales representative. Waldman used his position with ASAP to travel throughout the State of Florida, and elsewhere, to obtain genetic test and respiratory viral panel test swabs from Medicare beneficiaries. Waldman and his coconspirators used the test swabs, along with requisition forms containing forged and unauthorized signatures of medical practitioners, to obtain approximately $380,000 in illegal kickbacks and bribes for causing the submission of false and fraudulent claims for reimbursement from Medicare. The case is being prosecuted by Assistant U.S. Attorney Tiffany E. Fields of the U.S. Attorney’s Office for the Middle District of Florida.

Erin Kim, 54, of Orlando, Florida, was charged by indictment with conspiracy to distribute controlled substances and distribution of controlled substances, in connection with her role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the indictment, Kim was a nurse practitioner employed by Done, a California-based digital health company. In the course of her employment with Done, Kim prescribed Adderall and other stimulants that were not for a legitimate medical purpose in the usual course of professional practice. The indictment further alleges that Kim and others fabricated patient files and signed prescriptions for Adderall and other stimulants where Done patients did not meet the requisite diagnostic criteria for attention-deficit/hyperactivity disorder, where the prescriptions posed a risk of diversion, and where the dosages went beyond what was normally prescribed. In total, Kim is alleged to have prescribed over 1.5 million pills of Adderall and other stimulants, for which she was paid by Done over $800,000. Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force is prosecuting the case.
Eric Brewer, 28, of Lakeland, Florida, was charged by indictment with tampering with a consumer product and obtaining a controlled substance by fraud in connection with his unlawfully acquiring and tampering with fentanyl infusion bags. As alleged in the indictment, Brewer, a registered nurse who worked in intensive care units, engaged in two similar criminal schemes to divert fentanyl at five different Tampa-area hospitals across seven different dates. In the first scheme, which Brewer executed on several occasions, Brewer stole fentanyl by checking out 100 mL bags of liquid fentanyl from locked controlled substance cabinets but keeping the bags for himself rather than administering them to patients or returning them. In the second scheme, Brewer used hospital computers to research which patients were receiving fentanyl intravenously, entered those patients’ rooms even when he had no medical reason to do so, and surreptitiously siphoned fentanyl from their IV drip bags into his own vessel; Brewer would then go to the hospital bathroom, where he would inject himself with stolen fentanyl. Sometimes, Brewer tried to cover his theft by replacing the fentanyl he withdrew with an equivalent volume of saline, but sometimes he did not. In both scenarios, however, Brewer’s actions deprived the most vulnerable patients of needed medicine. Brewer was caught when colleagues observed him acting impaired during a shift and the person who entered the bathroom immediately after Brewer exited found a bloody paper towel and needle inside. Hospital officials subsequently examined records and video and discovered Brewer’s pattern of diversion. The case is being prosecuted by Assistant U.S. Attorney Mike Gordon of the U.S. Attorney’s Office for the Middle District of Florida.

Southern District of Florida

Marco Antonio Ramos Izquierdo, Marelys Ruiz Ulloa, 45, Jakeline Acnet Canova Cebrian, 58, Roberto Cisneros Cebrian, 53, Jose Antonio Rio Roche, 53, Reiniel Claro Estrada, 42, Maria De Los Angeles Abreu Perez, 37, Nelson Enrique Gonzalez Diaz, 38, Jonathan Jose Martinez Lambrano, 41, Ana Maria Gomez Contreras, 42, Levy Alberto Colina Garcia, 37, and Gloria Guillibeth Diaz Salas, 34, were charged by indictment with conspiracy to commit money laundering and money laundering for their role in distributing the proceeds of 14 durable medical equipment (“DME”) companies. According to the indictment, Medicare and Medicaid paid these 14 companies approximately $17,600,000 as a result of false and fraudulent claims for DME. The indictment details how the DME companies transferred approximately $3,906,649 of the fraud proceeds to shell companies, including those owned by Ramos Izquierdo, Ruiz Ulloa, Canova Cebrian, Cisneros Cebrian, Rio Roche, and Claro Estrada. Those defendants then made cash withdrawals from their shell companies and also wrote checks from the shell companies that received these fraud proceeds to individual check cashers, including individual checks between $4,000 and $9,000 totaling a combined approximate amount of $2,513,381 made out to Abreu Perez, Gonzalez Diaz, Martinez Lambrano, Gomez Contreras, Colina Garcia, and Diaz Salas. The case is being prosecuted by Assistant U.S. Attorney Will J. Rosenzweig of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Marx Calderon is handling asset forfeiture.
Santiago Garcia Jorge, 49, of Land O’ Lakes, Florida, was charged by indictment with conspiracy to commit money laundering and money laundering for his role in distributing the proceeds of a fraudulent durable medical equipment company. The indictment alleges that in connection with his role as the president and registered agent of Gold Medical Supply Inc., a company that submitted false and fraudulent claims to Medicare and Medicaid in the approximate amount of $7,498,260 and was paid approximately $1,402,478 by Medicare and Medicaid, Garcia Jorge transferred approximately $1,384,875 of the fraud proceeds to shell companies located in the Southern District of Florida. Garcia Jorge did so by writing approximately $174,990 in checks directly to those shell companies, but also by transferring approximately $1,209,855 to three other Gold Medical bank accounts that he controlled before then transferring them to the same shell companies. The case is being prosecuted by Assistant U.S. Attorney Will J. Rosenzweig of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Marx Calderon is handling asset forfeiture.
Jorge Acosta, 55, of Land O’ Lakes, Florida, was charged by information with conspiracy to commit health care fraud in connection with an alleged scheme to defraud various private insurance plans. According to the information, Acosta was a licensed physical therapist who worked at Phoenix Rehab Center Corp., a medical clinic based in Miami, Florida. Acosta’s co-conspirators offered and paid kickbacks to patient recruiters in exchange for referring beneficiaries of Administrative Services Only (“ASO”) corporate insurance plans, held by employers JetBlue Airways and AT&T Inc. and administered by Blue Cross Blue Shield (“BCBS”), to Phoenix Rehab for various forms of physical therapy treatments that they did not need and in many cases never received. Acosta falsified and backdated claims forms for submission to BCBS that falsely and fraudulently represented that various health care benefits had been provided by Phoenix Rehab to beneficiaries of BCBS and ASO insurance plans managed by BCBS. The case is being prosecuted by Assistant U.S. Attorney Will J. Rosenzweig of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Marx Calderon is handling asset forfeiture.
Omar Cabrera Hernandez, 55, of Miami, Florida, was charged by information with conspiracy to offer and pay health care kickbacks to patients. Hernandez, as the administrator of the clinic Advanced Community Wellness Center, Inc. in Hialeah, Florida, participated in a conspiracy to pay patients illegal kickbacks to attend psychosocial rehabilitation services at the clinic which were then billed to Medicaid. This conduct resulted in an improper benefit of at least $400,597 and in claims to Medicaid totaling over approximately $3.5 million. The case is being prosecuted by Assistant U.S. Attorney Timothy Abraham of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Emily Stone is handling asset forfeiture.
Yordany Rivera Bermudez, 35, of Fort Myers, Florida, was charged by indictment with health care fraud in connection with a scheme to defraud Medicare and Medicaid of nearly $3 million for durable medical equipment (“DME”) that was never supplied to Medicare beneficiaries and Medicaid recipients. As alleged in the indictment, Rivera Bermudez was the president and operator of Acqualina Health Medical Solutions Inc. (“Acqualina”), a company located in North Miami, Florida, that purported to provide DME to eligible Medicare and Medicaid recipients. In a ten-month period, Acqualina submitted approximately $2.9 million in allegedly fraudulent health care claims to Medicare and Medicaid for DME that Acqualina never provided, and that Medicare and Medicaid recipients never requested or needed. As a result, Medicare and Medicaid paid approximately $1.2 million to Acqualina. The case is being prosecuted by Special Assistant U.S. Attorney Marc Canzio of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Mitch Hyman is handling asset forfeiture.
Jorge Luis Pajon Rodriguez, 58, of Miami, Florida, was charged by information with conspiracy to offer and pay health care kickbacks to patients in connection with a scheme to defraud Medicaid. As alleged in the information, Pajon, as the owner of the Miami, Florida clinic Gables Community Wellness Center, Inc., participated in a conspiracy to pay patients illegal kickbacks to attend psychosocial rehabilitation services at the clinic which were then billed to Medicaid. This conduct resulted in an improper benefit of at least $1,338,184 and in claims to Medicaid totaling over approximately $6 million. The case is being prosecuted by Assistant U.S. Attorney Timothy Abraham of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Emily Stone is handling asset forfeiture.

Yoan Manuel Sanchez Cardet, 34, of Homestead, Florida, and Alain Cabrera Marquez, 48, of Austin, Texas, were charged by indictment with conspiracy to commit health care fraud and wire fraud in connection with an alleged scheme to fraudulently obtain more than $3.2 million in Medicare funds. According to the indictment, Sanchez Cardet was involved in arranging the purchase of a durable medical equipment company, PRNX Medical Supply Corp., that was acquired for the sole purpose of submitting fraudulent claims to Medicare. According to the indictment, Sanchez Cardet was also involved in installing Cabrera Marquez as the sole listed officer of PRNX Medical who signed relevant documents on behalf of the company, in order to conceal the identities of the beneficial owners of the company. The case is being prosecuted by Assistant U.S. Attorney Aimee C. Jimenez of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Daren Grove is handling asset forfeiture.

Daniel David Espinoza, 55, of Parkland, Florida, was charged by information with conspiracy to commit money laundering for allegedly laundering illegal proceeds derived from a health care fraud scheme. According to the information, five durable medical equipment (“DME”) companies received approximately $5 million from Medicare for the submission of false and fraudulent claims for DME that they did not actually provide and/or was not medically necessary. Espinoza then laundered approximately $3.4 million of those fraud proceeds, primarily through his own company, Danoza Enterprises, and disbursed the proceeds to himself, his family, and others involved in the fraud. The case is being prosecuted by Assistant U.S. Attorney Aimee C. Jimenez of the U.S. Attorney’s Office for the Southern District of Florida. Assistant U.S. Attorney Daren Grove is handling asset forfeiture.

Justin Blair, 34, and Trevor Blair, 30, both of Boca Raton, Florida, were charged by indictment with conspiracy to defraud the United States and to receive health care kickbacks, solicitation and receipt of kickbacks in connection with a federal health care program, conspiracy to commit money laundering, and money laundering in connection with an alleged kickback scheme involving a laboratory based in Texas. As alleged in the indictment, Justin Blair and Trevor Blair were partners in P.I.C. Group 21, LLC (“PIC Group”), a call center that conducted deceptive telemarketing to persuade Medicare beneficiaries and their doctors to order genetic tests. PIC Group allegedly sold signed orders to the lab, which billed Medicare more than $3.5 million based on the orders from PIC Group. PIC Group allegedly received more than $2.5 million in kickbacks and laundered the proceeds through entities controlled by the defendants. The case is being prosecuted by Trial Attorney Owen Dunn of the Florida Strike Force.
Enrique Perez-Paris, 47, of Aventura, Florida; Diego Sanudo Sanchez Chocron, 47, of Venice, California; Gregory Charles “Milo” Caskey, 57, of San Antonio, Texas; Omar Palacios, 34, of Miami, Florida; and Nadir Perez, 26, of Miami, Florida, were charged by superseding indictment with conspiracy to commit health care fraud, health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, and conspiracy to commit money laundering in connection with an alleged $65 million scheme to bill health care benefit programs, including Medicare and the Health Resources and Services Administration COVID-19 Uninsured Program, for medically unnecessary and otherwise non-reimbursable COVID-19 and genetic testing. Palacios and Perez were also charged with receipt of kickbacks in connection with a federal health care program. As alleged in the superseding indictment, Perez-Paris, Sanchez, and Caskey owned Innovative Genomics, an independent clinical laboratory in San Antonio, Texas. Perez-Paris, Sanchez, and Caskey paid kickbacks and bribes to physicians and patient recruiters, including Palacios and Perez, to generate orders for COVID-19 and genetic testing that Innovative Genomics would use to support false and fraudulent claims for reimbursement. The defendants also caused health care benefit programs to be billed for COVID-19 testing that the Food and Drug Administration had not approved for emergency-use authorization. The defendants further caused Medicare to be billed for genetic testing that patients did not need, that was procured by payments made directly to physicians, and that Innovative Genomics did not process. Trial Attorney Reginald Cuyler Jr. of the Florida Strike Force is prosecuting the case. Assistant U.S. Attorney Marx Calderon of the U.S. Attorney’s Office for the Southern District of Florida is handling asset forfeiture.
Adam Brosius, 59, of Delray Beach, Florida, Patrick Boyd, 43, and Charles Boyd, 46, both of Easton, Maryland were charged by indictment with conspiracy to introduce into interstate commerce adulterated and misbranded drugs and to defraud the United States; introducing into interstate commerce misbranded drugs; conspiracy to traffic in medical products with false documentation; conspiracy to commit wire fraud; and wire fraud. As alleged in the indictment, Patrick Boyd and Charles Boyd were the owners of Safe Chain Solutions LLC, a wholesale distributor of pharmaceutical drugs. Brosius was a part owner of Safe Chain and the owner of Worldwide Pharma Sales Group, Inc., which helped Safe Chain locate suppliers of HIV drugs and pharmacy customers to purchase HIV drugs. According to the indictment, Safe Chain purchased more than $90 million of heavily discounted and diverted prescription drugs, primarily HIV medication, from five black-market suppliers. These diverted HIV drugs were often acquired through unlawful “buyback” schemes, in which previously dispensed bottles of prescription drugs were purchased from patients. The drugs were then resold to Safe Chain with falsified documentation designed to conceal the true source of the medications. After purchasing HIV medication from the black-market suppliers, the defendants sold the diverted drugs to pharmacies throughout the country. Pharmacies then dispensed these diverted HIV medications to unsuspecting patients. At times, patients received bottles labeled as their prescription medication, but the bottles contained a different drug entirely, with one patient passing out and remaining unconscious for 24 hours after taking an anti-psychotic drug thinking it was his prescribed HIV medication. The case is being prosecuted by Trial Attorneys Alexander Thor Pogozelski of the Market Integrity and Major Frauds Unit and Jacqueline DerOvanesian of the Florida Strike Force. Assistant U.S. Attorney Jorge Delgado of the U.S. Attorney’s Office for the Southern District of Florida is handling asset forfeiture.
Alicia Hiller, 45, of Pompano Beach, Florida, was charged by indictment with conspiracy to commit wire fraud and health care fraud, and health care fraud, in connection with her role in an unlawful scheme to defraud Medicare by submitting false and fraudulent claims for medically unnecessary durable medical equipment (“DME”). As alleged in the indictment, Hiller was the owner of Lifeline Recruiting, Inc., which she used to pay medical providers to sign prescriptions for DME, even though the providers were not reviewing the beneficiaries’ medical records and were not making an actual assessment of medical necessity. Hiller described these providers as “happy clickers” or “auto-clickers.” Those prescriptions were then used to submit false and fraudulent claims to Medicare for the medically unnecessary DME. As a result of the scheme, Medicare paid more than $40 million on the false and fraudulent claims. Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force is prosecuting the case.
Wesley Jackson, 28, of Long Island City, New York was charged by information with health care fraud in connection with an alleged scheme to fraudulently bill Medicare for over $2.1 million for medically unnecessary orthotic braces, using sham contracts and invoices to disguise the payments. According to the information, Jackson, the owner of a marketing company called Jackson Media LLC, sold doctors’ orders for medically unnecessary orthotic braces to durable medical equipment suppliers in exchange for kickbacks and bribes. The case is being prosecuted by Trial Attorney Jacqueline DerOvanesian of the Florida Strike Force. Assistant U.S. Attorney Jorge Delgado of the U.S. Attorney’s Office for the Southern District of Florida is handling asset forfeiture.
Ryan Michael Pattrin, 48, of Fort Lauderdale, Florida, was charged by indictment with conspiracy to commit health care fraud and wire fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, and solicitation and receipt of kickbacks. According to the indictment, Pattrin was one of the owners of Infinity Medical Supply LLC, a durable medical equipment (“DME”) company that billed Medicare for medically unnecessary DME based on doctors’ orders procured through illegal kickbacks and bribes. The indictment also alleges that Pattrin was one of the owners of National Health Care Advocates LLC, a purported marketing company that referred doctors’ orders for DME to DME companies in exchange for illegal kickbacks and bribes. The indictment alleges that Pattrin and his co-conspirators caused DME companies, including Infinity, to submit over $7.9 million in false and fraudulent claims to Medicare. The case is being prosecuted by Trial Attorney Andrea Savdie of the Florida Strike Force.
Michael Cascone, 31, of Palm Beach County, Florida was charged by information with conspiracy to commit health care fraud. According to the information, Cascone owned two durable medical equipment (“DME”) companies, Limitless Medical Supplies, LLC and Your Medical Supply Co, LLC, that paid illegal kickbacks and bribes to a purported marketing company in exchange for referring beneficiaries and doctors’ orders for DME that was medically unnecessary and ineligible for reimbursement by Medicare. The information alleges that through Limitless Medical Supplies, LLC and Your Medical Supply Co, LLC, Cascone submitted approximately $3,493,466 in false and fraudulent claims for reimbursement from Medicare. The case is being prosecuted by Trial Attorney Andrea Savdie of the Florida Strike Force.
Angelica Pacheco, 37, of Hialeah, Florida, was charged by indictment with conspiracy to commit health care fraud and wire fraud, health care fraud, and wire fraud in a sober home scheme involving $19.2 million billed to private insurers. Pacheco owned and operated Florida Life Recovery and Rehabilitation LLC (“Florida Life”) which purportedly provided several levels of outpatient substance abuse care. As alleged in the indictment, Pacheco submitted or caused the submission of false and fraudulent claims to private insurers for therapy services that were not provided, or were not provided as billed, and excessive and medically unnecessary urinalyses that were not factored into patient treatment. The indictment further alleges that Pacheco fraudulently obtained Paycheck Protection Program and Economic Injury Disaster Loan Program loans on behalf of Florida Life by falsely certifying that the company was not engaged in any illegal activities. In November 2023, Pacheco was elected to the City Council for the City of Hialeah. The case is being prosecuted by Assistant Chief James Hayes of the National Rapid Response Strike Force and Trial Attorney Aisha Schafer Hylton of the Florida Strike Force.

Deborah Smith, 62, of Hialeah, Florida, and Mabel de la Caridad Rodriguez Brito, 53, of Miami, Florida, were charged by information with conspiracy to commit health care fraud in connection with an alleged scheme to fraudulently obtain over $58,000 in Medicare funds. According to the information, Smith and Rodriguez were employees at a medical facility, and sold Medicare patient information in exchange for cash. That patient information was later used to submit false and fraudulent claims to Medicare for durable medical equipment that was never provided and/or was medically unnecessary and ineligible for reimbursement by Medicare. The case is being prosecuted by Trial Attorney Jessica A. Massey of the Florida Strike Force and Health Care Fraud Unit Assistant Chief Emily Gurskis.
Betscy Kurian, 59, of Coral Springs, Florida, was charged by information with conspiracy to distribute and dispense controlled substances, in connection with a scheme to dispense controlled substances, primarily oxycodone. As alleged in the information, Kurian, a pharmacist, dispensed oxycodone knowing that these prescriptions were not written in the course of professional practice for a legitimate medical purpose. The case is being prosecuted by Trial Attorney Jacqueline DerOvanesian of the Florida Strike Force.
Lianet Sacerio, 38, of Miami, Florida, was charged by information with obstruction of criminal investigations of health care offenses. As charged in the information, from March 2022 through March 2023, Sacerio made false representations to law enforcement agents regarding her own knowledge, involvement, and financial interest in health care fraud offenses under investigation. The case is being prosecuted by Assistant U.S. Attorneys Joseph Egozi and Lindsey Lazopoulos Friedman of the Southern District of Florida. Assistant U.S. Attorney Joshua Paster is handling asset forfeiture.

Northern District of Illinois

Kathryn Bach, 59, of Wheaton, Illinois, a licensed clinical social worker, was charged by information with health care fraud, in connection with a scheme to defraud Medicare. As alleged in the information, between October 2020 and April 2022, Bach caused the submission of fraudulent claims to Medicare for psychological counseling services that were not actually provided. Bach purported to perform these services at memory care facilities in the Chicago metropolitan area. Through her scheme, Bach fraudulently obtained $122,130 in payments based on claims for services that were not provided. The case is being prosecuted by Trial Attorney Victor Yanz of the Midwest Strike Force.
Abdul Aziz Mohammed, 48, of New York, New York, was charged by complaint with health care fraud and engaging in a monetary transaction in criminally derived property, in connection with his ownership and operation of purported COVID-19 laboratory company Spectrum Lab Corp. As alleged in the complaint, Mohammed executed a scheme to defraud by using Spectrum Lab Corp. to bill Medicare for over-the-counter COVID-19 test kits that were not provided as represented. This fraud resulted in the submission of over $15 million in false and fraudulent claims to Medicare, and payments by Medicare of approximately $7.1 million based on these claims. The case is being prosecuted by Trial Attorneys Andres Almendarez and Victor Yanz of the Midwest Strike Force.

Eastern District of Kentucky

Stephanie Collins, 57, of Corbin, Kentucky, was charged by information with health care fraud in connection with a scheme to bill Medicare and Medicaid for prescription drugs that were never dispensed by her pharmacy. As alleged, between January 2014 and June 2020, Collins, the owner of Stephanie’s Down Home Pharmacy, knowingly and willfully caused claims for prescription drugs to be submitted to those health care programs despite knowing that the drugs at issue were never dispensed to pharmacy customers, and obtained approximately $730,000 as a result of the scheme. The case is being prosecuted by Assistant U.S. Attorney Andy Smith of the U.S. Attorney’s Office for the Eastern District of Kentucky.
Don V. Bryson, 69, of Oil Springs, Kentucky, was charged by information with a conspiracy to unlawfully distribute controlled substances by using the name and DEA registration number of another physician. As alleged, Bryson was a physician who had surrendered his medical license following a Kentucky Board of Medical Licensure investigation into his prescribing practices. Bryson continued to work as a “medical consultant” at a clinic in Paintsville, Kentucky owned by a co-conspirator, which utilized locum tenens providers to issue controlled substance prescriptions. In September 2021, Bryson agreed with the clinic owner to use the name and DEA registration number of a locum tenens provider no longer affiliated with the clinic, without that provider’s knowledge, in order to issue approximately 79 hydrocodone prescriptions, totaling approximately 6,915 hydrocodone pills. The case is being prosecuted by Assistant U.S. Attorney Andy Smith of the U.S. Attorney’s Office for the Eastern District of Kentucky.

Western District of Kentucky

Shafi Abbas, 57, of Pendleton, Kentucky, was charged by information with conspiracy to commit health care fraud and money laundering in connection with an alleged scheme to fraudulently obtain over $2.6 million in Medicare funds. According to the information, Abbas, through Aidmen Medical Equipment LLC and Justright Medical Equipment LLC, fraudulently billed Medicare for durable medical equipment which was medically unnecessary, unwanted by patients, and not prescribed by the patients’ medical providers. Based on those false and fraudulent claims, Medicare paid approximately $1.3 million. In addition, Abbas allegedly transferred offshore the proceeds of health care fraud in a value greater than $10,000. The case is being prosecuted by Assistant U.S. Attorney Joseph Ansari of the U.S. Attorney’s Office for the Western District of Kentucky.
Carissa Uptegraff, 44, of Glasgow, Kentucky, was charged by indictment with theft of medical products. According to the indictment, Uptegraff, a pharmacy employee, stole a pre-retail medical product, oxycodone, which had a value over $5,000. The alleged thefts took place at two different pharmacies prior to the controlled substances being made available for retail purchase by a consumer. The case is being prosecuted by Assistant U.S. Attorney Joseph Ansari of the U.S. Attorney’s Office for the Western District of Kentucky.
Dr. Lawrence Peters, 62, of Louisville, Kentucky, was charged by information with conspiracy to illegally use a Drug Enforcement Administration (“DEA”) registration number issued to another. According to the information, Dr. Lawrence Peters allegedly conspired with others in his medical practice to issue pre-signed and unsigned prescriptions for Schedule II controlled substances and further directed his staff to fill the prescriptions at his physician’s owned pharmacy. The case is being prosecuted by Assistant U.S. Attorneys Joseph Ansari and Chris Tieke of the U.S. Attorney’s Office for the Western District of Kentucky.
Tammy Daniels a/k/a Tammy Richardson, 55, of Louisville, Kentucky, was charged by indictment with mail fraud and health care fraud in connection with an alleged scheme to fraudulently obtain over $750,000 from her employer, a medical practice, and over $422,000 in Medicare funds. According to the indictment, Daniels was employed as the accounts manager for a medical practice when she used the medical practice’s credit cards to purchase personal items, transferred money from the practice’s bank account to pay the credit card invoices, transferred money from the practice’s bank account to pay for other personal credit card purchases, and used her access and position to bill for false and fraudulent medical procedures to pay credit card invoices in order to hide the unlawful use of the credit cards, all without her employer’s knowledge and authorization. As a result of the fraudulent scheme, health care benefit programs, including Medicare, paid over $79,000. The case is being prosecuted by Assistant U.S. Attorney Joseph Ansari of the U.S. Attorney’s Office for the Western District of Kentucky.
Michael Boaz, 45, and Christopher Augustus, 40, of Clinton, Kentucky were charged by indictment with conspiracy to commit health care fraud, health care fraud, and aggravated identity theft in connection with an alleged scheme to fraudulently obtain over $1,000,000 from health care benefit programs. According to the indictment, Boaz and Augustus falsely and fraudulently billed various health care benefit programs for medications dispensed from the Clinton and Bardwell Pharmacies by using material misrepresentations, material omissions, and deception in order to obtain authorization for the medications from physicians and nurse practitioners. In addition, the indictment alleges that Boaz and Augustus knowingly possessed, transferred, or used the means of identification of two individuals, a nurse practitioner and a physician, including the individuals’ names and unique National Provider Identifier numbers, without lawful authority, in relation to the health care fraud. The case is being prosecuted by Assistant U.S. Attorney Raymond McGee of the U.S. Attorney’s Office for the Western District of Kentucky.

Eastern District of Louisiana

Dennis Peyroux, 57, of Slidell, Louisiana, was charged by indictment with conspiracy to commit health care fraud and health care fraud in connection with a scheme to bill Medicare for over-the-counter (“OTC”) COVID-19 test kits that were not requested or otherwise ineligible for reimbursement. According to the indictment, starting in or around November 2022, Peyroux conspired with others to purchase Medicare beneficiary information, including names, Medicare identification numbers, and clearly fabricated recordings of individuals posing as beneficiaries and “requesting” OTC COVID-19 test kits, which Peyroux used to bill Medicare through his chiropractic clinic for test kits. Peyroux then misappropriated the credentials of a former nurse practitioner that worked for him and falsely listed the nurse practitioner as the referring provider on the thousands of false and fraudulent claims. In total, in around six months, Peyroux allegedly billed Medicare approximately $3.3 million in false and fraudulent claims for OTC COVID-19 test kits through his clinic, for which Medicare reimbursed approximately $3.2 million. The case is being prosecuted by Trial Attorney Kelly Z. Walters of the Gulf Coast Strike Force and Assistant U.S. Attorney Nicholas D. Moses of the U.S. Attorney’s Office for the Eastern District of Louisiana.
Dr. Benjamin Tekippe, 39, of Orleans Parish, Louisiana, was charged by second superseding indictment for his role in health care and unemployment insurance fraud schemes. Dr. Tekippe, a chiropractor and owner of Metairie Chiropractic, was charged with health care fraud, making a false statement to a federal agent, and wire fraud. As alleged in the second superseding indictment, Dr. Tekippe billed Blue Cross Blue Shield of Louisiana (“BCBSLA”) for chiropractic services he did not perform, lied to a federal agent about his falsification of medical records, and further claimed he was unemployed at the beginning of the COVID-19 pandemic, when he was, in fact, billing for chiropractic services purportedly performed during his time of unemployment. It is alleged that, in total, Dr. Tekippe fraudulently submitted over $2.3 million in claims to BCBSLA for services not performed and was reimbursed approximately $740,000. Additionally, it is alleged that Dr. Tekippe received $12,952 in unemployment insurance benefits to which he was not entitled. The case is being prosecuted by Trial Attorneys Kelly Z. Walters and Samantha Usher of the Gulf Coast Strike Force.
John Christopher Barrilleaux, 64, of Thibodaux, Louisiana, was charged by information with health care fraud in connection with a scheme to bill private insurance companies for mental health treatment and medical services that were not provided. According to court documents, Barrilleaux, a licensed clinical social worker, created treatment plans for patients that falsely and fraudulently indicated that they would receive mental health treatment on certain days, and then submitted false and fraudulent claims for purported services provided on those dates, even if no services were provided. Barrilleaux also allegedly misappropriated the medical credentials of a local gastroenterologist to bill for additional medical services which were not provided. In order to conceal the fraud, Barrilleaux fabricated patient notes and submitted the falsified notes to auditors in order to make it falsely appear as if he had provided services to patients. He then allegedly used the proceeds of the fraud for his personal benefit, including gambling, fine art, and real estate. It is alleged that, in total, Barrilleaux, through his companies, submitted approximately $6 million in false and fraudulent claims for which approximately $4.5 million was paid. The case is being prosecuted by Trial Attorney Kelly Z. Walters of the Gulf Coast Strike Force and Assistant U.S. Attorney Nicholas D. Moses of the U.S. Attorney’s Office for the Eastern District of Louisiana.

Middle District of Louisiana

Kevan Andre Hills, 30, Devin Tyrone Stampley, Jr., 32, and Asia Deshan Guess, 27, all of Baton Rouge, Louisiana, were charged by indictment with conspiracy to acquire and obtain possession of controlled substances by fraud and to distribute and possess with the intent to distribute controlled substances, conspiracy to commit health care fraud, and aggravated identity theft; Hills and Stampley were further charged with acquiring and obtaining possession of controlled substances by fraud; and Stampley was charged with one count of burglary of a pharmacy, all in connection with a scheme to forge prescriptions for controlled substances and cause the submission of false and fraudulent claims to Medicaid for the forged prescriptions. As alleged in the indictment, beginning in or around April 2021, and continuing through in or around February 2023, Hills, Stampley, Guess, and their co-conspirators fraudulently obtained controlled substances from pharmacies in the Baton Rouge area and elsewhere using at least 97 fraudulent prescriptions bearing the DEA registration numbers and other identifying information of at least 12 physicians and other medical professionals without authority. The indictment further alleges that, in April 2022, Stampley burglarized a pharmacy in Louisiana. The case is being prosecuted by Trial Attorneys Gary A. Crosby II and Samantha E. Usher of the Gulf Coast Strike Force and Assistant U.S. Attorney Kristen L. Craig of the U.S. Attorney’s Office for the Middle District of Louisiana.

Western District of Louisiana

Michael L. Riggins, 61, of Ouachita Parish, Louisiana, was charged by indictment with conspiracy to commit health care fraud and health care fraud for his role in a durable medical equipment (“DME”) scheme. As alleged in the indictment, Riggins was the owner of Bluewater Healthcare (“Bluewater”), a DME supply company in West Monroe, Louisiana. It is alleged that from 2018 to 2023, Riggins paid for doctors’ orders for pneumatic compression devices (“PCDs”), a type of DME, and tricked doctors into signing DME orders and certificates of medical necessity in order to bill for the expensive and medically unnecessary DME. In total, Riggins submitted over $3.8 million in fraudulent claims to Medicare for supplying PCDs and was reimbursed over $1.8 million. The case is being prosecuted by Trial Attorneys Samantha Usher and Kelly Z. Walters of the Gulf Coast Strike Force and Assistant U.S. Attorney Brian Flanagan of the U.S. Attorney’s Office for the Western District of Louisiana.

Eastern District of Michigan

Ibrahim Sammour, 63, and Bashier Sammour, 28, of Wayne County, Michigan, were charged by indictment with conspiracy to pay illegal kickbacks, Ibrahim Sammour was additionally charged with conspiracy to commit health care fraud and health care fraud, and Bashier Sammour was additionally charged with making false statements relating to health care matters, all in connection with an alleged scheme to fraudulently obtain over $2 million from Medicare. According to charging documents, the Sammours operated Individualized Home Health Care, P.C., through which they submitted false and fraudulent claims to Medicare for home health care services that were medically unnecessary, not provided as represented, or not rendered. Five others were also charged by information—two registered nurses, two group home owners, and a licensed practical nurse—for their involvement in the charged conspiracies. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Jeff Crapko of the Midwest Strike Force.
Yvette Hardy, 60, of Wayne County, Michigan, was charged by information with health care fraud in connection with an alleged scheme to fraudulently obtain over $3.4 million in Medicare funds. According to the information, Hardy, who owned and operated Pebble Brook Care Agency LLC, caused the submission of false and fraudulent claims to Medicare for psychotherapy services that were not provided as represented or not rendered at all. The case is being prosecuted by Trial Attorney Shankar Ramamurthy of the Midwest Strike Force.
Ruby Scott, 53, of Oakland County, Michigan, was charged by indictment with a conspiracy to defraud the United States and to pay illegal health care kickbacks, as well as with paying illegal health care kickbacks, in connection with an alleged scheme to fraudulently obtain over $2.2 million in Medicare funds. According to the indictment, Scott, who owned and operated Delta Home Health Care LLC, caused the submission of claims to Medicare for home health care services obtained through the payment of illegal kickbacks to patient recruiters in violation of the Anti-Kickback Statute. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Kelly Warner of the Midwest Strike Force.

Dr. Vijil Rahulan, 52, of Hyderabad, India, was charged by indictment with conspiracy to commit heath care fraud and health care fraud, in connection with an alleged scheme to fraudulently obtain over $82 million in Medicare funds. As alleged in the indictment, Rahulan caused the submission of false and fraudulent claims for durable medical equipment and genetic testing that were medically unnecessary or otherwise ineligible for reimbursement through Medicare because they were not the product of a doctor-patient relationship and examination. The indictment further alleges that the defendant’s fraudulent conduct resulted in over $28.7 million being paid by Medicare. The case is being prosecuted by Trial Attorneys Kelly Warner and Andres Almendarez of the Midwest Strike Force.
Amro Sharafeldin, 40, of Michigan, was charged by criminal complaint with a scheme to violate the Anti-Kickback Statute and illegally purchase Medicare beneficiary information, in connection with Sharafeldin’s operation of Prestige Specialty Pharmacy (“Prestige”) in Sterling Heights, Michigan. As alleged in the complaint, Sharafeldin, through Prestige, agreed to pay kickbacks and bribes to illegally acquire Medicare beneficiary information, which he and others then used in February and March 2023 to bill Medicare more than $1 million for over-the-counter COVID-19 test kits, regardless of whether the Medicare beneficiary requested the test kits. The case is being prosecuted by Assistant U.S. Attorney Andrew Lievense of the U.S. Attorney’s office for the Eastern District of Michigan.

Western District of Michigan

Dr. Theresa Kordish, 70, of Kalamazoo, Michigan, was charged by information with making a false statement in connection with a health care benefit program, in connection with a scheme to defraud Medicare. As alleged, Kordish used a telehealth application to improperly approve orders for medical braces and genetic testing. For each order, Kordish signed and certified that the order was medically indicated and necessary for a particular Medicare beneficiary. In reality, Kordish clicked to approve orders without conducting any meaningful review, often in a matter of seconds. Medicare paid over $794,000 based on the false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorney Patrick Castle of the U.S. Attorney’s Office for the Western District of Michigan.

Southern District of Mississippi

Reginald Fullwood, Jr., 59, of Madison, Mississippi, was charged by information with conspiracy to defraud the United States in connection with a scheme to pay a marketer kickbacks for completed doctors’ orders so that he could cause his durable medical equipment (“DME”) company, Jackson Medical Supply, to bill Medicare and Medicare Advantage plans for orthotic braces that were medically unnecessary and/or ineligible for reimbursement. When Medicare initiated an investigation of Jackson Medical Supply, the defendant opened another entity in the name of a nominee owner and again paid a marketer kickbacks in exchange for doctors’ orders so that the new entity could continue to bill Medicare and Medicare Advantage plans for orthotic braces. Overall, the defendant caused these entities to bill Medicare and Medicare Advantage approximately $12,441,625.30 and the entities were reimbursed approximately $6,448,092.61 for DME that was medically unnecessary and/or ineligible for reimbursement. The case is being prosecuted by Trial Attorney Sara Porter of the Gulf Coast Strike Force and Assistant U.S. Attorney Kimberly Purdie of the Southern District of Mississippi.

District of Montana

Dr. Ronald David Dean, 64, of Whitefish, Montana, was charged by information with conspiracy to commit wire fraud in connection with a telemedicine scheme. As alleged in the information, Dean was paid by a telemedicine company to sign orders for durable medical equipment that patients did not need. Dean then fraudulently charged Medicare and other government health programs for telemedicine office visits that did not occur. The telemedicine company also used Dean’s information to prescribe unneeded and unnecessary COVID-19 tests to patients. In total, Dean’s orders resulted in false billing to government health care programs of over $39.6 million. The case is being prosecuted by Assistant U.S. Attorney Michael A. Kakuk of the U.S. Attorney’s Office for the District of Montana.

District of New Jersey

Richard Abrazi, 42, of New York, New York, was charged by indictment in connection with an alleged $60 million conspiracy to defraud the United States and to pay and receive health care kickbacks. Abrazi was the owner of Enigma Management Corp and Up Services, Inc., two related diagnostic laboratories which did business as Alliance Laboratories. According to the indictment, Abrazi and others engaged in a scheme to pay and receive kickbacks and bribes in exchange for laboratory tests, including genetic tests, that Enigma and Up billed to Medicare. Abrazi and others also allegedly paid and received kickbacks and bribes in exchange for arranging for the ordering of medically unnecessary genetic tests that were ineligible for Medicare reimbursement. Enigma and Up allegedly received over $5 million from Medicare for laboratory testing that was procured by kickbacks and bribes, not medically necessary, and not eligible for reimbursement. The case is being prosecuted by Trial Attorney Hyungjoo Han of the Northeast Strike Force.
Dr. Erie Agustin, 68, of Queens, New York, was charged by information with conspiracy to pay and receive health care kickbacks. As alleged in the information, Agustin, a medical doctor, participated in a scheme to receive kickbacks and bribes in exchange for ordering laboratory tests, including expensive cancer genetic tests, that were billed to Medicare. The information alleges that Agustin disguised the kickbacks and bribes by, among other ways, receiving the payments in cash. As part of the kickback scheme, Agustin and his co-conspirators caused in excess of approximately $7.1 million in false and fraudulent claims for laboratory testing to be submitted to Medicare, on which Medicare paid $461,719. The case is being prosecuted by Trial Attorney Hyungjoo Han of the Northeast Strike Force.
Elizabeth Butterworth, 62, of Cape May Court House, New Jersey, was charged by information with conspiracy to unlawfully distribute a controlled substance. Butterworth was a licensed advanced practice nurse in New Jersey. According to court documents, Butterworth issued prescriptions for controlled substances, including oxycodone, to her pain management patients in exchange for them agreeing to return a portion of the pills to her after the prescriptions were filled. The information alleges that Butterworth maintained her co-conspirators on higher dosages of oxycodone while she continued to receive a portion of their pills. From approximately 2016 through November 2023, Butterworth allegedly issued her co-conspirators prescriptions that resulted in at least 5,340 pills being dispensed to her co-conspirators. The case is being prosecuted by Trial Attorneys Nicholas K. Peone and Paul J. Koob of the Northeast Strike Force.
Michael Procopio, 49, of Philadelphia, Pennsylvania, was charged by information with conspiracy to unlawfully distribute a controlled substance. As alleged, Procopio diverted prescription medications from doctors’ offices in South Philadelphia and South Jersey for sale on the streets. From approximately January 2022 through February 2024, Procopio distributed 496 pills to a confidential human source. The case is being prosecuted by Trial Attorneys Paul J. Koob and Nicholas K. Peone of the Northeast Strike Force.
Kimberlee Otero, 47, of Camden, New Jersey, was charged by information with conspiracy to unlawfully distribute and possess with intent to distribute a controlled substance. The case is being prosecuted by Trial Attorney Nicholas K. Peone of the Northeast Strike Force and Assistant U.S. Attorney Jeffrey Bender of the U.S. Attorney’s Office for the District of New Jersey.

Hyunji Choi, a/k/a “Regina Choi,” a/k/a “Regina Beatrice,” 39, of Woodside, New York, was charged by information with conspiracy to commit health care fraud in connection with a scheme to defraud the Amtrak health care plan. As alleged in the information, Choi, a medical biller, submitted false and fraudulent claims to the Amtrak health care plan for services that were not provided, resulting in loss to the Amtrak health care plan of at least approximately $959,902.79. Choi paid cash bribes and kickbacks to co-conspirator Amtrak employees, in return for the employees’ agreement to allow their insurance to be used for false billing. The case is being prosecuted by Assistant U.S. Attorneys Katherine M. Romano and Jessica R. Ecker of the U.S. Attorney’s Office for the District of New Jersey.
Timothy Bogen, 59, of Hamden, Connecticut, Kevin Frink, 52, of Willingboro, New Jersey, Dion Jacob, 50, of Brooklyn, New York, Quinton Johnson, 52, of Irvington, New Jersey, David Lonergan, 64, of Rockaway Park, New York, David McBrien, 36, of Levittown, Pennsylvania, Gregory Richardson, 34, of Roosevelt, New York, Rodolfo Rivera, 41, of Clayton, Delaware, Michael Toal, 34, of Hazlet, New Jersey, and Damany Walker, 41, of Irvington, New Jersey, were charged by indictment with conspiracy to commit health care fraud in connection with a scheme to defraud the Amtrak health care plan, which resulted in a loss of approximately $11,054,831 to Amtrak. The defendants were Amtrak employees and participants in the Amtrak health care plan who allowed their personal and insurance information, and in some cases that of their dependents, to be used for false and medically unnecessary billing in return for cash kickbacks and bribes paid by co-conspirator health care providers. The case is being prosecuted by Assistant U.S. Attorneys Katherine M. Romano and Jessica R. Ecker of the U.S. Attorney’s Office for the District of New Jersey.
Elise Nocella, 54, of Naples, Florida, was charged by information with conspiring to violate the Anti-Kickback Statute by paying kickbacks for durable medical equipment (“DME”) orders. As alleged in the information, Nocella, who owned and operated a marketing company that marketed DME, offered and paid physicians at a pain management practice kickbacks in exchange for DME orders. Nocella supplied the physicians with a variety of expensive items, including cash, full-season access to a suite for professional football games, expensive lunches and dinners at networking events and practice group meetings, and other expensive gifts, and subsequently billed Medicare and other health care benefit programs for the orders. The case is being prosecuted by Assistant U.S. Attorney DeNae Thomas of the U.S. Attorney’s Office for the District of New Jersey.
Tefylon Cameron, 57, of Powder Springs, Georgia, was charged by information with one count of conspiracy to commit health care fraud and one count of conspiracy to violate the Anti-Kickback Statute in connection with her role in a $14.9 million health care fraud and kickback scheme related to durable medical equipment (“DME”) and cancer genetic testing (“CGx”). As alleged in the information, Cameron and her co-conspirators owned, operated, and had a financial interest in DME companies and obtained doctors’ orders for orthotic braces for Medicare beneficiaries without regard to medical necessity. Cameron and her co-conspirators also owned, operated, and had a financial interest in a CGx company through which she agreed to provide a clinical laboratory with leads for beneficiaries who were qualified to receive federal health care benefits for CGx tests. The case is being prosecuted by Assistant U.S. Attorney Matthew Specht of the U.S. Attorney’s Office for the District of New Jersey.

Eastern District of New York

Feng “Jeff” Jiang, 42, of Oakland Gardens, New York, was charged by indictment with conspiracy to commit health care fraud, conspiracy to defraud the United States and to pay illegal health care kickbacks, conspiracy to commit money laundering, and money laundering in connection with an alleged $23.8 million scheme involving multiple New York pharmacies. As alleged in the indictment, Jiang and his co-conspirators paid kickbacks in the form of supermarket gift certificates and cash to Medicare beneficiaries and Medicaid recipients who filled medically unnecessary prescriptions at Elmcare Pharmacy Inc. and NY Elm Pharmacy Inc. The indictment further alleges that Jiang and others wrote checks to various “trading companies” to obtain cash that was distributed as profits among the pharmacies’ owners and used to pay illegal kickbacks and bribes. The case is being prosecuted by Trial Attorney Patrick J. Campbell of the Northeast Strike Force.
Lyn Ballener, 45, of Queens, New York, was charged by information with conspiracy to commit health care fraud in connection with a scheme to bill no-fault automobile insurance companies for diagnostic testing that she had not actually performed. According to the information, Ballener, a licensed physical therapist and clinic owner, conspired to submit claims to insurance companies using her billing credentials in exchange for kickbacks paid to Ballener’s company. The case is being prosecuted by Trial Attorneys Miriam L. Glaser Dauermann of the National Rapid Response Strike Force and Patrick J. Campbell of the Northeast Strike Force.
Joseph Tony Brown-Arkah, 76, of Brooklyn, New York, and Evens Jean, 58, of Cape Coral, Florida, were charged by indictment in connection with an alleged $7.1 million health care fraud and narcotics distribution scheme. Brown-Arkah and Jean were charged with conspiracy to commit health care fraud, health care fraud, conspiracy to distribute narcotics and narcotics distribution, and Jean was also charged with false statements. As alleged in the indictment, Brown-Arkah, the owner of American Medical Utilization Management Corporation, a medical clinic in Brooklyn, New York, along with Jean, a Nurse Practitioner, and others engaged in an alleged scheme to bill Medicare and Medicaid fraudulently for services not provided, not provided as billed, or provided by a provider who had been excluded from Medicare and Medicaid, and to prescribe narcotics pursuant to prescriptions that were not issued for a legitimate medical purpose by a provider acting in the usual course of professional practice. Additionally, as alleged in the indictment, Jean made multiple false statements to law enforcement regarding his prescriptions of buprenorphine. The case is being prosecuted by Trial Attorneys Miriam L. Glaser Dauermann of the National Rapid Response Strike Force and Margaret Mortimer of the Northeast Strike Force.

Rene Acevedo, 44, of Queens, New York, was charged by information with conspiracy to commit health care fraud and paying illegal kickbacks. According to the information, Acevedo, a licensed pharmacist, paid thousands of dollars in bribes to physicians in cash and entertainment in order to induce the physicians to refer patients to his Queens pharmacy. Acevedo also billed Medicare and Medicaid for drugs that he did not actually dispense. The pharmacy billed Medicare and Medicaid, and was paid, approximately $600,000 for the patients referred as a result of the bribes. The case is being prosecuted by Trial Attorneys Miriam L. Glaser Dauermann of the National Rapid Response Strike Force and Arun Bodapati of the Northeast Strike Force.

Albert Muratov, 46, of Forest Hills, New York, pleaded guilty to health care fraud in connection with a scheme to defraud Medicare by billing for undispensed cancer medication. Muratov, who operated Ave M Pharmacy in Brooklyn, New York, handled the pharmacy’s finances and payments and, together with others, caused the submission of approximately 253 claims to Medicare for Targretin Gel 1% (“Targretin”). Targretin is approved for topical treatment of lesions in patients with a certain cancer and cost over $34,000 per tube. From 2017 to 2021, the defendant and his co-conspirators billed Medicare for Targretin that was medically unnecessary, not ordered by a professional, or that they did not dispense; as a result, Medicare paid Ave M Pharmacy more than $4 million. The case is being prosecuted by Assistant U.S. Attorney John Vagelatos of the U.S. Attorney’s Office for the Eastern District of New York.

Eastern District of North Carolina

Tasha Lanet Holland-Kornegay, 51, of Sanford, North Carolina, was charged by indictment with health care fraud, making and using false health care documents, wire fraud, conspiracy, illegal financial transactions, aggravated identity theft, and false statements to influence a bank on a loan, in connection with an alleged scheme to fraudulently bill and document more than $5.2 million in Medicaid funds. According to the indictment, Holland-Kornegay, a licensed clinical mental health counselor, and owner of Our Treatment Center and Partners Against Sexually Transmitted Diseases, two companies operating in Raleigh, North Carolina, caused fraudulent claims for psychotherapy services to be billed to Medicaid. The indictment further alleges that Kornegay conspired with others to fabricate clinical notes for previously billed psychotherapy services. The case is being prosecuted by Special Assistant U.S. Attorney Tasha C. Gardner of the U.S. Attorney’s Office for the Eastern District of North Carolina.

Western District of Oklahoma

Dr. Dustin York, 39, and Vince Carter, 39, both of Oklahoma City, Oklahoma, were charged by indictment with health care fraud and conspiracy to pay kickbacks in connection with the delivery of durable medical equipment (“DME”). According to the indictment, York, a licensed chiropractor, and Carter, his business partner, operated Discover DME, a DME supplier. Through Discover DME, York and Carter are alleged to have purchased doctors’ orders, paid kickbacks to obtain referrals through telemarketing companies, and then submitted false and fraudulent claims to Medicare based on those doctors’ orders and referrals. In total, the defendants caused Discover DME to submit to a federal health care program false and fraudulent claims for DME totaling over $4.8 million. Discover DME was paid over $1.1 million as a result of the false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorneys Thomas Snyder and D.H. Dilbeck of the U.S. Attorney’s Office for the Western District of Oklahoma.
Priscilla Orange, 66, of Oklahoma City, Oklahoma, was charged by indictment with obstruction of a federal audit, federal program theft, and making false statements to the Small Business Administration. As alleged in the indictment Orange operated a daycare provider in Oklahoma City that primarily served low-income children. Orange applied on behalf of her business for federal funds from programs administered by the Departments of Agriculture and Health and Human Services, as well as the Small Business Administration, and received approximately $494,000, but she subsequently misspent the money on impermissible personal expenses. The indictment further alleges that Orange obstructed a federal audit of her use of certain of the funds. The case is being prosecuted by Assistant U.S. Attorney D.H. Dilbeck of the U.S. Attorney’s Office for the Western District of Oklahoma.

District of Rhode Island

Brandon Nowak, 32, and Jason Simmons, 33, both of Providence, Rhode Island, were charged by separate complaints with conspiracy to commit health care fraud, health care fraud, and filing false claims, in connection with a health care fraud billing scheme involving in over $2 million in fraudulent claims to federal health care benefit plans. As alleged in the complaint, Nowak and Simmons operated Alternative Integrative Medicine, LLC, doing business as AIM Health, at multiple locations in Rhode Island. The defendants were co-owners of AIM Health, with Nowak as President and Chief Executive Officer and Simmons as Vice President, Chief Financial Officer and Compliance Officer. According to the complaints, Nowak and Simmons conspired to defraud Medicare, Medicaid, TRICARE, the U.S. Department of Veterans Affairs, and numerous private insurers through fraudulent billing practices, which included billing for services not rendered, billing for non-covered services, and billing for high complexity office visits without providing that level of service. The false and fraudulent claims resulted in over $1.8 million in reimbursements. The case is being prosecuted by Assistant U.S. Attorneys John P. McAdams and Rachna Vyas of the U.S. Attorney’s Office for the District of Rhode Island.

Eastern District of Tennessee

Christopher Caleb Mullins, 40, and Barbara Megan Mullins, 37, both of Oak Ridge, Tennessee, and CAMM Care, LLC, doing business as Patriot Homecare (“CAMM Care”), were charged by indictment in connection with an alleged scheme to defraud the U.S. Department of Labor, Office of Worker’s Compensation Program, Division of Energy Employees Occupational Illness Compensation, otherwise known as DOL-DEEOIC. DOL-DEEOIC administers the health care benefit program designed to compensate current or former Department of Energy employees, vendors, contractors, and subcontractors diagnosed with occupational illnesses causally linked to toxic exposures during their employment. Among other health care benefits, this program provides home health benefits to qualifying beneficiaries, including skilled nursing care and non-skilled care. As alleged in the indictment, Caleb Mullins, the owner and President of CAMM Care, and Megan Mullins, the Executive Vice President of CAMM Care, conspired with each other and others not named in the indictment to create and submit fraudulent payment claims for homecare services that were not actually rendered. Samantha Seiber, 35, of Wartburg, Tennessee, Apryl Hard, 46, of Louisville, Tennessee, and Lois Hamby, 62, of Oliver Springs, Tennessee, were also charged in separate indictments with defrauding the DOL-DEEOIC. As alleged in the respective indictments, Seiber, Hard, and Hamby each had their own DOL-DEEOIC provider number and each billed the DOL-DEEOIC for skilled nursing services that were not actually rendered. The cases are being prosecuted by Assistant U.S. Attorneys William A. Roach, Jr., and Jeremy S. Dykes of the U.S. Attorney’s Office for the Eastern District of Tennessee.

Middle District of Tennessee

James Brandon “Brady” Washburn, 44, of Franklin, Tennessee, and Robert Houston McDowell, 43, of Murfreesboro, Tennessee, were charged by indictment with conspiracy to commit health care fraud, health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, and paying and receiving health care kickbacks, in connection with their role in selling doctors’ orders for medically unnecessary genetic tests, medications, and durable medical equipment (“DME”) to laboratories, pharmacies, and DME companies. The defendants also owned and operated their own DME companies in Franklin and Brentwood, Tennessee, and bought doctors’ orders for orthotic braces and submitted claims for medically unnecessary items to Medicare. The defendants obtained the orders by paying kickbacks and bribes to purported telemedicine companies and marketers in exchange for doctors signing orders for DME. The indictment alleges that the defendants and their co-conspirators received over $1 million in kickbacks for selling doctors’ orders to laboratories, pharmacies, and DME companies; that they submitted and caused to be submitted, through their DME companies, over $6 million in false and fraudulent claims to Medicare for DME; and that their DME companies were paid over $2 million on those claims. The case is being prosecuted by Assistant U.S. Attorneys Sarah K. Bogni and Robert S. Levine in the Middle District of Tennessee.
Paulo R. Costa, 36, of Palm City, Florida, and Mark J.W. Carr, 35, of Lighthouse Point, Florida were each charged by separate information with conspiracy to commit health care fraud and to pay and receive health care kickbacks in connection with an over $9 million scheme involving multiple pharmacies, including in Mt. Juliet and Goodlettsville, Tennessee. As alleged in the informations, the defendants obtained patient information through the use of call centers where telemarketers persuaded Medicare beneficiaries to accept prescriptions for expensive medications, which the beneficiaries neither needed nor wanted. The defendants obtained signed prescriptions by paying kickbacks to marketers and telemedicine companies and then billed Medicare Part D plan sponsors for prescriptions that were procured through the payment of kickbacks and that were medically unnecessary. The case is being prosecuted by Assistant U.S. Attorneys Robert S. Levine and Sarah K. Bogni in the Middle District of Tennessee.

Eastern District of Texas

Joseph C. Lutka, Jr., 50, of Crowley, Texas, was charged by information with health care fraud in connection with a scheme to fraudulently bill Medicare over $2.8 million. As alleged in the information, Lutka, the owner of Choice Medical Services, a mobile laboratory enrolled as a Medicare provider, fraudulently billed Medicare for COVID-19 sample collection and testing that Choice Medical Services did not perform, and submitted substantially inflated claims to Medicare for mileage reimbursement to pick up specimens from homebound patients. The case is being prosecuted by Assistant U.S. Attorney Sean J. Taylor of the U.S. Attorney’s Office for the Eastern District of Texas.

Northern District of Texas

Keith Gray, 37, of McKinney, Texas, was charged by indictment with one count of conspiracy to defraud the United States and to pay and receive health care kickbacks, five counts of paying health care kickbacks, and three counts of money laundering, in connection with a $335 million scheme to bill Medicare for medically unnecessary cardio genetic testing. Gray was an owner of two clinical laboratories, Axis Professional Labs, LLC (“Axis”), and Kingdom Health Laboratory, LLC (“Kingdom”). According to the indictment, Gray offered and paid kickbacks to marketers in exchange for their referral to Axis and Kingdom of Medicare beneficiaries’ DNA samples, personally identifiable information (including Medicare numbers), and signed doctors’ orders authorizing medically unnecessary cardio genetic testing. As part of the scheme, the marketers engaged other companies to solicit Medicare beneficiaries through telemarketing and to engage in “doctor chase,” i.e., to obtain the identity of beneficiaries’ primary care physicians and pressure them to approve genetic testing orders for patients who purportedly had already been “qualified” for the testing. Medicare paid Axis and Kingdom approximately $54 million as a result of the kickback-tainted claims, some of which Gray laundered by purchasing expensive luxury vehicles. The case is being prosecuted by Trial Attorney Gary Winters of the National Rapid Response Strike Force and Assistant Chief Brynn Schiess of the Texas Strike Force.

Southern District of Texas

Harold Albert “Al” Knowles, 56, of Delray Beach, Florida, and Chantal Swart, 49, of Boca Raton, Florida, were charged by indictment. Knowles was charged with conspiracy to commit health care fraud and conspiracy to defraud the United States and pay and receive kickbacks, and Swart was charged with conspiracy to defraud the United States and pay and receive kickbacks and receipt of health care kickbacks, all in connection with a $359 million scheme to bill Medicare for medically unnecessary genetic tests that were induced by kickbacks. As alleged in the indictment, Knowles was the owner of two Houston-area labs, Bio Choice and Bios Scientific. Knowles entered an agreement with Swart for the referral of Medicare beneficiary DNA samples and signed doctors’ orders for genetic testing that Knowles used to bill Medicare through his labs. Knowles concealed his kickback arrangement with Swart through sham flat fee contracts. Knowles knew that Swart and the marketers she worked with used call centers and telemedicine doctors to obtain DNA samples and signed doctors’ orders and that the providers Swart and the marketers she worked with used to obtain these orders were neither the beneficiaries’ treating physicians nor using the genetic testing to treat the beneficiaries. The case is being prosecuted by Trial Attorneys Andrew Tamayo and Monica Cooper of the Texas Strike Force.
Sharon Pickrom, 64, of Houston, Texas, was charged by indictment with conspiracy to defraud the United States and pay and receive kickbacks, and receipt of kickbacks, in connection with a $1.7 million health care fraud and kickback scheme. As alleged in the indictment, Pickrom, who controlled a purported nonprofit corporation, referred forged prescriptions in the names of Department of Labor – Office of Workers’ Compensation Programs claimants to Custom Care Pharmacy in exchange for illegal kickbacks and bribes. The case is being prosecuted by Trial Attorney Ethan Womble of the Texas Strike Force.
Darlene Burbridge, 65, and Carmalita Landry, 53, both of Houston, Texas, were charged by information with one count of conspiracy to defraud the United States and pay and receive kickbacks, in connection with a $1.7 million health care fraud and kickback scheme. As alleged in the information, Burbridge, who owned Criterion Therapy Center, a physical therapy company that serviced Department of Labor – Office of Workers’ Compensation Programs claimants, referred prescriptions to Landry, a pharmacist and owner of Custom Care Pharmacy, in exchange for illegal kickbacks and bribes. The case is being prosecuted by Trial Attorneys Ethan Womble and Devon Helfmeyer of the Texas Strike Force.

Ijeoma Victoria Ehieze, 61, of Katy, Texas, was charged by indictment with conspiracy to commit healthcare fraud, health care fraud, and conspiracy to pay and receive kickbacks, in connection with an alleged scheme to fraudulently obtain over $1.5 million in Medicare and Medicaid funds. As charged in the indictment, Ehieze, the owner of Sanctified Home Health Services, Inc., billed Medicare and Medicaid for home health services that were not provided and/or medically unnecessary and based on illegal kickback payments to marketers and patients, and was paid over $1 million on those false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorney Kathryn Olson of the U.S. Attorney’s Office for the Southern District of Texas.

Svitlana Meier, 50, of Clearwater, Florida, was charged by indictment with money laundering and unlawfully operating a money transmitting business in connection with a pharmacy at the center of a health care fraud scheme. Meier owned Kim Long Pharmacy, a Houston pharmacy that billed private insurance companies for medicines Kim Long Pharmacy never provided to alleged patients. During the course of the conspiracy, Kim Long Pharmacy received approximately $4.3 million of fraudulent funds from the insurance companies. At the direction of others, Meier then transferred approximately $3.6 million of the fraudulent proceeds to overseas accounts in Hong Kong and Singapore. The case is being prosecuted by Assistant U.S. Attorney Grace Murphy of the U.S. Attorney’s Office for the Southern District of Texas.
Michael Ogbebor, 43, of Richmond, Texas, was charged by indictment with health care fraud and fraud in connection with a major disaster in connection with an alleged scheme to fraudulently obtain over $26 million in private insurance and Economic Injury Disaster Loan Program (“EIDL”) funds. According to the indictment, Ogbebor created a “phantom” business under the name “Stafford Renal,” through which he billed private insurance for dialysis treatments purportedly administered to patients of his previous employer. In reality, the treatments were not administered to the patients. Ogbebor caused private insurance to be billed approximately $26 million and to pay over $5.1 million to Stafford Renal for services that were not rendered. Ogbebor also obtained an EIDL loan in the name of Stafford Renal in the amount of $150,000, which was based on a false and fraudulent application. The case is being prosecuted by Assistant U.S. Attorney Grace Murphy of the U.S. Attorney’s Office for the Southern District of Texas.

Eastern District of Virginia

Rama Prayaga, 59, of Vienna, Virginia, was charged by criminal complaint with healthcare fraud in connection with a $27.1 million scheme to defraud health insurance companies. As alleged in the complaint, Prayaga, a psychiatrist with offices in northern Virginia and the District of Columbia, used billing codes associated with longer, moderately complex patient visits to bill for negligible telemedicine patient encounters, some of which lasted less than a minute. This overbilling resulted in Prayaga billing insurance companies for “impossible days” – i.e., billing more than 24 hours in a day. Prayaga also pushed medically unnecessary transcranial magnetic stimulation treatments on patients, which he or his untrained staff members administered. Prayaga also pushed ketamine treatment, which his staff administered to patients mixed with soda. Prayaga was paid over $14.8 million based on the false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorneys Katherine E. Rumbaugh and Zachary H. Ray of the U.S. Attorney’s Office for the Eastern District of Virginia.

Western District of Virginia

Myron Joel Wyatt, 63, of Coeburn, Virginia, and Stephanie Brooke Davis, 54, of Lacassas, Tennessee, were charged by indictment with health care fraud and conspiracy to commit health care fraud in connection with a scheme to defraud Medicaid. As alleged in the indictment, the defendants worked for Company One, a company that provided mental and behavioral health services to Medicaid recipients. As alleged in the indictment, the defendants and others caused Company One to bill Virginia Medicaid for behavioral therapy services purportedly provided and supervised by Individual One, a licensed behavior analyst, as though Individual One had provided the services or had clinically directed the care provided by others. In reality, Individual One did not provide services to clients and she did not clinically supervise any other providers. In total, Company One submitted approximately 3,429 false and fraudulent claims to Virginia Medicaid under the name of Individual One. The case is being prosecuted by Special Assistant U.S. Attorney Janine Myatt of the U.S. Attorney’s Office for the Western District of Virginia and the Virginia Medicaid Fraud Control Unit.

Southern District of West Virginia

Brian McDevitt, 60, of Chapmanville, West Virginia, was charged by indictment with three counts of unlawful distribution of a controlled substance in connection with prescribing clonazepam outside the scope of professional practice and not for a legitimate medical purpose. As alleged in the indictment, McDevitt, a doctor of osteopathic medicine, issued clonazepam prescriptions on three separate dates that were outside the scope of professional practice and not for a legitimate medical purpose. The case is being prosecuted by Assistant U.S. Attorneys Owen Reynolds and Francesca Rollo of the U.S. Attorney’s Office for the Southern District of West Virginia.

Jacqueline Brewster, 54, of Belfry, Kentucky, was charged by indictment with obtaining controlled substances by fraud, tampering with consumer products, and wrongfully obtaining individually identifiable health information under false pretenses and with intent to use for personal gain in connection with the theft of, and tampering with, vials of hydromorphone at a hospital in Raleigh County, West Virginia. As alleged in the indictment, Brewster, a travel nurse, used her credentials to access hydromorphone for her own personal use. Brewster tampered with the hydromorphone vials by diluting the remaining liquid in the bottles to make it appear as though they were full. The case is being prosecuted by Assistant U.S. Attorney Owen Reynolds of the U.S. Attorney’s Office for the Southern District of West Virginia.

Eastern District of Wisconsin

Lori Butts, 47, of Wales, Wisconsin, was charged by indictment with healthcare fraud and wire fraud in connection with a scheme in which her company billed for the staffing of adult family homes that was not provided. The indictment alleges that her company received approximately $1.4 million to which it was not entitled and that Butts then converted a substantial portion of this money to her personal use. The case is being prosecuted by Assistant U.S. Attorneys Carter Stewart and Zachary Corey of the U.S. Attorney’s Office for the Eastern District of Wisconsin.

Cases Filed in State Court

Arizona

Rita Anagho, 52, of San Tan Valley, Arizona, was charged by three separate criminal indictments with engaging in a patient brokering scheme. As alleged in the indictments, Anagho conspired with other individuals while engaging in the patient brokering scheme to pay and/or receive consideration for patient referrals. It is further alleged in the indictments that Anagho agreed to pay and paid one thousand dollars or more for referred patients who were members and/or beneficiaries of health plans administered by the Arizona Health Care Cost Containment System, specifically targeting members/beneficiaries of the American Indian Health Plan. The case is being prosecuted by Assistant Attorney General Vineet Mehta Shaw of the Arizona Medicaid Fraud Control Unit.
Allison B. Sommers, 64, of Scottsdale, Arizona, was charged by criminal information with two counts of Possession of Drug Paraphernalia. As alleged in the indictment Sommers, a Nurse Practitioner, engaged in improper and unsafe prescribing practices, did not keep proper patient records and charged patients for their prescriptions based on the strength of the drugs. The case is being prosecuted by Assistant Attorney General Vineet Mehta Shaw of the Arizona Medicaid Fraud Control Unit.

California

Jaspreet Jagpal, 34, of Yuba City, California, was charged by complaint with insurance fraud and an enhancement for aggravated white collar crime in connection with billing for behavioral analysis services not rendered to five minor children. This fraudulent scheme caused a loss of approximately $166,755.50 over a ten-month span. As alleged in the complaint, Jagpal, the owner of One World Therapy, claimed that behavioral analysis services were provided to minor children that never occurred. The case is being prosecuted by Deputy Attorney General Ed Grubaugh of the California Medicaid Fraud Control Unit.

Joseph Depiazza, 68, of California, was charged by complaint with grand theft and presenting false Medicaid of California (“Medi-Cal”) claims in connection with In-Home Supportive Services (“IHSS”) fraudulent billings. As alleged in the complaint, Depiazza submitted a total of 31-time sheets to IHSS for services he claimed he rendered to an IHSS recipient while she was an inpatient and after her death. As a result of the scheme, IHSS paid Depiazza an approximate total of $51,423.71. The case is being prosecuted by Deputy Attorney General Sue Hong of the California Division of Medi-Cal Fraud and Elder Abuse.
Giacomo Lorenzo Garbarino, 65, of San Dimas, California, was charged by complaint with single counts of Medicaid of California (“Medi-Cal”) fraud, insurance fraud, and grand theft, in connection with a scheme to defraud the In-Home Supportive Services (“IHSS”) and Medi-Cal programs by submitting claims for healthcare services that either were never performed or did not qualify for reimbursement under program rules. As alleged in the complaint, between January 15, 2018 and September 20, 2022, Garbarino fraudulently billed the programs a total of $172,568.52 for in-home supportive services provided on days when the recipient of the services was hospitalized or living in a skilled nursing facility. Under the rules of the IHSS program, such services qualify for reimbursement under the Medi-Cal program only if the recipient is living in his own home when the services are provided. The case is being prosecuted by Deputy Attorney General Richard Moskowitz of the California Medicaid Fraud Control Unit.
Dr. Ahmad Omar Sabbagh, 50, of San Diego, California, was charged by complaint with making a false or fraudulent claim for payment of a health care benefit in connection with a scheme to fraudulently bill Medicaid of California Federally Qualified Health Center program for over $65,000 for services that he did not render. As alleged in the complaint, Sabbagh was a dentist contracted with Borrego Community Health Foundation to provide dental services to underserved populations and communities. Sabbagh filed fraudulent claims stating he provided services to his patients over multiple days, when in fact, the repeat visits did not occur. The case is being prosecuted by Deputy Attorney General Bianca Yip of the California Medicaid Fraud Control Unit.
Maria Menchaca, 59, of Norwalk, California, was charged by complaint with grand theft and presenting false Medicaid of California (“Medi-Cal”) claims. The investigation revealed that Maria Menchaca submitted false and fraudulent claims for In-Home Supportive Services even though the services were not rendered because the recipient was being cared for in various inpatient facilities. The fraud scheme resulted in a $25,060.81 loss to the Medi-Cal program. The case is being prosecuted by Deputy Attorney General Steven Smith of the California Medicaid Fraud Control Unit.

Indiana

Kristin S. Sturdivant, 34, of Logansport, Indiana, a Registered Nurse, was charged by information with failure to make, keep, or furnish records, obtaining a controlled substance by fraud, and furnishing false or fraudulent information. As alleged in the information, Sturdivant, while working at a nursing home, signed out narcotics for patient use but did not administer the medication to the patients on numerous occasions. The case is being prosecuted by Deputy Attorney General Robin Hodapp-Gillman of the Indiana Medicaid Fraud Control Unit.
Vincent Anthony Colonna, 70, of Cape Coral, Florida, a Registered Nurse, was charged by information with failure to make, keep, or furnish records, obtaining a controlled substance by fraud, and furnishing false or fraudulent information. It is alleged that Colonna, while working at a hospital, diverted medication from patients and did not properly dispose of waste, taking controlled substances for his own use. The case is being prosecuted by Deputy Attorney General Robin Hodapp-Gillman of the Indiana Medicaid Fraud Control Unit.
Amy Nicole Mullins, 36, of Rockport, Indiana, was charged by information with failure to make, keep or furnish records, and obtaining a controlled substance by fraud or deceit and theft. Mullins is alleged to have stolen medication prescribed to a patient in an Evansville nursing home. The case is being prosecuted by Deputy Attorney General Georgeanna Teipen of the Indiana Medicaid Fraud Control Unit.

Autumn Marie Duvall, 43, of Anderson, Indiana, a Registered Nurse, was charged by information with failure to make, keep or furnish records, obtaining a controlled substance by fraud or deceit, and possession of a narcotic drug. Duvall is alleged to have stolen narcotic pain medication prescribed for two residents of an assisted living facility in Evansville. One of the residents had already been discharged from the facility and reported the medication that she had brought to the facility when she was admitted could not be found when she was discharged. The case is being prosecuted by Deputy Attorney General Georgeanna Teipen of the Indiana Medicaid Fraud Control Unit.
Myah Alise Samples, 25, of Evansville, Indiana, a Qualified Medication Aide, was charged with failure to make, keep or furnish records, obtaining a controlled substance by fraud or deceit, and possession of a narcotic drug. As alleged in the information, Samples took narcotic pain medication prescribed to a patient in an assisted living facility in Evansville. The case is being prosecuted by Deputy Attorney General Georgeanna Teipen of the Indiana Medicaid Fraud Control Unit.
Edward Eon Board, 47, of Jeffersonville, Indiana, was charged by information with fraud, theft, and exploitation of an endangered adult. As alleged in the information, Board, while working as a Certified Nursing Aide, stole the credit card of a nursing home resident, which he used at a sports bar and to purchase various personal items on Amazon worth almost $4,000, including: motorcycle parts; a punk rock studded leather jacket; glitter high-top flashing sneakers; a hip-hop rhinestone necklace and other items of jewelry, and video games. The case is being prosecuted by Deputy Attorney General Maureen O’Donnell of the Indiana Medicaid Fraud Control Unit.
Andriana M. Bautista, 29, of Elkhart, Indiana, a Certified Nurse Anesthetist, was charged by information with nine counts of theft. It is alleged that Bautista, while working at a nursing home, obtained nine residents’ bank or credit cards and made unauthorized purchases and cash advances including payments to her Cash App account and other transactions. Bautista allegedly linked the residents’ cards to her Cash App account and made multiple transactions. The case is being prosecuted by the Elkhart County Prosecutors Office.
Shalynn M. Throw, 29, of LaPorte, Indiana, a Certified Nurse Anesthetist, was charged by information with fraud. It is alleged that Throw executed a scheme to defraud the Medicaid Program and Helping Hands by submitting false claims of providing homebound personal and companion services to a patient. It is further alleged that during the course of the investigation Throw admitting to being paid by Helping Hands for services which did not provide. The case is being prosecuted by Deputy Attorney General Georgeanna Teipen of the Indiana Medicaid Fraud Control Unit.
Rebecca E. Plaza, 60, of Indiana, a Licensed Practical Nurse, was charged by information with failure to make, keep, or furnish records and obtaining a controlled substance by fraud. It is alleged that Plaza, while working at a nursing home, diverted hydromorphone from nursing homes inventory. The case is being prosecuted by Deputy Attorney General Robin Hodapp-Gillman of the Indiana Medicaid Fraud Control Unit.
Jessica Lynn Hallam, 39, of Evansville, Indiana, was charged by information with diversion of controlled substances from Deaconess Gateway Hospital in Warrick County, Indiana. As alleged in the information, Hallam was reported by co-workers after becoming outwardly impaired during her shift as a Registered Nurse at the hospital. It is further alleged that during the subsequent investigation, Hallam admitted stealing morphine, dilaudid and lorazepam from the hospital and falsifying her documentation for several years. The case is being prosecuted by Deputy Attorney General Maureen O’Donnell of the Indiana Medicaid Fraud Control Unit.
Lori L. Pribble, 59, of North Vernon, Indiana, was charged by information with criminal recklessness. As alleged in the information, Pribble, while working as a Registered Nurse in a nursing home, flushed a patient’s catheter with vinegar, causing chemical burns to the victim’s bladder. Pribble obtained the vinegar from the facility’s kitchen after she was unable to locate the appropriate medical-grade solution ordered by the patient’s physician. The case is being prosecuted by Deputy Attorney General Maureen O’Donnell of the Indiana Medicaid Fraud Control Unit.
Sherri Lynn Shelby, 56, of Valparaiso, Indiana, a Registered Nurse, was charged by information with neglect of a dependent resulting in serious bodily injury. As alleged in the information, while working as the Health Facility Administrator of a nursing home in East Chicago, Indiana, Shelby was accompanying a patient resident of that nursing home who had limited and restricted capacity to another facility for a tour when a life-threatening incident occurred. Ultimately, the patient resident died. The case is being prosecuted by Deputy Attorney General Georgeanna Teipen of the Indiana Medicaid Fraud Control Unit.
Meredith G. Briles, 45, of Muncie, Indiana, a Registered Nurse, was charged by information with failure to make, keep, or furnish a record, obtaining a controlled substance by fraud, furnishing false or fraudulent information, and possession of a narcotic drug. It is alleged that Briles, while working at a nursing home, ordered controlled substances for patients, acquired hydrocodone from pharmacies, and did not deliver them to the facility for a period of a year. The case is being prosecuted by Deputy Attorney General Robin Hodapp-Gillman of the Indiana Medicaid Fraud Control Unit.
Katheryn Luna, 65, of Crown Point, Indiana, a Registered Nurse, was charged by information with failure to make, keep, or furnish a record, furnishing false or fraudulent information, and obtaining a controlled substance by fraud and furnishing false or fraudulent information. It is alleged that Luna, while working at a nursing home, on numerous occasions signed out narcotics for patient use but did not administer the medication to the patients. The case is being prosecuted by Deputy Attorney General Robin Hodapp-Gillman of the Indiana Medicaid Fraud Control Unit.

Louisiana

Camisha Robinson, 23, of Shreveport, Louisiana, was charged by information with Medicaid fraud. While employed as a DSW, Robinson submitted fraudulent time sheets indicating that she was providing personal care services that she could not have rendered because she was physically present at another job. The case is being prosecuted by Assistant Attorney General Lauren Harrell of the Louisiana Medicaid Fraud Control Unit.

New York

Jays Auto Care Inc., Hojo Detail Center Inc, Medi Cab Corp of Rensselaer, New York, John Gouzos, 47, of Glen Head, NY (the owner of Medi Cab Corp), and Richard Sehl, 55, of Mechanicville, NY (a high managerial agent of Medi Cab Corp), were charged by indictment with money laundering, and Medi Cab Corp., Gouzos, and Sehl (the “Medi Cab defendants”) were additionally charged with grand larceny, health care fraud, medical assistance provider prohibited practices – kickbacks, falsifying business records, and offering a false instrument for filing. As alleged in the indictment, the Medi Cab defendants allegedly paid Medicaid recipients kickbacks and falsely reported to Medicaid pick up and drop off addresses to substantially inflate the amount of money that Medicaid paid Medi Cab. The case is being prosecuted by Special Assistant Attorneys General Patrick Scully and Kathleen Boland of the New York Medicaid Fraud Control Unit under the supervision of Special Assistant Attorney General Thomas O’Hanlon, Chief of Criminal Investigations.

David Moore, 55, of Interlaken, New York, was charged by complaint with grand larceny, health care fraud, and medical assistance provider prohibited practices, in connection with a scheme to defraud Medicaid. As alleged in the complaint, between January 2019 through August 2023, David Moore, as the owner of ASAP 2, a transportation provider in Tompkins County, New York, submitted and caused to be submitted claims for payment to Medicaid that were the product of unlawful kickback payments to multiple Medicaid recipients, often transmitted by “Venmo” and “Cash App” services, and which were also falsely inflated by substantially increasing the claimed mileage for trips that were taken. Medicaid paid ASAP 2 in excess of $1 million based on the false and fraudulent claims. The case is being prosecuted by Assistant Attorney General William Gargan of the New York State Medicaid Fraud Control Unit.

Oklahoma

Jessica B. Branston, 37, of Tulsa, Oklahoma, was charged by information with Medicaid fraud and identity theft in connection with the submission of false claims to the Oklahoma Medicaid Program for services not rendered. As alleged in the information, Branston, a licensed professional counselor, submitted fraudulent claims for psychotherapy services that were never provided. The case is being prosecuted by Assistant Attorney General Candace Arnold of the Oklahoma Medicaid Fraud Control Unit.

Pennsylvania

Jacqueline Forman, 44, and Crystal Forman, 64, both of Philadelphia, Pennsylvania, were charged by criminal complaint with Medicaid fraud, theft by deception, and conspiracy in connection with a personal care attendant (PCA) fraud scheme. As alleged in the criminal complaint, Jacqueline was hired to provide PCA services for her mother Crystal. Jacqueline and Crystal submitted timekeeping records for at least 1,416.75 hours of PCA services that could not have been provided while Jacqueline was working on location at other jobs, one of which was in Idaho. The fraudulent submissions caused Medicaid to pay approximately $29,312 for services that were not rendered. The case is being prosecuted by Senior Deputy Attorney General Susann Shore of the Pennsylvania Medicaid Fraud Control Unit.
Tiffany Farris, 41, and Jonathan Banks, 40, both of Philadelphia, Pennsylvania, are charged with Medicaid fraud, theft by deception, tampering with public records or information, criminal use of a communication facility, and conspiracy in connection with a PCA fraud scheme. As alleged in the criminal complaints, Farris was employed to provide PCA services for Banks through Silver Heart Healthcare Agency, and each also had other simultaneous employment. Farris and Banks submitted timekeeping records for at least 1,713.00 hours of services Farris could not have provided while Farris and/or Banks were working on location at other jobs. These submissions caused Medicaid to pay out at least $34,847.46 for non-rendered services. Additionally, among Farris’s other employers were First Choice and Golden Age agencies, for which Farris was hired to provide PCA services to other consumers. With respect to this employment, Farris submitted timekeeping records for at least 437.50 hours of services she could not have provided because she was working at another job. These submissions caused Medicaid to pay out at least another $9,585.69 for non-rendered services. The case is being prosecuted by Senior Deputy Attorney General Jason Karasik of the Pennsylvania Medicaid Fraud Control Unit.

Puerto Rico

Luis A. Espinet-García, 57 of Canovanas, Puerto Rico was charged by complaint with submitting false and fraudulent claims for services not rendered to the Medicaid Program, illegal appropriation of public funds and illegal appropriation of identity, between November 2022 and May 2023. These actions caused a loss to the Puerto Rico Medicaid Program greater than $10,700.00. As alleged in the complaint, while Espinet served as a dentist, he submitted false claims to the health plan for services he never provided to his patients. Also, Espinet overcharged Medicaid beneficiaries for anesthesia when the service was covered under the health plan contract. The case is being prosecuted by Assistant District Attorney Brenda Rosado Aponte of the Puerto Rico Medicaid Fraud Control Unit.

Julio Martorell González, 81, of Dorado, Puerto Rico, and Laboratorio Clínico de San Juan, Inc. were charged by complaint with submitting false and fraudulent claims for services not rendered to the Medicaid program, illegal appropriation of public funds and illegal appropriation of identity, between August 2018 and December 2022. As alleged in the complaint, Martorell was the owner and administrator of Laboratorio Clínico de San Juan, Inc. a clinical laboratory located in San Juan, Puerto Rico. Over a four-year period, Martorell and Laboratorio Clínico San Juan, Inc. submitted false and fraudulent claims to services never provided, and that Medicaid beneficiaries never requested or needed. To support these fraudulent claims, Martorell used stolen means of identification of beneficiaries. These actions caused a loss to the Puerto Rico Medicaid Program greater than $50,000. The case is being prosecuted by Assistant District Attorney Brenda Rosado Aponte.

Rhode Island

Mark Breiding, 54, of Barrington, Rhode Island, was charged by information with one count of medical assistance fraud in connection with over approximately $70,000 he fraudulently obtained from the Rhode Island Medicaid Program for purported chiropractic services between 2019 and 2023. As alleged in the information, Breiding was employed as the owner and sole chiropractic practitioner for Breiding Chiropractic Clinic, located in East Greenwich, Rhode Island, where he allegedly billed Medicaid for services that were not medically necessary, were not provided as billed, or were never provided, including repeatedly billing for over 24 hours of chiropractic services in a single day, among other fraudulent billing practices. The case is being prosecuted by Special Assistant Attorney General Steven J. De Luca of the Rhode Island Office of the Attorney General.

Kary M. Almanzar Pagan, 26, of Bronx, New York, was charged by information with medical assistance fraud for allegedly submitting false timekeeping records for services not rendered, causing a loss to the Rhode Island Medicaid Program of $34,277.20. As alleged in the information, Almanzar Pagan was employed as a Personal Care Aide and allegedly submitted 30 false timesheets spanning over 60 weeks, which totaled approximately 2,400 fraudulent hours for services that were not rendered and during which time Almanzar Pagan was residing in another state. The case is being prosecuted by Special Assistant Attorney General Kate Constance Brody of the Rhode Island Office of the Attorney General.

South Dakota

Sharon Laraye Monson, 48, of Pierre, South Dakota, was charged by indictment with Medicaid fraud, perjury to obtain state benefits, and failure to keep necessary records upon which a claim is based, in connection with a $1.2 million dollar scheme to defraud the Medicaid program. As alleged in the indictment, Monson, a nurse and owner of At Home Nursing, fraudulently billed the Medicaid program for services that were not actually rendered. The case is being prosecuted by Assistant Attorney General Mandy Miiller of the South Dakota Medicaid Fraud Control Unit.

Jenny Michelle Loepp, 36, of Elk Point, South Dakota, was charged by indictment with possession of a controlled substance by theft, misrepresentation, or fraud in connection with a Xanax prescription, perjury, social services fraud, and failure to keep necessary records. As alleged in the indictment, Loepp, a certified nurse practitioner, prescribed Xanax to a patient but stole half of the pills from the bottle before giving them to the patient. The case is being prosecuted by Assistant Attorney General Mandy Miiller of the South Dakota Medicaid Fraud Control Unit.

Updated June 27, 2024

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