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Thursday 13 July 2017
National Healthcare Fraud Takedown Results in Charges Against More Than 400 Individuals, Including Several Chicago-Area Medical ProfessionalsRead the Press Release
CHICAGO — Several Chicago-area medical professionals, including two licensed physicians, are facing federal criminal charges as part of the largest health care fraud enforcement action in Department of Justice history, federal authorities announced today.
The national enforcement action taken by the Medicare Fraud Strike Force involved more than 400 defendants charged in 41 federal districts across the country, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. More than 20 state Medicaid Fraud Control Units participated in today’s arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to 295 providers, including doctors, nurses and pharmacists.
The national enforcement action was announced by U.S. Attorney General Jeff Sessions and U.S. Department of Health and Human Services Secretary Tom Price, M.D., along with Acting Assistant U.S. Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division; Acting Federal Bureau of Investigation Director Andrew McCabe; Acting Drug Enforcement Administration Administrator Chuck Rosenberg; Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG); IRS-Criminal Investigations Chief Jon Fort; CMS Administrator Seema Verma; and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division Fraud Section’s Health Care Fraud Unit, in conjunction with its Medicare Fraud Strike Force partners – a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
Several Chicago-area medical professionals, including two doctors, were charged as part of investigations in the Northern District of Illinois, announced Joel R. Levin, Acting United States Attorney for the Northern District of Illinois; Michael J. Anderson, Special Agent-in-Charge of the Chicago office of the FBI; Gabriel L. Grchan, Special Agent-in-Charge of the IRS Criminal Investigation Division in Chicago; and Lamont Pugh III, Special Agent-in-Charge of the Chicago Regional Office of the U.S. Department of Health and Human Services Office of Inspector General.
“Health care fraud is a serious crime that can have devastating consequences,” said Acting U.S. Attorney Levin. “Our office will continue to vigorously investigate and prosecute those who seek to enrich themselves through fraudulent health care schemes.”
“This week, we arrested once trusted doctors, nurses, and other medical professionals who were corrupted by greed and preyed on the vulnerable utilizing them to bill for services or drugs that were unnecessary or never provided,” said FBI Chicago Special Agent-in-Charge Anderson.
One of the Illinois cases involved BEATTA KABBANI, a licensed physical therapist, who was charged in a 13-count indictment with health care fraud and aggravated identity theft. Kabbani is the owner of MedCare Medical Group in Glenview. The indictment charges Kabbani with submitting more than $2 million in false claims to Blue Cross Blue Shield of Illinois and United Health Care. The charges state that Kabbani used a physician’s National Provider Identification number to substantiate some of those false claims. Kabbani is scheduled to be arraigned on July 26, 2017, before U.S. District Judge Gary Feinerman. The Kabbani case is being handled by Assistant U.S. Attorneys Heather McShain and Matthew Kutcher.
Another Illinois case involved JEFFREY WITEK and STEPHEN HOESLEY, licensed chiropractors who were charged in an 18-count indictment with health care fraud. The charges stem from their alleged participation in a scheme to defraud Blue Cross Blue Shield of Illinois. Witek and Hoesley submitted at least approximately $1.1 million in fraudulent claims to Blue Cross Blue Shield of Illinois that falsely represented that certain health care services were provided to patients, knowing that those services were not actually provided. Witek and Hoesley are scheduled to be arraigned on Aug. 2, 2017, before U.S. District Judge Matthew F. Kennelly. The Witek and Hoesley case is being handled by Special Assistant U.S. Attorney Jared Jodrey.
One of the Illinois investigations involved multiple medical professionals. ZOSIMA VICTUELLES, MYLENE MASICLAT, MARIBEL CABRERA, YASEEN ODEH and MOHAMMAD RAZA KHAN were charged in a 28-count indictment with conspiracy to offer and pay, and to solicit and receive, kickbacks and bribes for the referral of Medicare beneficiaries to Sure Care Home Health Corp. The indictment also charges substantive violations of the anti-kickback statute. Victuelles, Masiclat and Cabrera were the owners of Sure Care, a home health agency with offices in Glendale Heights and Rockford. Victuelles and Cabrera are also licensed nurses, while Odeh and Khan are licensed medical doctors. The charges stem from Victuelles, Masiclat, Cabrera and others paying Dr. Odeh, Dr. Khan and others more than $435,000 in kickbacks and bribes for the referral of Medicare beneficiaries to Sure Care. Arraignments in federal court in Chicago have not yet been scheduled. The case is being handled by Assistant U.S. Attorney Matthew Madden.
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged more than 3,500 defendants who collectively have falsely billed the Medicare program for more than $12.5 billion.
The public is reminded that an indictment is merely an allegation, and all defendants are presumed innocent until proven guilty.
National Health Care Fraud Takedown Results in Charges Against over 412 Individuals Responsible for $1.3 Billion in Fraud LossesRead the Press Release
Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
Attorney General Sessions and Secretary Price were joined in the announcement by Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting Director Andrew McCabe of the FBI, Acting Administrator Chuck Rosenberg of the Drug Enforcement Administration (DEA), Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG), Chief Don Fort of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
The charges announced today aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the CDC, approximately 91 Americans die every day of an opioid related overdose.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
“Healthcare fraud is not only a criminal act that costs billions of taxpayer dollars - it is an affront to all Americans who rely on our national healthcare programs for access to critical healthcare services and a violation of trust,” said Secretary Price. “The United States is home to the world’s best medical professionals, but their ability to provide affordable, high-quality care to their patients is jeopardized every time a criminal commits healthcare fraud. That is why this Administration is committed to bringing these criminals to justice, as President Trump demonstrated in his 2017 budget request calling for a new $70 million investment in the Health Care Fraud and Abuse Control Program. The historic results of this year’s national takedown represent significant progress toward protecting the integrity and sustainability of Medicare and Medicaid, which we will continue to build upon in the years to come.”
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.
“This week, thanks to the work of dedicated investigators and analysts, we arrested once-trusted doctors, pharmacists and other medical professionals who were corrupted by greed,” said Acting Director McCabe. “The FBI is committed to working with our partners on the front lines of the fight against heath care fraud to stop those who steal from the government and deceive the American public.”
“Health care fraud is a reprehensible crime. It not only represents a theft from taxpayers who fund these vital programs, but impacts the millions of Americans who rely on Medicare and Medicaid,” said Inspector General Levinson. “In the worst fraud cases, greed overpowers care, putting patients’ health at risk. OIG will continue to play a vital leadership role in the Medicare Fraud Strike Force to track down those who abuse important federal health care programs.”
“Our enforcement actions underscore the commitment of the Defense Criminal Investigative Service and our partners to vigorously investigate fraud perpetrated against the DoD's TRICARE Program. We will continue to relentlessly investigate health care fraud, ensure the taxpayers' health care dollars are properly spent, and endeavor to guarantee our service members, military retirees, and their dependents receive the high standard of care they deserve,” advised Deputy Director Mayo.
“Last year, an estimated 59,000 Americans died from a drug overdose, many linked to the misuse of prescription drugs. This is, quite simply, an epidemic,” said Acting Administrator Rosenberg. “There is a great responsibility that goes along with handling controlled prescription drugs, and DEA and its partners remain absolutely committed to fighting the opioid epidemic using all the tools at our disposal.”
“Every defendant in today’s announcement shares one common trait - greed,” said Chief Fort. “The desire for money and material items drove these individuals to perpetrate crimes against our healthcare system and prey upon many of the vulnerable in our society. Thanks to the financial expertise and diligence of IRS-CI special agents, who worked side-by-side with other federal, state and local law enforcement officers to uncover these schemes, these criminals are off the street and will now face the consequences of their actions.”
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.
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For the Strike Force locations, in the Southern District of Florida, a total of 77 defendants were charged with offenses relating to their participation in various fraud schemes involving over $141 million in false billings for services including home health care, mental health services and pharmacy fraud. In one case, the owner and operator of a purported addiction treatment center and home for recovering addicts and one other individual were charged in a scheme involving the submission of over $58 million in fraudulent medical insurance claims for purported drug treatment services. The allegations include actively recruiting addicted patients to move to South Florida so that the co-conspirators could bill insurance companies for fraudulent treatment and testing, in return for which, the co-conspirators offered kickbacks to patients in the form of gift cards, free airline travel, trips to casinos and strip clubs, and drugs.
In the Eastern District of Michigan, 32 defendants face charges for their alleged roles in fraud, kickback, money laundering and drug diversion schemes involving approximately $218 million in false claims for services that were medically unnecessary or never rendered. In one case, nine defendants, including six physicians, were charged with prescribing medically unnecessary controlled substances, some of which were sold on the street, and billing Medicare for $164 million in facet joint injections, drug testing, and other procedures that were medically unnecessary and/or not provided.
In the Southern District of Texas, 26 individuals were charged in cases involving over $66 million in alleged fraud. Among these defendants are a physician and a clinic owner who were indicted on one count of conspiracy to distribute and dispense controlled substances and three substantive counts of distribution of controlled substances in connection with a purported pain management clinic that is alleged to have been the highest prescribing hydrocodone clinic in Houston, where approximately 60-70 people were seen daily, and were issued medically unnecessary prescriptions for hydrocodone in exchange for approximately $300 cash per visit.
In the Central District of California, 17 defendants were charged for their roles in schemes to defraud Medicare out of approximately $147 million. Two of these defendants were indicted for their alleged involvement in a $41.5 million scheme to defraud Medicare and a private insurer. This was purportedly done by submitting fraudulent claims, and receiving payments for, prescription drugs that were not filled by the pharmacy nor given to patients.
In the Northern District of Illinois, 15 individuals were charged in cases related to six different schemes concerning home health care services and physical therapy fraud, kickbacks, and mail and wire fraud. These schemes involved allegedly over $12.7 million in fraudulent billing. One case allegedly involved $7 million in fraudulent billing to Medicare for home health services that were not necessary nor rendered.
In the Middle District of Florida, 10 individuals were charged with participating in a variety of schemes involving almost $14 million in fraudulent billing. In one case, three defendants were charged in a $4 million scheme to defraud the TRICARE program. In that case, it is alleged that a defendant falsely represented himself to be a retired Lieutenant Commander of the United States Navy Submarine Service. It is alleged that he did so in order to gain the trust and personal identifying information from TRICARE beneficiaries, many of whom were members and veterans of the armed forces, for use in the scheme.
In the Eastern District of New York, ten individuals were charged with participating in a variety of schemes including kickbacks, services not rendered, and money laundering involving over $151 million in fraudulent billings to Medicare and Medicaid. Approximately $100 million of those fraudulent billings were allegedly part of a scheme in which five health care professionals paid illegal kickbacks in exchange for patient referrals to their own clinics.
In the Southern Louisiana Strike Force, operating in the Middle and Eastern Districts of Louisiana as well as the Southern District of Mississippi, seven defendants were charged in connection with health care fraud, wire fraud, and kickback schemes involving more than $207 million in fraudulent billing. One case involved a pharmacist who was charged with submitting and causing the submission of $192 million in false and fraudulent claims to TRICARE and other health care benefit programs for dispensing compounded medications that were not medically necessary and often based on prescriptions induced by illegal kickback payments.
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In addition to the Strike Force locations, today’s enforcement actions include cases and investigations brought by an additional 31 U.S. Attorney’s Offices, including the execution of search warrants in investigations conducted by the Eastern District of California and the Northern District of Ohio.
In the Northern and Southern Districts of Alabama, three defendants were charged for their roles in two health care fraud schemes involving pharmacy fraud and drug diversion.
In the Eastern District of Arkansas, 24 defendants were charged for their roles in three drug diversion schemes that were all investigated by the DEA.
In the Northern and Southern Districts of California, four defendants, including a physician, were charged for their roles in a drug diversion scheme and a health care fraud scheme involving kickbacks.
In the District of Connecticut, three defendants were charged in two health care fraud schemes, including a scheme involving two physicians who fraudulently billed Medicaid for services that were not rendered and for the provision of oxycodone with knowledge that the prescriptions were not medically necessary.
In the Northern and Southern Districts of Georgia, three defendants were charged in two health care fraud schemes involving nearly $1.5 million in fraudulent billing.
In the Southern District of Illinois, five defendants were charged in five separate schemes to defraud the Medicaid program.
In the Northern and Southern Districts of Indiana, at least five defendants were charged in various health care fraud schemes related to the unlawful distribution and dispensing of controlled substances, kickbacks, and services not rendered.
In the Southern District of Iowa, five defendants were charged in two schemes involving the distribution of opioids.
In the Western District of Kentucky, 11 defendants were charged with defrauding the Medicaid program. In one case, four defendants, including three medical professionals, were charged with distributing controlled substances and fraudulently billing the Medicaid program.
In the District of Maine, an office manager was charged with embezzling funds from a medical office.
In the Eastern and Western Districts of Missouri, 16 defendants were charged in schemes involving over $16 million in claims, including 10 defendants charged as part of a scheme involving fraudulent lab testing.
In the District of Nebraska, a dentist was charged with defrauding the Medicaid program.
In the District of Nevada, two defendants, including a physician, were charged in a scheme involving false hospice claims.
In the Northern, Southern, and Western Districts of New York, five defendants, including two physicians and two pharmacists, were charged in schemes involving drug diversion and pharmacy fraud.
In the Southern District of Ohio, five defendants, including four physicians, were charged in connection with schemes involving $12 million in claims to the Medicaid program.
In the District of Puerto Rico, 13 defendants, including three physicians and two pharmacists, were charged in four schemes involving drug diversion, Medicaid fraud, and the theft of funds from a health care program.
In the Eastern District of Tennessee, three defendants were charged in a scheme involving fraudulent billings and the distribution of opioids.
In the Eastern, Northern, and Western Districts of Texas, nine defendants were charged in schemes involving over $42 million in fraudulent billing, including a scheme involving false claims for compounded medications.
In the District of Utah, a nurse practitioner was charged in connection with fraudulently obtaining a controlled substance, tampering with a consumer product, and infecting over seven individuals with Hepatitis C.
In the Eastern District of Virginia, a defendant was charged in connection with a scheme involving identify theft and fraudulent billings to the Medicaid program.
In addition, in the states of Arizona, Arkansas, California, Delaware, Illinois, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Vermont, Washington and Wisconsin, 96 defendants have been charged in criminal and civil actions with defrauding the Medicaid program out of over $31 million. These cases were investigated by each state’s respective Medicaid Fraud Control Units. In addition, the Medicaid Fraud Control Units of the states of Alabama, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Missouri, Nebraska, New York, North Carolina, Ohio, Texas, and Utah participated in the investigation of many of the federal cases discussed above.
The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices of the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois and the Middle District of Florida; and agents from the FBI, HHS-OIG, Drug Enforcement Administration, DCIS and state Medicaid Fraud Control Units.
A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent unless and until proven guilty.
Additional documents related to this announcement will shortly be available here: https://www.justice.gov/opa/documents-and-resources-july-13-2017.
This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2.5 billion in judgements and settlements related to matters alleging health care fraud.
National Health Care Fraud Takedown Results in Charges Against over 412 Individuals Responsible for $1.3 Billion in Fraud LossesRead the Press Release
WASHINGTON – Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
Attorney General Sessions and Secretary Price were joined in the announcement by Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting Director Andrew McCabe of the FBI, Acting Administrator Chuck Rosenberg of the Drug Enforcement Administration (DEA), Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG), Chief Don Fort of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
The charges announced today aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the CDC, approximately 91 Americans die every day of an opioid related overdose.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
“Healthcare fraud is not only a criminal act that costs billions of taxpayer dollars - it is an affront to all Americans who rely on our national healthcare programs for access to critical healthcare services and a violation of trust,” said Secretary Price. “The United States is home to the world’s best medical professionals, but their ability to provide affordable, high-quality care to their patients is jeopardized every time a criminal commits healthcare fraud. That is why this Administration is committed to bringing these criminals to justice, as President Trump demonstrated in his 2017 budget request calling for a new $70 million investment in the Health Care Fraud and Abuse Control Program. The historic results of this year’s national takedown represent significant progress toward protecting the integrity and sustainability of Medicare and Medicaid, which we will continue to build upon in the years to come.”
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.
“This week, thanks to the work of dedicated investigators and analysts, we arrested once-trusted doctors, pharmacists and other medical professionals who were corrupted by greed,” said Acting Director McCabe. “The FBI is committed to working with our partners on the front lines of the fight against heath care fraud to stop those who steal from the government and deceive the American public.”
“Health care fraud is a reprehensible crime. It not only represents a theft from taxpayers who fund these vital programs, but impacts the millions of Americans who rely on Medicare and Medicaid,” said Inspector General Levinson. “In the worst fraud cases, greed overpowers care, putting patients’ health at risk. OIG will continue to play a vital leadership role in the Medicare Fraud Strike Force to track down those who abuse important federal health care programs.”
“Our enforcement actions underscore the commitment of the Defense Criminal Investigative Service and our partners to vigorously investigate fraud perpetrated against the DoD's TRICARE Program. We will continue to relentlessly investigate health care fraud, ensure the taxpayers' health care dollars are properly spent, and endeavor to guarantee our service members, military retirees, and their dependents receive the high standard of care they deserve,” advised Deputy Director Mayo.
“Last year, an estimated 59,000 Americans died from a drug overdose, many linked to the misuse of prescription drugs. This is, quite simply, an epidemic,” said Acting Administrator Rosenberg. “There is a great responsibility that goes along with handling controlled prescription drugs, and DEA and its partners remain absolutely committed to fighting the opioid epidemic using all the tools at our disposal.”
“Every defendant in today’s announcement shares one common trait - greed,” said Chief Fort. “The desire for money and material items drove these individuals to perpetrate crimes against our healthcare system and prey upon many of the vulnerable in our society. Thanks to the financial expertise and diligence of IRS-CI special agents, who worked side-by-side with other federal, state and local law enforcement officers to uncover these schemes, these criminals are off the street and will now face the consequences of their actions.”
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.
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For the Strike Force locations, in the Southern District of Florida, a total of 77 defendants were charged with offenses relating to their participation in various fraud schemes involving over $141 million in false billings for services including home health care, mental health services and pharmacy fraud. In one case, the owner and operator of a purported addiction treatment center and home for recovering addicts and one other individual were charged in a scheme involving the submission of over $58 million in fraudulent medical insurance claims for purported drug treatment services. The allegations include actively recruiting addicted patients to move to South Florida so that the co-conspirators could bill insurance companies for fraudulent treatment and testing, in return for which, the co-conspirators offered kickbacks to patients in the form of gift cards, free airline travel, trips to casinos and strip clubs, and drugs.
In the Eastern District of Michigan, 32 defendants face charges for their alleged roles in fraud, kickback, money laundering and drug diversion schemes involving approximately $218 million in false claims for services that were medically unnecessary or never rendered. In one case, nine defendants, including six physicians, were charged with prescribing medically unnecessary controlled substances, some of which were sold on the street, and billing Medicare for $164 million in facet joint injections, drug testing, and other procedures that were medically unnecessary and/or not provided.
In the Southern District of Texas, 26 individuals were charged in cases involving over $66 million in alleged fraud. Among these defendants are a physician and a clinic owner who were indicted on one count of conspiracy to distribute and dispense controlled substances and three substantive counts of distribution of controlled substances in connection with a purported pain management clinic that is alleged to have been the highest prescribing hydrocodone clinic in Houston, where approximately 60-70 people were seen daily, and were issued medically unnecessary prescriptions for hydrocodone in exchange for approximately $300 cash per visit.
In the Central District of California, 17 defendants were charged for their roles in schemes to defraud Medicare out of approximately $147 million. Two of these defendants were indicted for their alleged involvement in a $41.5 million scheme to defraud Medicare and a private insurer. This was purportedly done by submitting fraudulent claims, and receiving payments for, prescription drugs that were not filled by the pharmacy nor given to patients.
In the Northern District of Illinois, 15 individuals were charged in cases related to six different schemes concerning home health care services and physical therapy fraud, kickbacks, and mail and wire fraud. These schemes involved allegedly over $12.7 million in fraudulent billing. One case allegedly involved $7 million in fraudulent billing to Medicare for home health services that were not necessary nor rendered.
In the Middle District of Florida, 10 individuals were charged with participating in a variety of schemes involving almost $14 million in fraudulent billing. In one case, three defendants were charged in a $4 million scheme to defraud the TRICARE program. In that case, it is alleged that a defendant falsely represented himself to be a retired Lieutenant Commander of the United States Navy Submarine Service. It is alleged that he did so in order to gain the trust and personal identifying information from TRICARE beneficiaries, many of whom were members and veterans of the armed forces, for use in the scheme.
In the Eastern District of New York, ten individuals were charged with participating in a variety of schemes including kickbacks, services not rendered, and money laundering involving over $151 million in fraudulent billings to Medicare and Medicaid. Approximately $100 million of those fraudulent billings were allegedly part of a scheme in which five health care professionals paid illegal kickbacks in exchange for patient referrals to their own clinics.
In the Southern Louisiana Strike Force, operating in the Middle and Eastern Districts of Louisiana as well as the Southern District of Mississippi, seven defendants were charged in connection with health care fraud, wire fraud, and kickback schemes involving more than $207 million in fraudulent billing. One case involved a pharmacist who was charged with submitting and causing the submission of $192 million in false and fraudulent claims to TRICARE and other health care benefit programs for dispensing compounded medications that were not medically necessary and often based on prescriptions induced by illegal kickback payments.
*********
In addition to the Strike Force locations, today’s enforcement actions include cases and investigations brought by an additional 31 U.S. Attorney’s Offices, including the execution of search warrants in investigations conducted by the Eastern District of California and the Northern District of Ohio.
In the Northern and Southern Districts of Alabama, three defendants were charged for their roles in two health care fraud schemes involving pharmacy fraud and drug diversion.
In the Eastern District of Arkansas, 24 defendants were charged for their roles in three drug diversion schemes that were all investigated by the DEA.
In the Northern and Southern Districts of California, four defendants, including a physician, were charged for their roles in a drug diversion scheme and a health care fraud scheme involving kickbacks.
In the District of Connecticut, three defendants were charged in two health care fraud schemes, including a scheme involving two physicians who fraudulently billed Medicaid for services that were not rendered and for the provision of oxycodone with knowledge that the prescriptions were not medically necessary.
In the Northern and Southern Districts of Georgia, three defendants were charged in two health care fraud schemes involving nearly $1.5 million in fraudulent billing.
In the Southern District of Illinois, five defendants were charged in five separate schemes to defraud the Medicaid program.
In the Northern and Southern Districts of Indiana, at least five defendants were charged in various health care fraud schemes related to the unlawful distribution and dispensing of controlled substances, kickbacks, and services not rendered.
In the Southern District of Iowa, five defendants were charged in two schemes involving the distribution of opioids.
In the Western District of Kentucky, 11 defendants were charged with defrauding the Medicaid program. In one case, four defendants, including three medical professionals, were charged with distributing controlled substances and fraudulently billing the Medicaid program.
In the District of Maine, an office manager was charged with embezzling funds from a medical office.
In the Eastern and Western Districts of Missouri, 16 defendants were charged in schemes involving over $16 million in claims, including 10 defendants charged as part of a scheme involving fraudulent lab testing.
In the District of Nebraska, a dentist was charged with defrauding the Medicaid program.
In the District of Nevada, two defendants, including a physician, were charged in a scheme involving false hospice claims.
In the Northern, Southern, and Western Districts of New York, five defendants, including two physicians and two pharmacists, were charged in schemes involving drug diversion and pharmacy fraud.
In the Southern District of Ohio, five defendants, including four physicians, were charged in connection with schemes involving $12 million in claims to the Medicaid program.
In the District of Puerto Rico, 13 defendants, including three physicians and two pharmacists, were charged in four schemes involving drug diversion, Medicaid fraud, and the theft of funds from a health care program.
In the Eastern District of Tennessee, three defendants were charged in a scheme involving fraudulent billings and the distribution of opioids.
In the Eastern, Northern, and Western Districts of Texas, nine defendants were charged in schemes involving over $42 million in fraudulent billing, including a scheme involving false claims for compounded medications.
In the District of Utah, a nurse practitioner was charged in connection with fraudulently obtaining a controlled substance, tampering with a consumer product, and infecting over seven individuals with Hepatitis C.
In the Eastern District of Virginia, a defendant was charged in connection with a scheme involving identify theft and fraudulent billings to the Medicaid program.
In addition, in the states of Arizona, Arkansas, California, Delaware, Illinois, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Vermont and Washington, 96 defendants have been charged in criminal and civil actions with defrauding the Medicaid program out of over $31 million. These cases were investigated by each state’s respective Medicaid Fraud Control Units. In addition, the Medicaid Fraud Control Units of the states of Alabama, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Missouri, Nebraska, New York, North Carolina, Ohio, Texas, and Utah participated in the investigation of many of the federal cases discussed above.
The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices of the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois and the Middle District of Florida; and agents from the FBI, HHS-OIG, Drug Enforcement Administration, DCIS and state Medicaid Fraud Control Units.
A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent unless and until proven guilty.
Additional documents related to this announcement will shortly be available here: https://www.justice.gov/opa/documents-and-resources-july-13-2017.
This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2.5 billion in judgements and settlements related to matters alleging health care fraud.
National Health Care Fraud Takedown Results in Charges Against 412 IndividualsRead the Press Release
Five Individuals Arrested on Opioid Charges in Southern District of Iowa
WASHINGTON - Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts. Of those charged, over 120 defendants were charged for their roles in prescribing and distributing opioids and other dangerous narcotics.
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
Nationally, the defendants announced today are charged with various health care fraud-related crimes, including conspiracy to commit health care fraud, violations of the anti-kickback statutes and money laundering, as well as crimes involving the illegal prescribing and distribution of opioids and other dangerous narcotics. The charges announced today aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic. According to the CDC, approximately 91 Americans die every day of an opioid related overdose.
Five individuals were indicted in the Southern District of Iowa in two schemes involving the distribution of opioids, announced United States Attorney Kevin E. VanderSchel. Shawne Marie Widener, age 47, of Hamburg, Iowa, was charged with multiple counts of possession with intent to distribute hydrocodone and oxycodone. Mark Edward May, age 31; Chiann May Jones, age 32; Clara Ann Milks, age 37; and Jeremiah D. Jones, age 40; all of Missouri Valley, Iowa, were charged with conspiracy and distribution of hydrocodone and oxycodone. The public is reminded that an indictment is merely an allegation, and all individuals are presumed innocent unless and until proven guilty.
These Iowa matters were investigated by the Department of Health and Human Services – Office of the Inspector General (HHS-OIG), Drug Enforcement Administration (DEA), Iowa Department of Public Safety - Division of Narcotics Enforcement, and the Iowa Medicaid Fraud Control Unit. These cases are being prosecuted by the United States Attorney’s Office for the Southern District of Iowa
National Health Care Fraud Takedown Results in Charges against over 412 Individuals Responsible for $1.3 Billion in Fraud LossesRead the Press Release
Largest Health Care Fraud Enforcement Action in Department of Justice History
WASHINGTON – Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
Attorney General Sessions and Secretary Price were joined in the announcement by Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting Director Andrew McCabe of the FBI, Acting Administrator Chuck Rosenberg of the Drug Enforcement Administration (DEA), Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG), Chief Don Fort of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
charges announced today aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the CDC, approximately 91 Americans die every day of an opioid related overdose.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
“Healthcare fraud is not only a criminal act that costs billions of taxpayer dollars - it is an affront to all Americans who rely on our national healthcare programs for access to critical healthcare services and a violation of trust,” said Secretary Price. “The United States is home to the world’s best medical professionals, but their ability to provide affordable, high-quality care to their patients is jeopardized every time a criminal commits healthcare fraud. That is why this Administration is committed to bringing these criminals to justice, as President Trump demonstrated in his 2017 budget request calling for a new $70 million investment in the Health Care Fraud and Abuse Control Program. The historic results of this year’s national takedown represent significant progress toward protecting the integrity and sustainability of Medicare and Medicaid, which we will continue to build upon in the years to come.”
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.
“This week, thanks to the work of dedicated investigators and analysts, we arrested once-trusted doctors, pharmacists and other medical professionals who were corrupted by greed,” said Acting Director McCabe. “The FBI is committed to working with our partners on the front lines of the fight against heath care fraud to stop those who steal from the government and deceive the American public.”
“Health care fraud is a reprehensible crime. It not only represents a theft from taxpayers who fund these vital programs, but impacts the millions of Americans who rely on Medicare and Medicaid,” said Inspector General Levinson. “In the worst fraud cases, greed overpowers care, putting patients’ health at risk. OIG will continue to play a vital leadership role in the Medicare Fraud Strike Force to track down those who abuse important federal health care programs.”
“Our enforcement actions underscore the commitment of the Defense Criminal Investigative Service and our partners to vigorously investigate fraud perpetrated against the DoD's TRICARE Program. We will continue to relentlessly investigate health care fraud, ensure the taxpayers' health care dollars are properly spent, and endeavor to guarantee our service members, military retirees, and their dependents receive the high standard of care they deserve,” advised Deputy Director Mayo.
“Last year, an estimated 59,000 Americans died from a drug overdose, many linked to the misuse of prescription drugs. This is, quite simply, an epidemic,” said Acting Administrator Rosenberg. “There is a great responsibility that goes along with handling controlled prescription drugs, and DEA and its partners remain absolutely committed to fighting the opioid epidemic using all the tools at our disposal.”
“Every defendant in today’s announcement shares one common trait - greed,” said Chief Fort. “The desire for money and material items drove these individuals to perpetrate crimes against our healthcare system and prey upon many of the vulnerable in our society. Thanks to the financial expertise and diligence of IRS-CI special agents, who worked side-by-side with other federal, state and local law enforcement officers to uncover these schemes, these criminals are off the street and will now face the consequences of their actions.”
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.
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For the Strike Force locations, in the Southern District of Florida, a total of 77 defendants were charged with offenses relating to their participation in various fraud schemes involving over $141 million in false billings for services including home health care, mental health services and pharmacy fraud. In one case, the owner and operator of a purported addiction treatment center and home for recovering addicts and one other individual were charged in a scheme involving the submission of over $58 million in fraudulent medical insurance claims for purported drug treatment services. The allegations include actively recruiting addicted patients to move to South Florida so that the co-conspirators could bill insurance companies for fraudulent treatment and testing, in return for which, the co-conspirators offered kickbacks to patients in the form of gift cards, free airline travel, trips to casinos and strip clubs, and drugs.
In the Eastern District of Michigan, 32 defendants face charges for their alleged roles in fraud, kickback, money laundering and drug diversion schemes involving approximately $218 million in false claims for services that were medically unnecessary or never rendered. In one case, nine defendants, including six physicians, were charged with prescribing medically unnecessary controlled substances, some of which were sold on the street, and billing Medicare for $164 million in facet joint injections, drug testing, and other procedures that were medically unnecessary and/or not provided.
In the Southern District of Texas, 26 individuals were charged in cases involving over $66 million in alleged fraud. Among these defendants are a physician and a clinic owner who were indicted on one count of conspiracy to distribute and dispense controlled substances and three substantive counts of distribution of controlled substances in connection with a purported pain management clinic that is alleged to have been the highest prescribing hydrocodone clinic in Houston, where approximately 60-70 people were seen daily, and were issued medically unnecessary prescriptions for hydrocodone in exchange for approximately $300 cash per visit.
In the Central District of California, 17 defendants were charged for their roles in schemes to defraud Medicare out of approximately $147 million. Two of these defendants were indicted for their alleged involvement in a $41.5 million scheme to defraud Medicare and a private insurer. This was purportedly done by submitting fraudulent claims, and receiving payments for, prescription drugs that were not filled by the pharmacy nor given to patients.
In the Northern District of Illinois, 15 individuals were charged in cases related to six different schemes concerning home health care services and physical therapy fraud, kickbacks, and mail and wire fraud. These schemes involved allegedly over $12.7 million in fraudulent billing. One case allegedly involved $7 million in fraudulent billing to Medicare for home health services that were not necessary nor rendered.
In the Middle District of Florida, 10 individuals were charged with participating in a variety of schemes involving almost $14 million in fraudulent billing. In one case, three defendants were charged in a $4 million scheme to defraud the TRICARE program. In that case, it is alleged that a defendant falsely represented himself to be a retired Lieutenant Commander of the United States Navy Submarine Service. It is alleged that he did so in order to gain the trust and personal identifying information from TRICARE beneficiaries, many of whom were members and veterans of the armed forces, for use in the scheme.
In the Eastern District of New York, ten individuals were charged with participating in a variety of schemes including kickbacks, services not rendered, and money laundering involving over $151 million in fraudulent billings to Medicare and Medicaid. Approximately $100 million of those fraudulent billings were allegedly part of a scheme in which five health care professionals paid illegal kickbacks in exchange for patient referrals to their own clinics.
In the Southern Louisiana Strike Force, operating in the Middle and Eastern Districts of Louisiana as well as the Southern District of Mississippi, seven defendants were charged in connection with health care fraud, wire fraud, and kickback schemes involving more than $207 million in fraudulent billing. One case involved a pharmacist who was charged with submitting and causing the submission of $192 million in false and fraudulent claims to TRICARE and other health care benefit programs for dispensing compounded medications that were not medically necessary and often based on prescriptions induced by illegal kickback payments.
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In addition to the Strike Force locations, today’s enforcement actions include cases and investigations brought by an additional 31 U.S. Attorney’s Offices, including the execution of search warrants in investigations conducted by the Eastern District of California and the Northern District of Ohio.
In the Northern and Southern Districts of Alabama, three defendants were charged for their roles in two health care fraud schemes involving pharmacy fraud and drug diversion.
In the Eastern District of Arkansas, 24 defendants were charged for their roles in three drug diversion schemes that were all investigated by the DEA.
In the Northern and Southern Districts of California, four defendants, including a physician, were charged for their roles in a drug diversion scheme and a health care fraud scheme involving kickbacks.
In the District of Connecticut, three defendants were charged in two health care fraud schemes, including a scheme involving two physicians who fraudulently billed Medicaid for services that were not rendered and for the provision of oxycodone with knowledge that the prescriptions were not medically necessary.
In the Northern and Southern Districts of Georgia, three defendants were charged in two health care fraud schemes involving nearly $1.5 million in fraudulent billing.
In the Southern District of Illinois, five defendants were charged in five separate schemes to defraud the Medicaid program.
In the Northern and Southern Districts of Indiana, at least five defendants were charged in various health care fraud schemes related to the unlawful distribution and dispensing of controlled substances, kickbacks, and services not rendered.
In the Southern District of Iowa, five defendants were charged in two schemes involving the distribution of opioids.
In the Western District of Kentucky, 11 defendants were charged with defrauding the Medicaid program. In one case, four defendants, including three medical professionals, were charged with distributing controlled substances and fraudulently billing the Medicaid program.
In the District of Maine, an office manager was charged with embezzling funds from a medical office.
In the Eastern and Western Districts of Missouri, 16 defendants were charged in schemes involving over $16 million in claims, including 10 defendants charged as part of a scheme involving fraudulent lab testing.
In the District of Nebraska, a dentist was charged with defrauding the Medicaid program.
In the District of Nevada, two defendants, including a physician, were charged in a scheme involving false hospice claims.
In the Northern, Southern, and Western Districts of New York, five defendants, including two physicians and two pharmacists, were charged in schemes involving drug diversion and pharmacy fraud.
In the Southern District of Ohio, five defendants, including four physicians, were charged in connection with schemes involving $12 million in claims to the Medicaid program.
In the District of Puerto Rico, 13 defendants, including three physicians and two pharmacists, were charged in four schemes involving drug diversion, Medicaid fraud, and the theft of funds from a health care program.
In the Eastern District of Tennessee, three defendants were charged in a scheme involving fraudulent billings and the distribution of opioids.
In the Eastern, Northern, and Western Districts of Texas, nine defendants were charged in schemes involving over $42 million in fraudulent billing, including a scheme involving false claims for compounded medications.
In the District of Utah, a nurse practitioner was charged in connection with fraudulently obtaining a controlled substance, tampering with a consumer product, and infecting over seven individuals with Hepatitis C.
In the Eastern District of Virginia, a defendant was charged in connection with a scheme involving identify theft and fraudulent billings to the Medicaid program.
In addition, in the states of Arizona, Arkansas, California, Delaware, Illinois, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Vermont and Washington, 96 defendants have been charged in criminal and civil actions with defrauding the Medicaid program out of over $31 million. These cases were investigated by each state’s respective Medicaid Fraud Control Units. In addition, the Medicaid Fraud Control Units of the states of Alabama, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Missouri, Nebraska, New York, North Carolina, Ohio, Texas, and Utah participated in the investigation of many of the federal cases discussed above.
The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices of the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois and the Middle District of Florida; and agents from the FBI, HHS-OIG, Drug Enforcement Administration, DCIS and state Medicaid Fraud Control Units.
A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent unless and until proven guilty.
Additional documents related to this announcement will shortly be available here: https://www.justice.gov/opa/documents-and-resources-july-13-2017.
This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2.5 billion in judgements and settlements related to matters alleging health care fraud.
National Health Care Fraud Takedown Results in Charges Against over 412 Individuals Responsible for over $1.3 Billion in Fraud LossesRead the Press Release
WASHINGTON – Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including over 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving over $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension against 295 providers, including doctors, nurses, and pharmacists.
Attorney General Sessions and Secretary Price were joined in the announcement by Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting Director Andrew McCabe of the FBI, Acting Administrator Chuck Rosenberg of the Drug Enforcement Administration (DEA), Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG), Chief Don Fort of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
The charges announced today aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics. According to the Centers for Disease Control, approximately 91 Americans die every day of an opioid related overdose.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
“Protecting our nation’s health care programs is a top priority of our Office,” said Acting U.S. Attorney Muldrow. “The coordinated actions today demonstrate our resolve to prosecute those who commit fraud against our health care programs. We will continue in our pursuit against those who violate the law to enrich themselves by defrauding our public systems and its customers by stealing from federal health care programs and the American taxpayers.”
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid, and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.
The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices of the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois, and Middle District of Florida; and agents from the FBI, HHS-OIG, Drug Enforcement Administration, DCIS, and state Medicaid Fraud Control Units.
A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent unless and until proven guilty.
Additional documents related to this announcement will shortly be available here: https://www.justice.gov/opa/documents-and-resources-july-13-2017.
In the Middle District of Florida, 10 individuals were charged with participating in a variety of schemes.
Middle District of Florida Case Highlights
Richard Martin (56, Orlando), a former sales representative for Advanced BioHealing, Inc. (ABH), has been charged with conspiracy to violate the anti-kickback statute and to commit mail and health care fraud. According to court documents, ABH was a biopharmaceutical company that developed and commercialized bioengineered tissue products and regenerative medicine therapies. In 2006, ABH acquired the rights to Dermagraft, a bioengineered skin substitute approved for the treatment of diabetic foot ulcers, and began selling the product to treating physicians. The indictment alleges that in late 2010, Martin and others conspired to bill the Medicare Part B program as if an entire Dermagraft (38 square centimeters) was used to treat each Medicare beneficiary. In truth, Martin and others routinely divided or split the skin substitute into multiple sections for applications on multiple Medicare beneficiaries, resulting in double billing. The indictment further alleges that Martin violated the anti-kickback statute by offering and providing free office medical supplies, free Dermagraft samples, multiple meals and other consumables, and uncompensated medical office procedures and services.
Larry B. Howard (53, Oviedo), a pharmacist and the owner and operator of Fertility Pharmacy d/b/a TRICARE Wellness, has been charged with one count of conspiracy to pay and receive illegal kickbacks, two counts of paying illegal kickbacks, and two counts of money laundering. Nicole R. Bramwell (51, Apopka), a physician, and Raymond L. Stone (57, Orlando), a patient recruiter, have each been charged with one count of conspiracy to pay and receive illegal kickbacks and one count of receiving illegal kickbacks. These charges stem from their alleged roles in a $4.3 million compounding pharmacy scheme that impacted the TRICARE program.
Michael J. Anderson (64, formerly of Windermere), a managing member and operator of DMA Logistics LLC, has been charged with one count of conspiracy to commit health care fraud and wire fraud, and two counts of money laundering. These charges stem from Anderson’s alleged role in a $5.7 million compounding pharmacy fraud scheme that impacted the TRICARE program.
Podiatrist Michael Rotstein (Ocala, 55) has pleaded guilty to one count of healthcare fraud. He faces a maximum penalty of 10 years’ imprisonment and must pay mandatory restitution of approximately $1.5 million. A sentencing date has not yet been set. According to the plea agreement, when billing the Medicare and TRICARE programs Rotstein claimed that nearly half of his procedures were for the removal of skin and muscle, placing him in the top one-percent of billers nationwide for this procedure. In reality, Rotstein did not actually perform these procedures. Rather, the majority of the times that he billed for these procedures, he was actually performing routine foot care, including the clipping of toenails, which is not a reimbursable service under the Medicare or TRICARE program. Since the services performed were not reimbursable, Rotstein devised a scheme to submit claims to Medicare and TRICARE that included using a false diagnosis code and false billing code. As a result of the scheme, Rotstein received $1,504,952.67 in healthcare reimbursements to which he was not entitled.
Jack Gehring (68, Margate) has been charged with trafficking prescription opioids, primarily oxycodone, from late 2010 through 2017. According to the criminal complaint, in addition to acquiring pills himself, Gehring conspired with family members, including his brother, Patrick Gehring (59, Davie), his daughter, Tina Gehring (45, Coral Springs), and several others, including Sean Grelecki (45, Deltona). The conspirators fraudulently acquired and filled prescriptions for thousands of oxycodone pills, and other drugs, in order to illegally distribute them at black market prices of $20 per pill or more. Gehring paid for the health visits and the pharmacy costs for the oxycodone for those who fraudulently acquired pills for him. He also paid the prescription filler $600 to $900 per month, depending on the number of pills acquired. Jack Gehring then distributed thousands of oxycodone pills in Florida, Massachusetts, Connecticut, and elsewhere.
The Middle District of Florida cases are being handled by Assistant U.S. Attorneys Jay Trezevant, Thomas Palermo, Jason Mehta, Jackson Boggs, and DOJ Senior Trial Attorney Christopher Hunter of the Fraud Section.
This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2.5 billion in judgments and settlements related to matters alleging health care fraud.
National Health Care Fraud Takedown Results in Charges Against over 412 Individuals Responsible for $1.3 Billion in Fraud LossesRead the Press Release
WASHINGTON – Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
Attorney General Sessions and Secretary Price were joined in the announcement by Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting Director Andrew McCabe of the FBI, Acting Administrator Chuck Rosenberg of the Drug Enforcement Administration (DEA), Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG), Chief Don Fort of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
The charges announced today aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the CDC, approximately 91 Americans die every day of an opioid related overdose.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
“Today’s announcement demonstrates the Department of Justice’s commitment to focus investigative resources on individuals who choose to pursue profit over public health. Ultimately, health care fraud deprives the elderly and disabled from benefits they are entitled to receive,” said US Attorney Rosa Emilia Rodríguez-Vélez. “We will continue to aggressively pursue and prosecute those who commit fraud against our nation’s federal healthcare programs.”
“Healthcare fraud is not only a criminal act that costs billions of taxpayer dollars - it is an affront to all Americans who rely on our national healthcare programs for access to critical healthcare services and a violation of trust,” said Secretary Price. “The United States is home to the world’s best medical professionals, but their ability to provide affordable, high-quality care to their patients is jeopardized every time a criminal commits healthcare fraud. That is why this Administration is committed to bringing these criminals to justice, as President Trump demonstrated in his 2017 budget request calling for a new $70 million investment in the Health Care Fraud and Abuse Control Program. The historic results of this year’s national takedown represent significant progress toward protecting the integrity and sustainability of Medicare and Medicaid, which we will continue to build upon in the years to come.”
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.
As part of this national effort, the District of Puerto Rico charged 13 individuals in six separate indictments, including three physicians and two pharmacists, in four schemes involving drug diversion, Medicaid fraud, and the theft of funds from a health care program. Defendants Miguel Hernández-Marquez, owner of Farmacia Condado Moderno in Caguas; Guillermo Tirado-Menéndez, a physician specialized in internal medicine with offices located in Caguas and Cidra; Gilberto Figueroa-Trinidad, aka “Chino;” Rebecca Sierra-López, aka “Rebe,” a nurse; William Vélez-Montes, a pharmacist; and Myrna Nevares-Sobrino, a pharmacist, are charged for their participation in a conspiracy to manufacture, distribute and dispense - outside the scope of professional practice and not for a legitimate medical purpose - a controlled substance, that is, at least 70,000 units of Oxycodone (commonly known as Percocet), and at least 40,000 units of Alprazolam (commonly known as Xanax).
In a separate indictment, defendants Hernández-Marquez, Figueroa-Trinidad, Vélez-Montes and Nevares-Sobrino; along with Luis Vélez-Quiñones, a physician specialized in internal medicine with office located in Guánica; and Laura López-Rolón are charged with conspiracy to manufacture, distribute and dispense - outside the scope of professional practice and not for a legitimate medical purpose - a controlled substance, that is, at least 77,000 units of Oxycodone, at least 47,000 units of Alprazolam, and at least 40,000 units of Tramadol.
In a third indictment, Ivette Caraballo-Pérez, aka “Tita” and Steven Velázquez-Pérez are charged with conspiracy to possess with intent to distribute Oxycodone. The fourth indictment charges José Vega-Emmanuelli, a DEA registrant with the authorization to dispense controlled substances, with possession with intent to dispense, outside the scope of professional practice and not for a legitimate medical purpose, Oxycodone and Alprazolam.
Defendant Luz De Alba Quezada-De Jesús, a Postal Service employee, is charged with health care fraud and false statements relating to health care matters. Quezada-De Jesús certified that she was unemployed in order to receive Medicaid benefits, also known as Mi Salud, through First Medical Health Plan Inc. In a separate indictment, Yalixa Flores-Fuentes, employed by MMM Healthcare, LLC is charged with bank fraud, aggravated identity theft, and embezzlement in connection with health care. Flores-Fuentes submitted false invoices for catering services and, using her status as an employee of MMM, caused checks to be drawn which she later cashed for herself.
The cases are being handled by Assistant U.S. Attorneys Teresa Zapata-Valladares, and Susan Z. Jorgensen, and Special Assistant U.S. Attorney Amanda C. Soto-Ortega.
“The arrests conducted in Puerto Rico last Monday as part of the nationwide “Diversion and Health Care Takedown” shed some light to the communities in the island that DEA, other federal and state agencies will target any kind of illicit drug trafficking activity threatening our communities,” stated DEA Special Agent in Charge Matthew G. Donahue. “The opioid addiction issue in the United States has become a national crisis, for this reason we are working hard and proactively to keep our neighborhoods and communities safe and to protect the lives of our citizens. This enforcement operation sends a message to the medical professionals that once they dishonor their Hippocratic Oath, DEA will investigate them and bring any physician or pharmacist to justice that violates federal narcotics laws and regulations. Law enforcement agencies/departments in Puerto Rico are part of our communities support networks and our goals and mandates are to prevent the individuals responsible who are dealing and trafficking in these opioid substances from killing our families and friends selling one baggy, one deck, capsule, and one pill. DEA will stay here, and we will prevail.”
“This indictment is another reminder that the misappropriation of federal funds is illegal and unacceptable,” said Scott J. Lampert, Special Agent in Charge, Office of Inspector General, U.S. Department of Health and Human Services. “HHS-OIG, along with our law enforcement partners, will not tolerate this behavior and will remain vigilant in our efforts to protect the integrity of our federal health care programs.”
Eileen Neff, Special Agent-in-Charge, U.S. Postal Service Office of Inspector General stated: “The U.S. Postal Service Office of Inspector General investigates those who would defraud the Postal Service as well as Postal Service employees alleged to commit fraud against other government programs. We will continue to work closely with our law enforcement partners in investigations such as this and we thank the U.S. Attorney’s Office and HHS-OIG for their assistance with our investigations.”
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.
This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2.5 billion in judgements and settlements related to matters alleging health care fraud.
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National Health Care Fraud Takedown Includes Two Central Ohio Companies and Owners Charged with False BillingRead the Press Release
COLUMBUS, Ohio – A federal grand jury has returned separate indictments charging two central Ohio health care companies and the people who own them with health care fraud. One company allegedly billed government insurance programs for unnecessary medical procedures and the other is accused of billing government insurance programs for pain and scar creams that recipients said they never requested or wanted.
The two Ohio cases are part of a nationwide health care fraud takedown announced today by Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D.
Benjamin C. Glassman, United States Attorney for the Southern District of Ohio; Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services; Office of Inspector General – Chicago Region; the Medicaid Fraud Control Unit in Ohio Attorney General Mike DeWine’s Office; Angela Byers, Special Agent in Charge, Federal Bureau of Investigation Cincinnati; Timothy J. Plancon, Special Agent in Charge, Drug Enforcement Administration (DEA); and Steven W. Schierholt, Executive Director of the Ohio Board of Pharmacy announced the indictments today as part of a nationwide crackdown on fraudulent health care providers.
One indictment alleges that Salim Dahdah who owns and operates the Ohio Institute of Cardiac Care (OICC) in Springfield, and his wife Cindy Dahdah who owns Accubil, a company that handles the billing for OICC, received more than $2 million from Medicare and Medicaid for medically unnecessary nuclear stress tests and medically unnecessary coronary interventions such as pacemaker insertion and stent procedures. The indictment charges them with conspiracy to commit health care fraud and health care fraud, crimes punishable by up to ten years in prison, and health care false statements a crime which carries a maximum sentence of five years in prison.
The grand jury also indicted Darrell Bryant and Gifty Kusi, a husband and wife who own and manage Health & Wellness Pharmacy in Dublin. Kusi and Dr. Jornel Rivera owned and operated Health & Wellness Medical Center, also in Dublin. The indictment alleges that they fraudulently received more than $3 million from the Ohio Department of Medicaid and Medicaid Managed Care Organizations (MCOs) through multiple schemes including billing for compound creams that were not provided or not requested by patients, billing for counseling services that were not provided or billing for group counseling sessions as individual counseling services. The indictment charges all three defendants with conspiracy to commit health care fraud and health care fraud.
“Health care fraud creates victims out of patients, providers, and taxpayers,” U.S. Attorney Glassman said. “It’s a crime that breaks the bonds of trust between doctor and patient, and between government and the people, just for the sake of personal greed.”
“The charges announced today should send a strong message to criminals that theft from vital health care programs will not be tolerated”, said SAC Pugh of HHS Office of Inspector General. “The OIG and our law enforcement partners will continue to be vigilant in our efforts to protect tax payer dollars that are intended to aid our most vulnerable citizens.”
“Both of these cases are egregious,” said Attorney General DeWine. “In the OICC case, the investigation found that patients underwent dangerous and completely unnecessary medical procedures, and in the Health and Wellness Pharmacy case, the investigation found that people who legitimately needed drug treatment and counseling weren’t getting it – even though the company charged for it. In the midst of the opioid epidemic in Ohio, it is critical that healthcare providers are rendering services that are meant to help Ohioans struggling with addiction.”
“Some of the charges described include medically unnecessary procedures performed which could cause patient harm. This is the most egregious form of health care fraud”, said SAC Byers of the FBI, adding that “Health care fraud contributes to rising health care costs for everyone.”
Today’s nationwide enforcement action is the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
U.S. Attorney Glassman commended the investigation of this case by the HHS-OIG, Ohio Attorney General Mike DeWine’s Medicaid Fraud Control Unit and IRS Criminal Investigation, as well as Assistant United States Attorney Kenneth Affeldt and Special Assistant United States Attorney Maritsa Flaherty, who are representing the United States in this case.
An indictment merely contains allegations, and the defendant is presumed innocent unless proven guilty in a court of law.
Mount Morris Man Sentenced on Child PornographyRead the Press Release
CONTACT: Barbara Burns
PHONE: (716) 843-5817
FAX: (716) 551-3051ROCHESTER, N.Y.—Acting U.S. Attorney James P. Kennedy, Jr. announced today that Calvin R. Patrick, 35, of Mount Morris, NY, who was convicted of receipt of child pornography, was sentenced to 295 months in prison by Chief U.S. District Judge Frank P. Geraci, Jr.
Assistant U.S. Attorney Tiffany H. Lee, who is handling the case, stated that in the fall of 2015, Patrick enticed two minor females under the age of 18 to send to him sexually explicit pictures of themselves. The defendant used the application known as “Kik” to communicate with a 14-year-old female in Florida and a female in Pennsylvania who was not quite 12 years-old.
The plea is the culmination of an investigation by the Federal Bureau of Investigation, under the direction of Special Agent-in-Charge Adam S. Cohen; the Mount Morris Police Department, under the direction of Chief Kenneth Mignemi; the Livingston County Probation Department, under the direction of Director Lynne C. Mignemi; and the Livingston County District Attorney’s Office, under the direction of Gregory J. McCaffrey.
Michigan Real Estate Businessman Sentenced to Prison for Obstructing the Internal Revenue Laws and Bank FraudRead the Press Release
A Michigan business owner was sentenced to serve a year and a day in prison today for obstructing and impeding the internal revenue laws and committing bank fraud, announced Acting Deputy Assistant Attorney General Stuart M. Goldberg of the Justice Department’s Tax Division.
According to documents filed with the court, Richard Pierce filed fraudulent 2004 through 2013 individual income tax returns. Those returns failed to report more than $9 million in gross business receipts that several of his real estate businesses earned, including Phoenix Real Estate Company, Phoenix Preferred Properties LLC, Detroit Matrix, First Metro Properties LLC, First Metro Real Estate Services LLC, Phoenix Office Plaza-II LLC, Rosedale/Grandmont Properties LLC, and RFP Ventures LLC. As a result of those fraudulent filings, Pierce caused a tax loss of more than $400,000.
In 2007, Pierce also committed bank fraud by submitting a fraudulent loan application to a mortgage lender on which he failed to disclose that the buyer of a residential property was receiving a kickback from the seller.
In addition to the term of prison imposed, Pierce was ordered to serve two years of supervised release and to pay restitution to the Internal Revenue Service (IRS), the amount of which will be determined at a later date. Pierce pleaded guilty in February 2015.
Acting Deputy Assistant Attorney General Goldberg commended special agents of IRS Criminal Investigation, who conducted the investigation, and Trial Attorneys Mark McDonald and Christopher O’Donnell of the Tax Division, who prosecuted the case. Acting Deputy Assistant Attorney General Goldberg also thanked the U.S. Attorney’s Office for the Eastern District of Michigan for their substantial assistance.
Additional information about the Tax Division’s enforcement efforts can be found on the division’s website.
Miami-Based Physician Pleads Guilty for Role in Pain Pill Diversion and Medicare Fraud SchemeRead the Press Release
A licensed physician in Miami pleaded guilty in federal court yesterday for his role in a multi-faceted $4.8 million health care fraud scheme that ran from April 2011 to February 2017, involving the submission of false and fraudulent claims to Medicare and the illegal prescribing of Schedule II (e.g., oxycodone and hydrocodone) and Schedule IV (e.g., alprazolam) controlled substances.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office, and Special Agent in Charge Brian Swain of the U.S. Secret Service’s (USSS) Miami Field Office made the announcement.
Roberto A. Fernandez, M.D., 51, of Miami, pleaded guilty before U.S. District Judge Cecelia M. Altonaga of the Southern District of Florida to one count of conspiracy to commit health care fraud and wire fraud. Sentencing is set for September 20.
According to admissions made as part of his guilty plea, Fernandez referred Medicare beneficiaries to pharmacy owners in exchange for illegal health care kickbacks. Fernandez admitted knowing that the pharmacy owners were billing and receiving reimbursements from Medicare for prescription drugs based upon the prescriptions he sold, and that his patients did not truly need many of the medications he prescribed in exchange for the kickbacks. For example, he admitted providing prescriptions for expensive, name brand drugs, including anti-psychotics and HIV/AIDS medications that were not medically necessary.
Fernandez also solicited referrals of Medicare beneficiaries to his own practices from his co-conspirators, he admitted, including submitting claims to Medicare under his Part B provider number for services he did not, in fact, render to Medicare beneficiaries. Additionally, Fernandez admitted receiving kickbacks in return for signing plans of care and prescriptions for home health services.
Fernandez also admitted that he prescribed controlled substances, including dangerous opioids, to patients and patient recruiters in return for $100 - $200 cash per prescription. Fernandez admitted that he knew these patients did not need the controlled substances he prescribed. Furthermore, Fernandez admitted that he wrote many of these controlled substance prescriptions for patients that he did not even examine.
The FBI, HHS-OIG, and USSS investigated the case, which was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. Former Fraud Section Trial Attorney and current Assistant U.S. Attorney Lisa H. Miller of the Southern District of Florida and Fraud Section Trial Attorney Adam G. Yoffie are prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 3,000 defendants who have collectively billed the Medicare program for more than $11 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.
Mexican men indicted for reentering the U.S.Read the Press Release
Two Mexican men have been indicted for illegally re-entering the country, said Acting U.S. Attorney David A. Sierleja.
Jose Martin Bautista-Mondragon, 46, was found to be in Ohio after being deported in 2014 and 2016, according to the indictment.
Oman Mendiola was found in Ohio after being deported in 2011, according to the indictment.
If convicted, the defendant’s sentence will be determined by the Court after reviewing factors unique to this case, including the defendant’s prior criminal record, if any, the defendant’s role in the offense and the characteristics of the violation. In all cases the sentence will not exceed the statutory maximum and, in most cases, it will be less than the maximum.
The investigating agency in these cases is the Immigration and Customs Enforcement of the Department of Homeland Security. The cases are being handled by Assistant U.S. Attorneys Tracey Ballard Tangeman and Noah Hood.
An indictment is only a charge and is not evidence of guilt. Defendants are entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.
Medford Woman Sentenced for Stealing Personal Information from Former EmployerRead the Press Release
BOSTON - A former employee of Tufts Health Plan was sentenced today in federal court in Boston for stealing the identifying information of over 8,000 Medicare customers.
Lynrolte Cezaire, 29, of Medford, was sentenced by U.S. District Court Judge George A. O’Toole Jr. to two years and one day in prison and two years of supervised release. Following a seven-day jury trial in April 2017, Cezaire was convicted by a federal jury of unlawfully disclosing Social Security numbers and aggravated identity theft.
During her time as an employee in the Medicare enrollment department at Tufts Health Plan, from 2011 to 2014, Cezaire helped a coworker, Emeline Lubin, photograph Cezaire’s computer screen while it displayed lists of Medicare customers’ names, dates of birth, and Social Security numbers. Lubin then gave the information to Sniders Jean-Jacques, a Florida man who was involved in a scheme with Lubin’s brother, Marvin, to use stolen identities to steal Social Security benefits and to file false tax returns and collect the refunds.
In October 2014, Marvin Lubin was sentenced to one year and one day in prison; in December 2014, Jean-Jacques was sentenced to two years in prison; and in May 2017, Emeline Lubin was sentenced to three months in prison.
Acting United States Attorney William D. Weinreb; Scott Antolik, Special Agent in Charge of the Office of Inspector General, Social Security Administration, Office of Investigations, Boston Field Division; Phillip Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of the Inspector General; Joel P. Garland, Special Agent in Charge of the Internal Revenue Service’s Criminal Investigation in Boston; and Stephen A. Marks, Special Agent in Charge of the U.S. Secret Service, Boston Field Office, made the announcement. Assistance was also provided by the Suffolk County District Attorney’s Office. Assistant U.S. Attorney Robert Richardson of Weinreb’s Major Crimes Unit prosecuted the case.
McLean County Man Sentenced to 5 1/2 Years in Prison for Receiving Child PornographyRead the Press Release
PEORIA, Ill. – A Bloomington, Ill., man, Braman Benjamin Broy, 22, has been sentenced to 68 months (5 years, 8 months) in prison for receiving child pornography. In addition to the prison term, U.S. District Judge Michael M. Mihm ordered that Broy remain on supervised release for eight years following his release from incarceration. Broy will be required to register as a sex offender.
Broy pleaded guilty on Jan. 9, 2017. According to court documents, Broy was a member of Playpen, a hidden website dedicated to sharing child pornography that operated on the Tor network, from August 2014 until March 2015. In February 2015, Broy logged into Playpen and downloaded content depicting the sexual exploitation of children. During a search of his residence, agents located a computer and hard drives that contained more than 2,600 images and 530 videos of child pornography.
Broy has been detained in the custody of the U.S. Marshals Service since his arrest on May 31, 2016.
The case was prosecuted by Assistant U.S. Attorney Ronald L. Hanna, and investigated by the FBI.
This case was brought as part of Project Safe Childhood, a nationwide initiative to combat the growing epidemic of child sexual exploitation and abuse launched in May 2006 by the Department of Justice. Led by U.S. Attorneys’ Offices and the Criminal Division’s Child Exploitation and Obscenity Section (CEOS), Project Safe Childhood marshals federal, state and local resources to better locate, apprehend and prosecute individuals who exploit children via the Internet as well as to identify and rescue victims. For more information about Project Safe Childhood, please visit www.projectsafechildhood.gov.
Massachusetts Woman Pleads Guilty to Drug Distribution ConspiracyRead the Press Release
CONCORD, N.H. – Acting United States Attorney John J. Farley announced today that Leslie Aberle, 33, of Salisbury, Massachusetts, pleaded guilty to conspiring to distribute and to possess with the intent to distribute heroin and fentanyl.
According to documents that were filed in court, on October 16, 2015, Aberle drove Mark Ross and Eve Tarmey to Lawrence, Massachusetts, in order to obtain a quantity of heroin. Ross obtained the drugs from a source in Lawrence while Aberle and Tarmey waited in Aberle’s car. After Ross acquired the drugs, the three returned to the Riviera Motel. Ross and Jazzmyn Rood also used a portion of the drugs and Ross provided a portion to Tarmey. The following morning, Tarmey was found dead in the motel room. The New Hampshire Medical Examiner later found that Ms. Tarmey died of acute fentanyl intoxication.
“The U.S. Attorney’s Office is dedicated to working with our law enforcement partners to combat the distribution of fentanyl and other dangerous drugs,” said Acting U.S. Attorney Farley. “Fentanyl and other opioids are responsible for the deaths of far too many citizens of the Granite State. We will continue to work each day with our law enforcement partners to prosecute those who are distributing these drugs in New Hampshire.”
“Opioid abuse is at epidemic levels in New Hampshire,” said DEA Special Agent in Charge Michael J. Ferguson. “Fentanyl and heroin are causing overdose deaths across the Granite State in record numbers, and DEA is committed to aggressively pursue anyone who distributes these poisons in order to profit and destroy people’s lives. This investigation demonstrates the strength and continued commitment of our local, state and federal law enforcement partners.”
A sentencing hearing is set for August 22, 2017. Under the terms of a plea agreement, both parties are recommending a sentence of 60 months in prison.
The case was investigated by the Rochester Police Department and the Drug Enforcement Administration assisted in the investigation. The case is being prosecuted by Assistant U.S. Attorney Donald Feith.
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Massachusetts Man Pleaded Guilty to Conspiring to Defraud the IRS Using Stolen IDs of Puerto Rico Residents to Claim Tax RefundsRead the Press Release
A Lawrence, Massachusetts man pleaded guilty today during his trial in the District of Massachusetts to conspiring to defraud the Internal Revenue Service (IRS), access device fraud, theft of government property, aggravated identity theft and money laundering, announced Acting Deputy Assistant Attorney General Stuart M. Goldberg of the Justice Department’s Tax Division and Acting U.S. Attorney William D. Weinreb for the District of Massachusetts.
According to the evidence presented at trial, from 2008 through 2015, Furvio Flete-Garcia, 45, obtained the personal identification information of Puerto Rico residents and, without their knowledge or consent, paid others to prepare and file tax returns with the IRS in their names. These returns listed fake income and tax withholdings and sought fraudulent refunds. Flete-Garcia would pick up the tax refund checks from addresses he controlled and cashed them with co-conspirators for a percentage of their face value. In total, he negotiated millions in fraudulent refund checks at two different check cashing businesses in Lawrence.
Flete-Garcia is scheduled to be sentenced on Sept. 25 by U.S. District Judge Leo Sorokin. Flete-Garcia faces a statutory maximum sentence of five years in prison for conspiracy, 10 years in prison for each count of theft of government property and access device fraud, 20 years in prison for each count of money laundering and a mandatory minimum sentence of two years in prison for aggravated identity theft. He also faces a period of supervised release, restitution and monetary penalties. Flete-Garcia’s co-defendant, Juan Santiago, pleaded guilty in April 2016 to conspiracy to defraud the IRS, access device fraud, conversion of government property and aggravated identity theft. He is scheduled to be sentenced on Sept. 8.
Acting Deputy Assistant Attorney General Goldberg and Acting U.S. Attorney Weinreb thanked special agents of IRS Criminal Investigation, who conducted the investigation, and Senior Litigation Counsel Corey Smith and Trial Attorney Sean Green of the Tax Division, who prosecuted the case. Acting Deputy Assistant Attorney General Goldberg also thanked the U.S. Immigration and Customs Enforcement’s Homeland Security Investigations, the Secret Service, the Social Security Administration Office of Inspector General, the U.S. Postal Inspection Service and the U.S. Attorney’s Office for the District of Massachusetts for assisting in the investigation and prosecution.
Additional information about the Tax Division’s enforcement efforts can be found on the division’s website.
Kinderhook Podiatrist Pleads Guilty to Health Care Fraud, Pays $410,000 to Resolve False Claims Act LiabilityRead the Press Release
ALBANY, NEW YORK – Podiatrist Perrin D. Edwards, age 64, of Kinderhook, New York, pled guilty on Tuesday to health care fraud for illegally charging Medicare and private insurance companies for services that he never provided. Edwards has also paid $410,000 to the United States to resolve his civil liability for his submission of false claims for payment to the Medicare program.
The announcement was made by Acting United States Attorney Grant C. Jaquith; Scott J. Lampert, Special Agent in Charge of the New York Regional Office for the Department of Health and Human Services, Office of Inspector General; and Vadim D. Thomas, Special Agent in Charge of the Albany Field Office of the Federal Bureau of Investigation.
Edwards’s guilty plea was entered as part of a nationwide law enforcement operation targeting health care fraud, announced today by Attorney General Jeff Sessions and other officials in Washington, D.C. (see news release).
As part of his guilty plea, Edwards admitted that he operated a podiatry practice with offices in Hudson and Albany, New York, and caused false and fraudulent claims to be submitted to Medicare and private insurance companies for podiatric medical services that he had not performed or that he knew would not be covered by insurance.
Edwards admitted that he performed routine foot care services that were not covered by insurers, and falsely represented that nail debridement services were performed for some patients. Nail debridement is the process of removing dead and diseased portions of a toenail in order to significantly reduce its thickness and length, with the aim of allowing the patient to move around without pain.
Edwards also submitted claims to insurers for the trimming of normal toenails for patients Edwards knew did not suffer from any systemic condition such that Medicare and other insurers would cover his services. In connection with these fraudulent claims, Edwards caused false information to be entered into the patients’ medical records indicating that the patients suffered from systemic conditions and had reported symptoms that were not present.
Edwards faces up to 10 years in prison, up to 3 years of post-imprisonment supervised release, and the possibility of a fine, when he is sentenced by United States District Judge Mae A. D’Agostino on November 14, 2017. A defendant’s sentence is imposed by a judge based on the particular statute the defendant is charged with violating, the U.S. Sentencing Guidelines and other factors.
As part of the civil settlement, Edwards has paid $410,000 to the United States and admitted that he submitted, or caused others to submit, false claims for payment to the government representing that he had performed toenail debridements. Edwards also admitted that he submitted, or caused others to submit, false claims for payment for trimming toenails of patients that he knew did not suffer from conditions covered by Medicare.
This case was investigated by the Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation. The criminal case is being prosecuted by Assistant United States Attorney Jeffrey C. Coffman. The United States was represented in the civil case by Assistant United States Attorney Adam J. Katz.
KC Man Sentenced for Marriage FraudRead the Press Release
KANSAS CITY, Mo. – Tom Larson, Acting United States Attorney for the Western District of Missouri, announced that a Kansas City, Mo., man was sentenced in federal court today for his role in leading a marriage fraud conspiracy.
Delmar Dixon, 49, of Kansas City, was sentenced by U.S. District Judge Gary A. Fenner to three years in federal prison without parole.
Dixon pleaded guilty on March 8, 2017, to leading a conspiracy to assist African nationals in circumventing immigration laws by arranging fraudulent marriages. Dixon also pleaded guilty to falsely swearing in an immigration matter.
Dixon admitted that he arranged 30 to 40 fraudulent marriages, including his own. Dixon charged the African nationals $1,000 upfront for his services, which included providing them U.S. citizen spouses. The African nationals were additionally required to pay $500 to the spouse at the time of the wedding, and an additional $500 immediately after completion of the wedding. They were required to pay their spouses $250 each month after the weddings until the immigration process was complete. The African nationals were coached by Dixon on how to make their marriages appear legitimate.
In addition to arranging fraudulent marriages, Dixon engaged in a fraudulent marriage himself. Dixon obtained a marriage license on March 19, 2008, and married a Kenyan national who had entered the United States as a B2 nonimmigrant visitor but overstayed her visa.
Co-defendant Traci R. Porter, 45, of Kansas City, Mo., was sentenced to two years in federal prison without parole. Co-defendant Tierra Ofield, 24, of Kansas City, Mo., was sentenced to one year and one day in federal prison without parole. Co-defendants Kakeland Barnes, 37, Shakeisha Harrison, 37, and Stephanie Harris, 22, all of Kansas City, Mo., have pleaded guilty to their roles in the marriage fraud conspiracy and await sentencing.
This case is being prosecuted by Special Assistant U.S. Attorney Kim Moore. It was investigated by Immigration and Customs Enforcement's (ICE) Homeland Security Investigations (HSI) and U.S. Citizenship and Immigration Services, Fraud Detection and National Security.
Justice Department Files Sexual Harrassmnet Lawsuit Against Owner and Seller of North Carolina HomesRead the Press Release
CHARLOTTE, N.C. – The Justice Department today announced that it has filed a lawsuit against Robert N. Hatfield, who rents, sells, and finances homes in Wilkes County, North Carolina. The lawsuit alleges that Hatfield sexually harassed actual and prospective female residents and borrowers in violation of the Fair Housing Act and the Equal Credit Opportunity Act.
The complaint, filed in the U.S. District Court for the Western District of North Carolina, alleges that for over ten years Hatfield has committed egregious acts of sexual harassment against multiple women who have lived in or inquired about his homes. According to the complaint, Hatfield operates some of his homes as rental properties, which he manages, and offers and provides financing to purchasers of his other homes. The suit alleges that Hatfield’s conduct has included making unwelcome sexual comments and advances, engaging in unwanted sexual touching and groping, offering tangible housing benefits in exchange for sex acts, and taking or threatening to take adverse housing actions against women who object to his harassment.
“Sexual harassment in housing and lending is unacceptable, and indeed is illegal,” said Acting Assistant Attorney General Tom Wheeler of the Justice Department’s Civil Rights Division. “Every woman has the right to feel safe in her home, and the Justice Department will continue to vigorously enforce the federal civil rights laws to hold accountable those who violate this basic right.”
“The victims in this case merely wanted to rent or buy a home, a place of sanctity and safety,” said U.S. Attorney Jill Westmoreland Rose of the Western District of North Carolina. “Unfortunately, the process became sordid when Hatfield used the critical need for housing as leverage to make unwanted and aggressive sexual advances. This lawsuit should serve as fair warning that Mr. Hatfield’s actions were not only unlawful, but repugnant to the citizens of Western North Carolina - and this office will work vigorously to protect the women, families and other vulnerable individuals harmed by this type of conduct.”
The lawsuit seeks monetary damages to compensate victims, a civil penalty, and a court order barring further discrimination and requiring additional preventive measures. The complaint is an allegation of unlawful conduct. The allegations must be proven in federal court.
Individuals who believe they may have been victims of housing or lending discrimination by Robert Hatfield or who have information about this matter can contact the Justice Department by phone at 1-800-896-7743, mailbox number 3, or by e-mail at [email protected]. More information about the Civil Rights Division and the laws it enforces is available at http://www.justice.gov/crt.
Justice Department Files Sexual Harassment Lawsuit against Owner and Seller of North Carolina HomesRead the Press Release
The Justice Department today announced that it has filed a lawsuit against Robert N. Hatfield, who rents, sells, and finances homes in Wilkes County, North Carolina. The lawsuit alleges that Hatfield sexually harassed actual and prospective female residents and borrowers in violation of the Fair Housing Act and the Equal Credit Opportunity Act.
The complaint, filed in the U.S. District Court for the Western District of North Carolina, alleges that for over ten years Hatfield has committed egregious acts of sexual harassment against multiple women who have lived in or inquired about his homes. According to the complaint, Hatfield operates some of his homes as rental properties, which he manages, and offers and provides financing to purchasers of his other homes. The suit alleges that Hatfield’s conduct has included making unwelcome sexual comments and advances, engaging in unwanted sexual touching and groping, offering tangible housing benefits in exchange for sex acts, and taking or threatening to take adverse housing actions against women who object to his harassment.
“Sexual harassment in housing and lending is unacceptable, and indeed is illegal,” said Acting Assistant Attorney General Tom Wheeler of the Justice Department’s Civil Rights Division. “Every woman has the right to feel safe in her home, and the Justice Department will continue to vigorously enforce the federal civil rights laws to hold accountable those who violate this basic right.”
“The victims in this case merely wanted to rent or buy a home, a place of sanctity and safety,” said U.S. Attorney Jill Westmoreland Rose of the Western District of North Carolina. “Unfortunately, the process became sordid when Hatfield used the critical need for housing as leverage to make unwanted and aggressive sexual advances. This lawsuit should serve as fair warning that Mr. Hatfield’s actions were not only unlawful, but repugnant to the citizens of Western North Carolina - and this office will work vigorously to protect the women, families and other vulnerable individuals harmed by this type of conduct.”
The lawsuit seeks monetary damages to compensate victims, a civil penalty, and a court order barring further discrimination and requiring additional preventive measures. The complaint is an allegation of unlawful conduct. The allegations must be proven in federal court.
Individuals who believe they may have been victims of housing or lending discrimination by Robert Hatfield or who have information about this matter can contact the Justice Department by phone at 1-800-896-7743, mailbox number 3, or by e-mail at [email protected]. More information about the Civil Rights Division and the laws it enforces is available at http://www.justice.gov/crt.
Jury Finds Mother Guilty of Smuggling Methamphetamine and Cash Inside Car SeatsRead the Press Release
LITTLE ROCK—Patrick C. Harris, Acting United States Attorney for the Eastern District of Arkansas, and Matthew Barden, Assistant Special Agent in Charge, Drug Enforcement Administration (DEA), Little Rock District Office, announced today that a federal jury found Elsa Solis, 38, of Batesville, guilty of conspiracy to possess with intent to distribute methamphetamine, possession with the intent to distribute methamphetamine, and misprision in a case that involved smuggling 2.5 kilos of methamphetamine and $19,000 cash inside two car seats.
United States District Judge Kristine G. Baker presided over the three-day trial, which concluded Wednesday with the jury verdict finding Solis guilty on all counts. Solis will be sentenced by Judge Baker at a later date.
“It is reprehensible that a mother would use her children to attempt to conceal her methamphetamine smuggling,” Harris said. “This conspiracy involved multiple kilos of methamphetamine intended to poison our communities, and the hard work of everyone involved ensured a jury verdict which completes the successful dismantling of this dangerous drug trafficking organization.”
Solis is the final member of the charged conspiracy to be convicted. The individuals charged in the conspiracy included Solis and her boyfriend, Ivan Pedraza, as well as six others. Pedraza previously pleaded guilty to conspiracy and possession with intent to distribute methamphetamine. The other six defendants also previously pleaded guilty to various charges associated with the case.
Testimony during the trial established that prior to the discovery of the loaded car seats on July 19, 2015, Homeland Security Investigations and the DEA intercepted two packages which contained 18 kilograms of methamphetamine that were mailed from Mexico and addressed to the addresses of individuals involved in the conspiracy.
Evidence at trial included recorded wiretap phone calls between Pedraza and Solis. The phone calls were in Spanish and translations were provided to the jury. DEA Special Agent LeAnn Bakr explained to the jury how a wiretap is obtained, how calls are monitored, and that 11 such calls were selected and translated for the trial.
In the recorded calls the jury heard Solis agreeing to buy acetone, which is used by methamphetamine traffickers to rid the substance of impurities before sale. The recorded calls also documented a trip to Dallas taken by Pedraza, Solis, and her two children in July 2015. The jury heard calls that discussed how Pedraza and Solis needed to buy new car seats, since the others were left in Batesville. One call recorded Pedraza talking about how one car seat left behind was still loaded with “stew.” Former DEA Task Force Officer Ryan Temple, now with North Little Rock Police Department testified that “stew” was a code word for methamphetamine.
Officer Temple also provided surveillance during Solis and Pedraza’s trip to Dallas. He testified that Solis, Pedraza, and her two children drove to Dallas in a Honda Pilot on a Friday, and arrived in the Dallas area after midnight, only to leave early on Sunday morning less than 36 hours later.
Calls intercepted during the Dallas trip recorded Solis asking Pedraza if he had “fixed” everything while she had waited at the hotel pool and arcade with her children. Agents also overheard Pedraza planning the delivery with other co-conspirators and discussing how much methamphetamine was ready to be delivered when he returned to Arkansas.
Officer Temple testified that he and his surveillance team witnessed Pedraza receive the methamphetamine at the hotel after agents intercepted a call that stated that the co-conspirator would arrive at the hotel with a blender box.
After the Honda left the Dallas area that early Sunday morning, Arkansas State Police Trooper Timothy Callison performed a traffic stop on the vehicle as it entered Saline county. The trooper located methamphetamine, which totaled to 2.5 kilos, and $19,000 in cash, in the bottom of the car seats, which he noticed were abnormally heavy. The trooper was able to remove the bottoms of the car seats—discovering the methamphetamine and cash—with a drill that was also located in the vehicle. The trooper testified that the drill had only one bit, and it fit perfectly with the car seat screws, needing no adjustments. More than $1,700 cash was later found in Solis’ purse when she was in custody.
Law enforcement later located approximately $40,000 and more methamphetamine in subsequent search warrants executed on two homes related to the conspiracy in Batesville and one home in Little Rock.
The statutory penalty for conspiracy to possess with intent to distribute and for possession with intent to distribute more than 500 grams of methamphetamine is not less than 10 years’ imprisonment, not more than life, a $10,000,000 fine, or both, and not less than five years of supervised release. The statutory penalty for misprision, which makes it a crime to have knowledge that a crime is being committed while taking a step to conceal and not report the crime, is not more than three years’ imprisonment, a $250,000 fine, and one year of supervised release.
The investigation was conducted by the DEA, with assistance from the Arkansas State Police and other local agencies. The case was prosecuted by Assistant United States Attorneys Erin O’Leary and Allison Bragg.
Jury Convicts Two of Federal Charges Relating to the Distribution of Drugs That Resulted in OverdosesRead the Press Release
The case involved a cluster of overdoses, in Montgomery County, caused by carfentanil.
LEXINGTON, Ky. – Today, a federal jury convicted Robert Shields, of Cincinnati, and Wesley Hamm, of Mount Sterling, Ky., of one count of conspiracy to distribute carfentanil, fentanyl, and heroin; one count of distribution of carfentanil resulting in death; and one count of distribution of carfentanil resulting in serious bodily injury. The charges involved a cluster of drug overdoses, within a 12-hour period, in Montgomery County, in August of 2016. The jury returned its verdict after an hour and twenty minutes of deliberation, following four days of trial.
“These defendants were illegally distributing extremely dangerous drugs; and all too predictably, that resulted in overdoses and an unnecessary death,” said Carlton S. Shier, IV, Acting United States Attorney for the Eastern District of Kentucky. “Carfentanil is designed for large mammals – not humans – and presents a grave danger to the public. These defendants brazenly risked the lives of the people in Montgomery County and our office remains committed to using the severe penalties available to punish drug trafficking resulting in overdoses under federal law. The great work of our local and federal law enforcement partners made this case possible and helps make our Overdose Prosecution Initiative such a success.”
Both men face a minimum of twenty years and a maximum of life imprisonment.
Acting United States Attorney Shier; Timothy J. Plancon, Special Agent in Charge of the Detroit Field Division of the DEA; Fred Shortridge, Montgomery County Sheriff; and David Charles, Chief of the Mount Sterling Police Department, jointly announced the verdict.
Formal sentencing for both defendants is scheduled for November 17, 2017. The investigation was conducted by DEA, the Montgomery County Sheriff’s Office, and the Mount Sterling Police Department. Assistant U.S. Attorney Todd Bradbury prosecuted the case on behalf of the federal government.
Jury Convicts Two Latin Kings Gang Members of Witness RetaliationRead the Press Release
CONTACT: Barbara Burns
PHONE: (716) 843-5817
FAX: (716) 551-3051BUFFALO, N.Y. - Acting U.S. Attorney James P. Kennedy, Jr. announced today that, following a week-long trial, a federal jury has convicted Jose Escalera, a/k/a Tank, 41, of Buffalo, NY, and Giovanni Cotto, a/k/a Monte, 36, of Springfield, Massachusetts, of retaliating against a witness. The charge carries a maximum sentence of life in prison and a $250,000 fine.
Assistant U.S. Attorneys Michael P. Felicetta and Meghan A. Tokash, who handled the prosecution of the case, stated that in 2014, the defendants ordered the assault of a witness testifying for the Government at a federal trial that involved a murder. One of the defendants in that case was a member of the Latin Kings Gang. Escalera and Cotto, also members of the Latin Kings Gang, ordered the assault against the witness for testifying against their Latin King brother.
Back in 2014, the witness, after completing three days of testimony, was returned to the Cattaraugus County Jail where he was being detained. The following day, while in the recreation yard at the jail, the witness was viciously assaulted. The assault included multiple contusions and a broken jaw. The injuries resulted in the witness undergoing surgery and having his jaw wired shut, preventing him from completing his testimony for several weeks.
Evidence presented by the Government included the testimony of the assailant who was also charged and convicted for his role in the assault.
The verdict is the result of an investigation by the Drug Enforcement Administration, under the direction of Special Agent-in-Charge James J. Hunt, New York Field Division, and the Cattaraugus County Sheriff’s Department, under the direction of Sheriff Timothy Whitcomb.
Escalera is scheduled to be sentenced on October 18, 2017, at 12:30 p.m. before U.S. District Judge Richard J. Arcara, who presided over the trial of the case. Cotto will be sentenced on October 20, 2017, at 12:30 p.m.
Judge Sentences Houston Man for Attempted Importation of MethRead the Press Release
LAREDO, Texas – A 52-year-old Houston man has been sentenced in Laredo federal court to a 94-month-term of imprisonment for attempting to import 17 kilograms of methamphetamine, announced Acting U.S. Attorney Abe Martinez. Octavio Gomez-Solis pleaded guilty March 6, 2017.
Today, U.S. District Judge Diana Saldana imposed the sentence which will be immediately followed by three years of supervised release. In handing down the sentence, the court noted the defendant’s criminal history and stated that a lengthy prison sentence was needed to deter such conduct.
On Dec. 20, 2016, Gomez-Solis arrived at the Lincoln-Juarez Bridge and applied for admittance to the United States. At that time, a K9 alerted to the presence of narcotics and Gomez-Solis was referred to secondary inspection. U.S. Customs and Border Protection (CBP) agents then discovered 12 bundles concealed within the radiator of the vehicle. The bundles of methamphetamine weighed a total of 17.52 kilograms.
Gomez-Solis admitted he knew he was transporting something “illegal,” but was not sure what type of drug it was.
He has been and will remain in custody pending transfer to a U.S. Bureau of Prisons facility to be determined in the near future.
Immigration and Customs Enforcement’s Homeland Security Investigations and CBP conducted the investigation. Assistant U.S. Attorney Alfredo De La Rosa prosecuted the case.
Jamaican National Sentenced for Conspiracy to Commit Mail FraudRead the Press Release
Acting U.S. Attorney Duane A. Evans announced that ANDREW O’NEIL BOWYER, age 26, a resident of Jamaica, was sentenced today after previously pleading guilty to a one-count Indictment for Conspiracy to Commit Mail Fraud.
U.S. District Judge Carl J. Barbier sentenced BOWYER to 78 months incarceration, followed by 3 years of supervised release, and a $100 special assessment. A hearing on restitution is set for October 5, 2017.
According to court records, on or before August 2013, BOWYER and others operated a scheme to contact elderly individuals and people with diminished capacity who would be susceptible to being scammed. The scheme involved contacting victims by telephone through Voice Over Internet Protocol (“VoIP”) and informing them they had won the Publisher’s Clearing House Sweepstakes or similar lottery and needed to pay BOWYER and others monies by cash, check, wire, and other methods in order to claim their lottery winnings.
BOWYER and others obtained names, addresses, and other biographical information from an unknown source. They used the information to identify victims, telephone them, or direct others to telephone them, to represent that they had won the sweepstakes and inform them they would need to send him or others money in order to claim their winnings.
It was part of the scheme and artifice to defraud that on or around March 30, 2015, BOWYER employed false representations and promises in order to convince V.L., an elderly person, into believing she had won a sweepstakes, causing V.L. to send money via the United States Postal Service to CC-1, a co-conspirator living in New Orleans. V.L. sent the money to CC-1 in reliance on BOWYER’s false representations and promises that if she sent the money to CC-1, she would be awarded sweepstakes winnings. Immediately after receiving the funds in the mail from V.L., CC-1 deposited the money into his bank account in New Orleans, and initiated a wire transfer of the funds from the account to BOWYER’s account in Jamaica.
Acting U.S. Attorney Evans praised the work of the United States Postal Service, Office of Inspector General, United States Secret Service, and the United States Department of Homeland Security in investigating this matter. Assistant U.S. Attorney Sharan E. Lieberman was in charge of the prosecution.
Insys Regional Manager Pleads Guilty to Kickback ConspiracyRead the Press Release
Acting United States Attorney Steve Butler of the Southern District of Alabama announces that Karen Hill, the former Insys Therapeutics Regional Manager for the southeastern United States, has pled guilty to conspiring to pay illegal kickbacks to doctors in exchange for their prescribing the instant-release fentanyl drug Subsys.
In June 2012, Karen Hill was hired by Insys Therapeutics to be a sales representative in Florida for the instant-release fentanyl drug Subsys. Prior to coming to Insys, Hill was a sales representative for Cephalon, Inc. where she gained experience selling another instant-release fentanyl drug under the brand name Actiq. During the course of her employment at Cephalon, Cephalon agreed to pay $425 million to the Department of Justice to resolve allegations of illegal marketing practices involving Actiq.
Subsys is only FDA approved for “the management of breakthrough pain in cancer patients 18 years of age and older who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain.” Despite this very limited FDA indication, Insys initially tasked Hill with getting pain management doctors in Florida to prescribe Subsys to their patients. As a sales representative, Hill was initially responsible for working directly with doctors in Florida, particularly in the Jacksonville, Tampa, Orlando, and Miami metro areas.
During her time as a sales representative, Hill taught other sales representatives how to entice doctors to prescribe Subsys. In one recorded conversation, Hill told another sales representative that the key to getting doctors to prescribe Subsys was not selling them on the drug itself, but rather finding out what motivated the doctor. She gave examples that some of her doctors were motivated by money, chocolate, and spending time with her. When the sales representative asked Hill how to identify doctors who were financially motivated to prescribe Subsys, Hill explained that she looks for doctors that are “money hungry,” and went on to describe how to figure out if a doctor has a “light in their eyes” and is willing to “play ball.”
In August 2013, Hill was promoted to be the Insys Regional Director for a territory that covered Florida and Mobile, Alabama. In this role, she oversaw and facilitated the payment for speaking programs to certain doctors, including Dr. Xiulu Ruan and Dr. John Patrick Couch. These payments were made as an inducement, and in exchange for, these doctors continuing to prescribe Subsys to their patients. Hill was a manager at various levels in the southeast region during the rest of her career at Insys.
For certain high prescribing doctors, Hill admitted that she conspired with others within Insys to pay these doctors illegal kickbacks in the form of speaking fees. The way the scheme worked was that doctors who were prescribing high volumes of Subsys, or those who had the ability to do so in short order, were signed up by Insys as “speakers.” The doctors would put on short presentations about the drug and then would receive an honorarium ranging typically ranging from $1,600.00 to $3,000.00. As part of her plea, Hill admitted that the speaking programs were merely a pretext through which Insys could line the pockets of certain doctors.
In February 2017, Dr. Ruan and Dr. Couch, who practiced in Mobile, Alabama, were convicted by a federal jury in Mobile of numerous charges related to their pain management practice, including receiving illegal kickbacks from Insys. During that trial, former Insys sales representative Natalie Perhacs testified against the doctors. Prior to her testimony, Perhacs had pled guilty to conspiring to pay illegal kickbacks to Dr. Ruan and Dr. Couch in exchange for their prescribing Subsys. Dr. Ruan and Dr. Couch were sentenced to 21 years and 20 years in federal prison, respectively. Perhacs still awaits sentencing.
Hill is just one of several former Insys employees that have pled guilty to felony charges in several different districts. She is scheduled to be sentenced in January 2018.
Following Hill’s guilty plea, Acting United States Attorney Steve Butler stated, “This is a very important development in this ongoing case. Ms. Hill was a high-level manager within Insys, and was a key player in the conspiracy to pay doctors illegal kickbacks in exchange for prescribing Subsys to their patients. As we saw during the trial of Dr. Ruan and Dr. Couch, Subsys is an extremely potent drug that can have devastating consequences if it is prescribed to patients who should not be taking instant-release fentanyl.”
DEA ASAC, John (Bret) Hamilton, stated, “The evidence was overwhelming that the motivation for this crime was financial gain. The DEA will continue to target corrupt individuals in the medical industry with vigor. Americans should not have to worry whether or not their doctors have been influenced to prescribe a life-altering drug without a legitimate need. They should be able to trust the advice and prescriptions they are given are for their best health, not the financial gain of others.”
FBI SAC, Rob Lasky stated, “This case is a testament to the dedicated men and women who have investigated and prosecuted this case. This particular case would have placed a strain on any one agency’s resources but with the inter agency cooperation that was so evident here these defendants have been put on notice that this type of behavior in the medical community will not be tolerated.”
This OCDETF case was jointly investigated by the DEA-Mobile and FBI-Mobile, and was prosecuted by Assistant United States Attorneys Christopher Bodnar and Deborah Griffin.
Indiana Livestock Broker Charged with Fraud, Money LaunderingRead the Press Release
CINCINNATI– A federal grand jury has charged Brian D. Jones, 38, of Vevay, Indiana with defrauding investors in his livestock brokerage business.
Benjamin C. Glassman, United States Attorney for the Southern District of Ohio and Angela L. Byers, Special Agent in Charge, Federal Bureau of Investigation (FBI), Cincinnati Field Office, announced the indictment which was unsealed today.
The indictment alleges that Jones operated a business buying bull calves from dairy farms in Wisconsin and selling them to cattle ranches in Texas and Missouri. He began soliciting investors in 2015, promising sizable returns for the investments.
Rather than invest the funds, the indictment alleges, Jones used the funds for his personal benefit such as gambling at casinos. The indictment also alleges that Jones used the investment funds to pay “returns” back to earlier investors as if the funds had actually generated income through investment in his business. By the end of 2015, the indictment says, Jones had squandered funds from the cattle purchasers and was in debt with his suppliers and purchasers. Investigators are still calculating the number of investors and the amount of money involved in the alleged fraud.
“The indictment alleges that Jones fabricated bank documents to show that he had sizable business deposits that would soon be ‘released’ by the bank,” U.S. Attorney Glassman said. “He also allegedly sent checks to investors including some in the Southern District of Ohio for investment returns, only to have the checks bounce due to insufficient funds in his account.”
Jones faces four counts of wire fraud, each punishable by up to 20 years in prison and a $250,000 fine if he’s convicted. The indictment also charges him with four counts of money laundering. Three are punishable by up to ten years in prison. One money laundering charges carries a potential sentence of 20 years in prison. Two additional counts seek forfeiture of all property and proceeds of any crimes of which Jones is convicted.
FBI agents arrested Jones in southern Indiana today. Jones appeared U.S. Magistrate Judge Stephanie Bowman for an initial appearance and to schedule further court dates.
U.S. Attorney Glassman commended the investigation of this case by the FBI, as well as Assistant United States Attorney Timothy S. Mangan, who is prosecuting the case.
An indictment merely contains allegations, and the defendant is presumed innocent unless proven guilty in a court of law.
Houston man pleads guilty to distributing cocaineRead the Press Release
LAFAYETTE, La. – Acting U.S. Attorney Alexander C. Van Hook announced that a Houston man pleaded guilty Tuesday to possessing with intent to distribute cocaine after the drug was found in his car.
Isidro Badillo, 22, of Houston, Texas, pleaded guilty before U.S. District Judge Jay C. Zainey to one count of possession with intent to distribute controlled substances. According to the guilty plea, Lake Charles police stopped Badillo’s vehicle August 8, 2016 on Interstate 10. Police searched the vehicle and found 5 kilograms of powder cocaine in the trunk. Badillo knew of the cocaine and said he was driving to an unspecified location outside of New Orleans for delivery and later distribution.
Badillo faces 10 years to life in prison, five years of supervised release and a $10 million fine. The court set sentencing for October 11, 2017.
Homeland Security Investigations and the Lake Charles Police Department conducted the investigation. Assistant U.S. Attorney Dominic Rossetti is prosecuting the case.
Guatemalan National Sentenced for Illegal Reentry After DeportationRead the Press Release
BOSTON - A Guatemalan national was sentenced today in federal court in Boston for a federal immigration crime.
Jose Sanchez-Alarcon, 40, pleaded guilty to one count of illegally reentering the United States after being deported before U.S. District Court Judge Allison D. Burroughs, who sentenced Sanchez-Alarcon to time served. Sanchez-Alarcon will be subject to deportation.
Sanchez-Alarcon was deported in February 2011, and in May 2017, federal agents discovered Sanchez-Alarcon in Boston and determined him to be illegally present in the United States.
Acting United States Attorney William D. Weinreb and Matthew J. Etre, Special Agent in Charge of Homeland Security Investigations in Boston, made the announcement today. Assistant U.S. Attorney Kenneth G. Shine of Weinreb’s Major Crimes Unit prosecuted the case.
Great Falls Man Pleads Guilty to Methamphetamine and Firearms OffensesRead the Press Release
GREAT FALLS – Robert David Linn, Jr., a 52-year-old resident of Great Falls, pleaded guilty to possession with intent to distribute methamphetamine and possessing a firearm in furtherance of a drug trafficking crime. Linn’s plea could result in a term of life in prison and his sentence can be no less than 15 years.
In late 2015, the Russell Country Drug Task Force began investigating the defendant, Robert David Linn, Jr., for trafficking methamphetamine in Great Falls, Montana. Through further investigation, law enforcement learned that the defendant typically sold a pound of methamphetamine for $15,000, or an ounce of methamphetamine for $1,250. On occasion, the defendant sold smaller quantities of heroin. Law enforcement also acquired information that the defendant frequently traded methamphetamine for stolen property.
Throughout 2016 and 2017, law enforcement seized approximately five pounds of actual methamphetamine from various individuals in Great Falls who had all received their methamphetamine directly from the defendant. On April 8, 2017, law enforcement arrested the defendant after receiving information that he had recently received approximately 30 pounds of methamphetamine through delivery by a shipping company.
Following the defendant’s arrest, law enforcement executed numerous search warrants. First, law enforcement went to a home in Great Falls where agents had information that the defendant stored his methamphetamine supply. There, agents seized 4359.2 grams, or approximately ten pounds, of actual methamphetamine from a concealed location in the home. Agents also seized 13 firearms located in extremely close proximity to the methamphetamine. These firearms included two semi-automatic rifles, four revolvers, and seven semi-automatic pistols. Upon further examination, two of the firearms possessed obliterated serial numbers, and agents discovered three of the firearms were stolen. Law enforcement also seized 202.2 grams of actual methamphetamine from the defendant’s truck. Lastly, in addition to the methamphetamine seizures, agents recovered over $250,000 in cash proceeds from the defendant and his associates.
Linn is detained pending his sentencing on October 19, 2017 in front of U.S. District Judge Brian Morris.
Gloucester Seafood Executive Sentenced for Tax ChargeRead the Press Release
BOSTON – A senior sales executive at a seafood processing company in Gloucester was sentenced today in federal court in Boston for tax fraud.
Richard J. Pandolfo, 71, of North Andover, was sentenced by U.S. District Court Judge Richard G. Stearns to one year of probation with six months to be served in home confinement, a fine of $5,000, and restitution of $25,879. In April 2017, Pandolfo pleaded guilty to one count of making and subscribing a false tax return.
From 2008 to 2012, Pandolfo received substantial supplemental income for his work at a seafood processing company in Gloucester from the company’s president. Some of those payments were made directly to Pandolfo or to his spouse, but Pandolfo did not report or pay taxes on any of those payments. Other payments were made by a corporate entity controlled by the seafood processor’s president to a purported interior design company set up in the name of Pandolfo’s spouse. Pandolfo did report that income, but improperly deducted personal expenses from that income as business expenses, thereby improperly reducing the taxes he owed. In total, Pandolfo failed to pay $25,879 in taxes, which he agreed to pay in restitution to the Internal Revenue Service as part of his plea agreement.
Acting United States Attorney William D. Weinreb and Joel P. Garland, Special Agent in Charge of the Internal Revenue Service’s Criminal Investigation in Boston, made the announcement. Assistant U.S. Attorneys Stephen E. Frank and Brian A. Pérez-Daple of Weinreb’s Economic Crimes Unit prosecuted the case.
Four Individuals Charged in Healthcare Fraud SchemeRead the Press Release
DALLAS — Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
As part of that enforcement, Erik Bugen, 42, Jody Sheffield, 43, Matthew Hawrylak, 41, and Britt Hawrylak, 38, were charged by information for their role in a $36 million fraud scheme involving unnecessary and improperly prescribed toxicology and DNA cancer screening tests which were billed to TRICARE, announced the United States Attorney’s Office of the Northern District of Texas.
Each defendant faces a maximum statutory penalty of 5 years in federal prison and a $250,000 fine.
According to the one-count felony charge filed yesterday, from May 2014 and continuing to July 2017, Bugen, Sheffield, Matthew Hawrylak, and Britt Hawrylak caused false and fraudulent claims to be submitted for health care benefits. The false and fraudulent claims were for toxicology and DNA cancer screening tests that were not legitimately prescribed, not needed, not provided as billed, and which were the product of kickbacks.
Bugen, Sheffield, Matthew Hawrylak, and Britt Hawrylak operated ADAR Group, located in Killeen, Texas solely to achieve the objective of their scheme to defraud and to unlawfully enrich themselves by submitting false and fraudulent claims for health care benefits. Britt Hawrylak operated Tiger Racing Team, located in Fort Worth, Texas and Matthew Hawrylak operated Zorin Holdings, also located in Fort Worth, Texas. The Hawrylak’s received payments from Xpress Laboratories and Progen Lab for referring testing orders for TRICARE beneficiaries. Britt Hawrylak and Matthew Hawrylak then split payments from Xpress Laboratories and Progen Lab between themselves and Bugen and Sheffield.
According to the information filed in the case, Bugen and Sheffield would give Wal-Mart gift cards in exchange for urine and saliva specimens. These specimens were then mailed to Xpress Laboratories and Progen Lab for unnecessary toxicology and DNA cancer screening tests and billed to TRICARE by Cockerell Dermatopathology, a laboratory specializing in the evaluation of dermatologic disorders and located in Dallas, Texas. Bugen and Sheffield disguised the gift cards as a food assistance program for low-income beneficiaries. ADAR Group employees collected urine and saliva samples from as many as 200 beneficiaries per day.
Bugen and Sheffield paid doctors a flat fee per month to sign orders for toxicology and DNA cancer screening tests. The doctors never saw the patients and had no doctor-patient relationship with the patients. Beneficiaries did not receive the results of their tests. ADAR employees obtained signature stamps from the doctors and stamped the doctors’ signatures on testing orders before sending the forms to Xpress Laboratories and Progen Lab. ADAR Group employees also placed false diagnosis codes on TRICARE claim submissions to make it appear that the beneficiary needed the testing. This was done to ensure that TRICARE would accept, and pay, the claim.
Bugen, Sheffield, Matthew Hawrylak, and Britt Hawrylak caused to be submitted to TRICARE, at least approximately $36 million in false and fraudulent claims. TRICARE paid Cockerell approximately $4.8 million as payment for those claims.
The Defense Criminal Investigative Service, Veteran’s Affairs- Office of Inspector General, and Federal Bureau of Investigation, are investigating. Assistant U.S. Attorney Adrienne Frazior is in charge of the prosecution.
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Four Charged in Counterfeit Body Building Steroid ConspiracyRead the Press Release
BOSTON – Four individuals were charged yesterday in federal court in Boston for their roles in a conspiracy to traffic counterfeit steroids, including testosterone and trenbolone, to bodybuilders.
Tyler Bauman, a/k/a “musclehead 320,” 32, of Shrewsbury, and Philip Goodwin, 36, of Lynn, were charged with one count of conspiracy to distribute controlled substances, one count of conspiracy to traffic counterfeit drugs, one count of trafficking counterfeit drugs, one count of possession with intent to distribute controlled substances and one count of money laundering conspiracy.
Kathryn Green, a/k/a Katie Green, a/k/a Katy Green, 30, of Shrewsbury, and Brian Petzke, 49, of Saugus, were charged with one count of conspiracy to distribute controlled substances.
All four defendants were previously arrested and charged by complaint on April 12, 2017, along with two other co-defendants, Robert Medeiros and Melissa Sclafani. Medeiros pleaded guilty in June and will be sentenced on Sept. 21, 2017.
According to court documents, from approximately May 2015 until April 12, 2017, the conspirators manufactured steroid products - made from raw materials purchased overseas - in Goodwin’s home, and marketed them as “Onyx” steroids using “Onyx” labels that were also ordered from overseas suppliers. Onyx, now owned by Amgen Inc., is a legitimate pharmaceutical company that does not manufacture steroids.
The defendants allegedly sold the steroids to customers across the United States using email and social media platforms, collected payment through money remitters, such as Western Union and MoneyGram, and used false identifications and multiple remitter locations to pick up the proceeds. Some of the defendants laundered proceeds from the steroid sales through Wicked Tan LLC, a tanning business located in Beverly, which they owned and operated specifically to launder the proceeds of the steroid operation.
The charges of conspiracy to traffic in counterfeit drugs and conspiracy to distribute controlled substances provide for a sentence of no greater than five years in prison, three years of supervised release, and a fine of up to $250,000 or twice the gross gain or loss of the conspiracy. The charge of possession of a controlled substance provides for a sentence of no greater than 10 years in prison, three years of supervised release, and a fine of up to $250,000 or twice the gross gain or loss of the conspiracy. The charge of trafficking in counterfeit drugs provides for a sentence of no greater than 20 years in prison, three years of supervised release, and a fine of $5 million. The charge of money laundering conspiracy provides for a sentence of no greater than 20 years in prison, three years of supervised release, and a fine of $500,000 or twice the gross gain or loss of the conspiracy. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.
Acting United States Attorney William D. Weinreb; Matthew Etre, Special Agent in Charge of Homeland Security Investigations in Boston; Shelly Binkowski, Inspector in Charge of the U.S. Postal Inspection Service; and Jeffrey Ebersole, Special Agent in Charge of the Food and Drug Administration, Office of Criminal Investigations, New York Field Office, made the announcement today. Assistant U.S. Attorneys Amy Harman Burkart and David J. D’Addio of Weinreb’s Cybercrime Unit are prosecuting the case.
The details contained in the charging documents are allegations. The defendants are presumed to be innocent unless and until proven guilty beyond a reasonable doubt in a court of law.
Fort Wayne Man Sentenced to 125 Months ImprisonmentRead the Press Release
FORT WAYNE – The Acting United States Attorney for the Northern District of Indiana, Clifford D. Johnson, announces that, Eddie Martin, Jr., age 18, of Fort Wayne, Indiana, was sentenced before United States District Court Judge Theresa Springmann for robbery under the Hobbs Act along with using, carrying and brandishing a firearm during and in relation to a crime of violence.
Martin was sentenced to 125 months imprisonment and 2 years of supervised release and was ordered to pay $1,586 in restitution to the victims of the offense.
According to documents filed in this case, on or about November 19, 2016, Martin took U.S. currency from an employee of Pizza by Vito’s using physical force and violence and the threatened use of force, violence and the fear of injury and in doing so brandished a firearm.
This case was the result of an investigation by the Bureau of Alcohol, Tobacco, Firearms and Explosives and the Fort Wayne Police Department and was handled by Assistant United States Attorney Stacey R. Speith.
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Former Newark Watershed Conservation Official Sentenced to Eight Years in Prison in Bribery and Kickback SchemeRead the Press Release
NEWARK, N.J. – A former high-ranking employee of the Newark Watershed Conservation and Development Corp. (NWCDC) was sentenced today to 96 months in prison for accepting $956,948 in kickback payments for his and the former executive director’s assistance in awarding work to contractors, Acting U.S. Attorney William E. Fitzpatrick announced.
Donald Bernard Sr., 69, of West Orange, New Jersey, previously pleaded guilty before U.S. District Judge Jose Linares to Counts 9 and 10 of a 20-count indictment returned in December 2014, charging him with the use of interstate facilities to promote and facilitate bribery in violation of the Travel Act, and Count 1 of an information that charges him with making and subscribing a false personal tax return for the 2009 tax year. Judge Linares imposed the sentence today in Newark federal court.
According to documents filed in these and other cases and statements made in court:
Bernard served as a consultant to the NWCDC (from 2008 to January 2010) and then as a salaried employee (from January 2010 to March 2013). From 2008 to March 2013, Bernard was part of a corrupt arrangement with former NWCDC Executive Director Linda Watkins Brashear to solicit $956,948 in cash kickbacks from certain NWCDC contractors in exchange for providing them work and other assistance. Bernard and Brashear facilitated NWCDC payments to contractors to fund cash kickbacks to themselves, knowing payments were inflated above the amount of any work performed. They knew that in numerous instances no work at all had been performed. Bernard and Brashear used their email accounts to facilitate this scheme.
Two contractors from whom Bernard and Brashear obtained substantial cash kickbacks were Jim P. Enterprises and New Beginnings Environmental Services, both companies hired to perform landscaping, snow removal, clean-up and sign-posting services, which were affiliated with Bernard but purportedly operated by James Porter. Bernard admitted receiving $409,823 in bribes and kickbacks from Porter’s companies, funded by inflated and fraudulently obtained payments from the NWCDC, during the period January 2008 to December 2012. Bernard also admitted receiving approximately $85,000 from Essex Home Improvements, a contracting company operated by DeRosa, during the period January 2008 to March 2013, which he received either directly or indirectly through companies Bernard controlled.
Bernard also admitted filing a U.S. Individual Income Tax Return, Form 1040, for tax year 2009, which did not include approximately $314,000 in unreported income he received in kickbacks.
A co-defendant, Giacomo “Jack” DeRosa, 60, of Clinton Township, New Jersey, previously pleaded guilty to laundering a portion of $85,000 he provided to Bernard from January 2008 to August 2012 in connection with roofing work that Bernard facilitated for DeRosa with the NWCDC. DeRosa was sentenced on Oct. 25, 2016, to six months in prison.
Brashear pleaded guilty on Dec. 21, 2015, to devising a scheme to defraud the NWCDC as well as filing a false tax return by failing to report substantial income she received in connection with the kickback scheme. She is scheduled to be sentenced Sept. 11, 2017. Among the approximately $1 million in kickbacks that Brashear admitted receiving were approximately $260,000 from Porter and $27,000 from DeRosa. Porter pleaded guilty in January 2015 to conspiracy to defraud the NWCDC of honest services, money and property through the use of interstate wire transmissions, as well as tax evasion for his role in the kickback scheme. He is scheduled to be sentenced July 20, 2017.
DeRosa admitted that from January 2008 to August 2012 he provided Bernard with a stream of payments totaling approximately $85,000 for Bernard’s action and assistance in procuring NWCDC roofing work for DeRosa’s company. DeRosa provided these payments to Bernard either directly, or to Bernard’s consulting firm, or to a Newark-based civic organization run by Bernard, the African American Heritage Parade Committee. DeRosa also admitted to laundering $20,000 of the money by having it paid to Bernard indirectly through intermediaries in order to disguise DeRosa or Essex Home Improvements as the source of the funds. Two intermediaries DeRosa admitted to using to launder funds provided to Bernard included a subcontractor doing work for DeRosa’s company and Porter.
In addition to the prison term, Judge Linares sentenced Bernard to three years of supervised release.
Acting U.S. Attorney Fitzpatrick credited special agents of the FBI’s Newark Field Office, under the direction of Special Agent in Charge Timothy Gallagher; IRS – Criminal Investigation, Newark Field Office, under the direction of Special Agent in Charge Jonathan D. Larsen; and the U.S. Department of Housing and Urban Development, Office of Inspector General, Newark office, under the direction of Special Agent in Charge Christina Scaringi, as well as criminal investigators of the U.S. Attorney’s Office, for the investigation leading to today’s guilty pleas. Acting U.S. Attorney Fitzpatrick also thanked the N.J. Office of the State Comptroller, under the direction of State Comptroller Philip James Degnan, for its assistance in the investigation.
The government is represented by Assistant U.S. Attorneys Jacques Pierre and Senior Litigation Counsel Leslie Schwartz of the U.S. Attorney’s Office Special Prosecutions Division.
Former Lancaster Pharmacist Sentenced to Federal PrisonRead the Press Release
Columbia, South Carolina------United States Attorney Beth Drake stated today that Gregory S. Boone, age 47, of Lancaster, South Carolina, was sentenced to 18 months imprisonment for willful failure to pay over taxes, in violation of Title 26, United States Code Section 7202.
According to information presented during his guilty plea, Boone owned both the Lancaster Pharmacy and the Medicine Shoppe pharmacy in Rock Hill. While the owner, Boone withheld federal income taxes from his employees’ wages and kept the money for himself. In addition, facts presented during the hearing showed that Boone had failed to pay his income taxes since the year 2000. Based on IRS calculations, Boone failed to pay over $350,000 in federal income taxes.
The case was investigated by the Internal Revenue Service Charlotte Field Office Criminal Division working cooperatively with the IRS Civil Enforcement Division and was prosecuted by Assistant United States Attorney T. DeWayne Pearson of the Columbia office.
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Former Honeywell Employee Sentenced for $50,000 Fraud SchemeRead the Press Release
KANSAS CITY, Mo. – Tom Larson, Acting United States Attorney for the Western District of Missouri, announced that a former Honeywell employee was sentenced in federal court today for engaging in a fraud scheme that caused a loss of more than $50,000.
Trent L. Christie, 37, of Olathe, Kan., was sentenced by U.S. District Judge Howard F. Sachs to one year and one day in federal prison without parole. Christie has also fully paid $50,480 in restitution to Honeywell.
Christie was employed at the Kansas City branch of Honeywell Federal Manufacturing and Technologies, a management and operating contractor for the National Nuclear Security Administration (NNSA), which is the agency under the U.S. Department of Energy responsible for enhancing national security through the military application of nuclear science.
On Dec. 15, 2016, Christie pleaded guilty to four counts of wire fraud. Christie admitted that, in his capacity as a Honeywell employee with purchasing authority, he submitted purchase orders for approximately 129 pieces of equipment, all without the permission or knowledge of either Honeywell or the NNSA. None of the equipment was classified.
Christie engaged in his fraud scheme from June 15, 2010, to Aug. 27, 2014. The costs to Honeywell and subsequently to the NNSA of the unnecessary equipment was approximately $50,480.
After receiving the equipment, Christie advertised the items for sale on eBay. If sold, he removed the items from the Honeywell facility and shipped them, often from his personal residence, to the purchaser. Total sales by Christie netted him approximately $20,847.
This case was prosecuted by Senior Litigation Counsel Gregg R. Coonrod. It was investigated by the Department of Energy, Office of the Inspector General.
Former Aurora Business Owner Indicted for $26 Million Fraud SchemesRead the Press Release
SPRINGFIELD, Mo. – Tom Larson, Acting United States Attorney for the Western District of Missouri, announced today that a former Aurora, Mo., business owner has been indicted by a federal grand jury today for fraud schemes by which he stole more than $26 million, as well as money laundering and other charges.
Russell Grundy, 48, of Hilton Head Island, S. Carolina, formerly of Aurora, was charged in a 30-count indictment returned by a federal grand jury in Springfield, Mo., on Tuesday, July 11, 2017. Grundy was arrested today.
Grundy was the owner of several companies that focused on advanced technologies, ranging from software development to computer security to addressing the software and hardware technological needs of its clientele. Grundy’s companies included Innovative Objects, LLC, PILR Technology, LLC, Choice Technologies, LLC, Wyerless, LLC, and Audio Input, LLC.
Land O’Lakes/Nutra Blend Fraud Scheme
Grundy (through his company Innovative Objects) was contracted by Land O’Lakes, Inc., and its subsidiary, Nutra Blend, LLC, from January 2004 to Sept. 27, 2015, to create propriety software to inventory, track, and coordinate the disbursement of products. Grundy also contracted with Land O’Lakes and Nutra Blend to provide equipment and technical support for the use, upkeep and maintenance of the software.
The indictment alleges that Grundy falsely told Land O’Lakes and Nutra Blend that third party software programs were built into that proprietary software and were essential to the successful operation of the software. Grundy allegedly claimed that some of the payments made to Innovative Objects were remitted to third party license holders. In reality, the indictment says, there were no third party licensee fees; instead, Grundy kept those payments for his personal or unrelated expenses.
The indictment charges Grundy with six counts of wire fraud related to a series of payments from August 2013 to April 2015, totaling $862,856.
Miami Nations Enterprise Fraud Scheme
Grundy engaged Miami Nations Enterprise in negotiations to provide financial assistance in the form of loans, and for Miami Nations Enterprise to purchase a controlling interest in all of Grundy’s technology-based companies.
According to the indictment, Grundy falsely told Miami Nations Enterprise that his companies had been awarded a $3.5 million contract from Wal-Mart Stores, Inc., to develop and provide information technology services. Grundy allegedly presented numerous e-mails, invoices, conditional award letters and other documents to support his false claims. From May 19, 2014, to June 24, 2015, Miami Nations Enterprise loaned Grundy the money to cover the costs associated with software and hardware purchases and training necessary to obtain the $3.5 million Wal-Mart contract.
On Aug. 24, 2014, Miami Nations Enterprise paid an additional amount to purchase a 70 percent interest in Grundy’s companies.
Officials with Miami Nations Enterprise later discovered that neither Grundy nor any of his companies had been awarded any contract with Wal-Mart, and determined that the e-mails, conditional contract award, invoices and bank deposits Grundy had used to support his claims were fraudulently created.
The indictment charges Grundy with 10 counts of wire fraud related to a series of payments from May 19, 2014, to April 12, 2015, totaling $5,990,000.
Additional Charges
In addition to the wire fraud schemes, the indictment charges Grundy with four counts of making a false statement on a loan application. Grundy applied for three loans from UMB Bank on Oct. 17, 2014, totaling $11,390,800. Grundy applied for a $1,850,000 loan from the People’s Bank of Seneca on Aug. 27, 2015. Grundy allegedly made material false statements in each of those loan applications.
Grundy is also charged with 10 counts of money laundering.
The indictment also contains a forfeiture allegation, which would require Grundy to forfeit to the government any property obtained as a result of the alleged wire fraud violations, including a money judgment of at least $26,060,000.
Larson cautioned that the charges contained in this indictment are simply accusations, and not evidence of guilt.
This case is being prosecuted by Assistant U.S. Attorneys Patrick Carney and Casey Clark. It was investigated by the FBI and IRS-Criminal Investigation.
Executive Office for Immigration Review Swears in Immigration JudgeRead the Press Release
FALLS CHURCH, VA - The Executive Office for Immigration Review (EOIR) today announced the investiture of a new immigration judge. Chief Immigration Judge MaryBeth Keller presided over the investiture during a ceremony held this afternoon at EOIR headquarters in Falls Church, Va.
After a thorough application process, Attorney General Jeff Sessions appointed James M. McCarthy to his new position.
"We welcome Judge McCarthy to the ranks of immigration judges at EOIR," said Acting Director James McHenry. "EOIR is committed to reducing its significant pending caseload, and Judge McCarthy’s presence augments our ability to do that in one of our highest-volume courts."
Biographical information follows.
James M. McCarthy, Immigration Judge, New York City Immigration Court
Attorney General Jeff Sessions appointed James M. McCarthy to begin hearing cases in July 2017. Judge McCarthy earned a Bachelor of Science degree in 1983 from St. John’s University and a Juris Doctor in 1995 from Brooklyn Law School. From 2014 to 2017, he served as a senior attorney for Immigration and Customs Enforcement (ICE), Department of Homeland Security (DHS), in New York, N.Y. From 2011 to 2014, he served as a deputy chief counsel for the Office of Chief Counsel, ICE, DHS, also in New York. From 2009 to 2011, he served as a senior attorney for ICE, DHS, in Eloy, Ariz. From 2004 to 2009, he served as an assistant chief counsel for ICE, DHS, in Eloy and Florence, Ariz. From 2000 to 2004, he served as an examining attorney for the Mayoral Commission to Combat Police Corruption, New York City Department of Investigations. From 1995 to 2000, he served as an assistant district attorney, and later as a senior assistant district attorney, at the Kings County District Attorney’s Office, in Brooklyn, N.Y. Judge McCarthy is a member of the New York State Bar.
Eleven Charged, Including Two Businesses, in Western District of Kentucky, as Part of the National Health Care Fraud TakedownRead the Press Release
National health care fraud takedown results in charges against over 412
individuals responsible for over $1.3 billion in fraud losses
Largest health care fraud enforcement action in Department of Justice history
LOUISVILLE, Ky. –United States Attorney John E. Kuhn, Jr. today announced the results of a health care fraud sweep in the Western District of Kentucky as part of the national health care fraud takedown led by the Justice Department. The takedown, in the Western District of Kentucky, resulted in charges against two businesses, and nine individuals, for their alleged participation in health care fraud schemes.
“We trust the medical community to do no harm – certainly no intentional harm,” stated United States Attorney John Kuhn. “Unfortunately, health care fraud harms our health insurers, public agencies, and ultimately patients and taxpayers. Alarmingly, we often see health care fraud combined with other crimes such as unlawful dispensing of opioids, which does even more harm. Today we announce the cooperative efforts of multiple agencies, working to stop the illegal practices by a small segment of the medical community in an effort to restore safety for patients. Investigating and prosecuting health care fraud is one of the Department of Justice’s highest priorities.”
U.S. Attorney Kuhn was joined in the announcement by:
Amy Hess, Special Agent in Charge, Louisville Division, Federal Bureau of Investigation. “To those prioritizing profit over their oath to honestly provide for the public health, the message should be clear that the collective resources of local, state and federal law enforcement will identify your illegal activity and bring you to justice.”
“Healthcare providers that prescribe controlled substances illegally will continue to be a DEA priority,” said Chicago Field Division Special Agent in Charge Dennis A. Wichern. “Too many lives have been lost and too many families forever scarred due to prescription drug abuse.”
“We expect doctors and other medical professionals who bill Medicare and Medicaid to provide quality services to those served by the programs, not rip off scarce government health care funds," said Special Agent in Charge Derrick L. Jackson, of the U.S. Department of Health and Human Services, Office of Inspector General. “Coordinating with our law enforcement partners, our agents work hard to ensure those who steal from federal health care programs are brought to justice.”
Office of Kentucky Attorney General, General Andy Beshear. “The single greatest threat to Kentucky is our drug epidemic, and as attorney general, I am committed to holding accountable any individual or company that carelessly overprescribes opioids to our citizens, many of them battling addiction,” Beshear said. “This national takedown is a critical step to stop this activity and stop fraud to our Medicaid program to better protect our most vulnerable senior citizens and children. I appreciate the efforts of the task force and my Office of Medicaid Fraud and Abuse to hold providers accountable.”
“This coordinated enforcement effort emphasizes the seriousness of healthcare fraud and the detrimental impact it has on our community. We will continue to partner with other state and federal law enforcement agencies to investigate those who perpetrate fraud against federal and state governments, private insurance companies and individual citizens,” said Tracey D. Montaño, Special Agent in Charge of the Nashville Field Office of IRS, Criminal Investigation.”
Office of Indiana Attorney General, General Curtis Hill. “Medicaid fraud is not a victimless crime,” said Indiana Attorney General Curtis Hill. “When licensed professionals and organizations target those who rely on Medicaid, they’re also putting taxpayers on the hook. These actions truly impact all of us. The culmination of these investigations is extremely rewarding for the investigators and lawyers in our Medicaid Fraud Control Unit who work tirelessly to bring these offenders to justice. I applaud their efforts.”
Anthony S. Gooden, Senior Supervisory Agent, Louisville Division, U.S. Postal Inspection Service. “Today’s challenging economy makes it critical that we safeguard the nation’s mail stream against criminal misuse and protect USPS customers from criminal attack through use of the mails. We as Postal Inspectors are dedicated to protecting the public and helping them guard their hard-earned money from fraudulent activity.”
Gregory C. Burns, Jr. Lt. Colonel with LMPD. “With the scourge of opioid addiction going on across America today, it is more important than ever that local law enforcement and federal law enforcement continue to engage in collaborative partnerships together to fight this epidemic on all levels. A multi-faceted approach must also be maintained in order to sustain long term success in this effort.”
In the Western District of Kentucky, three separate cases were indicted on June 27, 2017, and an additional case was charged in a superseding indictment that was unsealed yesterday. The charges included unlawful distribution and dispensing of controlled substances, health care fraud, money laundering, and aggravated identity theft.
Specifically, in United States v. Jeffrey Campbell, Mark Dyer, Dawn Antle and Physicians Primary Care, PLLC, the defendants, from Jefferson County, Kentucky, were charged with one count unlawful distribution and dispensing of controlled substances-conspiracy, four counts of unlawful distribution and dispensing of controlled substances-schedule II, two counts of unlawful distribution and dispensing of controlled substances-hydrocodone, one count health care fraud conspiracy, 11 counts health care fraud – fraudulent coding, one count health care fraud-physical therapy, and one count health care fraud Proove biosciences. The charges stem from the defendant’s intentionally distributing and dispensing controlled substances to patients allegedly without a legitimate medical purpose and outside of the usual course of professional medical practice. Further, the defendants allegedly fraudulently billed various health care benefit programs by coding physical therapy, counseling and exercise services, using evaluation and management codes in order to obtain a higher rate of reimbursement and fraudulently billing various health care benefit programs for physical therapy services, using evaluation and management codes as if a physician performed a service on the patients, but in reality, a non-physician and non-physical therapist performed the services on patients. Also the defendants caused Proove Bioscience, Inc. to falsely and fraudulently bill various health care benefit programs for genetic tests administered to Physicians Primary Care patients that were not medically necessary and never interpreted.
In United States v. Claudia Lopez, defendant Lopez, of Jefferson County, Kentucky, was charged by grand jury indictment with one count health care fraud-fraudulent billings, and three counts of mail theft. The charges stem from the defendant’s role in a scheme while operating the Top Care Chiropractic and Wellness Center Corporation, fraudulently billing United Health Care for medical services never provided.
In United States v. Janice Patterson, Tanesha Washington, and Katerrell Kennedy , the defendants, from Jefferson County, Kentucky, were charged with one count unlawful distribution-conspiracy, fifteen counts health care fraud, two counts health care fraud-conspiracy, eight counts money laundering, and three counts aggravated identity theft. The charges stem from their alleged role in a scheme to knowingly and intentionally distribute and dispense scheduled and controlled substances. Defendant Patterson, while operating the JM Autism Foundation Trust is charged with falsely and fraudulently billing Anthem, Inc. for autism services never performed. Further defendants Patterson and Kennedy, while operating Total Spectrum Autism Services, LLC, falsely and fraudulently billed Anthem, Inc. for autism services never performed. Further, Patterson is charged with aggravated identity theft and money laundering. Patterson allegedly used the identification of providers and created accounts and fraudulently billed for services. The money laundering counts total over $150,000.
In United States v. Med1st of Evansville, P.C., Karen Poeling, and Mitchel Stukey the named defendants were charged in a superseding indictment. They are charged with conspiracy to commit health care fraud, two counts of conspiracy to violate the controlled substance act, and conspiracy to commit money laundering. The charges stem from the defendants’ role in a scheme to defraud health care benefit programs, in connection with the delivery of or payment for benefits, services by causing the submission of false and fraudulent claims to Medicaid, Medicare, Anthem and other insurance carriers. Med1st is alleged to have directed staff to falsely bill for medically unnecessary facet block injections, billing for conscious sedation, which was never performed, providing back braces which were not medically necessary and performing unnecessary tests. Further defendant Stukey conspired with others to illegally distribute and dispense controlled substances. Conspirator A signed blank prescription pads and permitted individuals acting at the direction of Stukey, to conduct evaluations of patients and to use pre-signed pads to prescribe medication to patients. Further, all defendants are charged with committing money.
These cases are being handled by Assistant United States Attorneys, Joe Ansari, Lettricea Jefferson-Webb, and Jessica Malloy. U.S. Attorney Kuhn acknowledged and credited the law enforcement agencies investigating these cases: Federal Bureau of Investigation (FBI), the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG), the U.S. Drug Enforcement Administration (DEA), the United States Postal Inspection Service, the Internal Revenue Service Criminal Investigation, Indiana and Kentucky Medicaid Fraud Control Units, the Department of Defense Criminal Investigative Service and the Louisville Metro Police Department.
Earlier today, Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving over 412 charged defendants across 41 federal districts, including over 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving over $1.3 billion in false billings. Of those charged, today’s action also involved charges against over 120 defendants, including doctors, for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to 295 providers, including doctors, nurses and pharmacists.
The indictment of a person by a Grand Jury is an accusation only and that person is presumed innocent until and unless proven guilty.
East Chicago Man Found Guilty After 3-Day Jury TrialRead the Press Release
HAMMOND – Acting United States Attorney for the Northern District of Indiana, Clifford D. Johnson, announced that Mauricio Portes, age 49, of East Chicago, Indiana was convicted of conspiracy to distribute 500 grams or more of cocaine after a three-day jury trial before United States District Court Philip P. Simon.
According to documents filed in this case, Mauricio Portes was part of a conspiracy that was distributing cocaine within the Northern District between January 1, 2015 and May 28, 2015.
This case was the result of an investigation by the Drug Enforcement Administration and was prosecuted by Assistant United States Attorney Thomas M. McGrath and Special Assistant United States Attorney Armando Salinas.
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Dominican National Sentenced for Firearms and Identity Fraud OffensesRead the Press Release
BOSTON – A Dominican national was sentenced yesterday in federal court in Boston for a firearm offense and using a false social security number.
Leudy Enrique Rodriguez Mojica, 26, was sentenced by U.S. District Court Judge Nathaniel M. Gorton to time served (approximately 16 months) and three years of supervised release. Rodriguez Mojica will be subject to deportation. In April 2017, Rodriquez Mojica pleaded guilty to one count of being an alien unlawfully present in the United States in possession of a firearm and one count of falsely representing a social security number to be his.
On March 23, 2016, Rodriguez Mojica was encountered in Lawrence by law enforcement who recovered a loaded 9mm pistol from the defendant. In addition, on an earlier occasion, Rodriguez Mojica used the name, date of birth, and social security number of a United States citizen to obtain a Massachusetts identification card.
Acting United States Attorney William D. Weinreb; Matthew J. Etre, Special Agent in Charge of Homeland Security Investigations in Boston; and Scott Antolik, Special Agent in Charge of the Social Security Administration, Office of Inspector General, Office of Investigations, Boston Field Division, made the announcement. Assistance was also provided by the Federal Bureau of Investigation and Lawrence Police Department. Assistant U.S. Attorney Robert E. Richardson of Weinreb’s Major Crimes Unit prosecuted the case.
Dominican National Charged with Identity Theft and Social Security FraudRead the Press Release
BOSTON – A Dominican national was charged today in federal court in Boston with stealing the identity of a U.S. citizen from Puerto Rico.
Jhonny Emilio Pimentel Aybar, 34, a Dominican national residing in Everett, was charged by indictment with three counts of misuse of a Social Security number and three counts of aggravated identity theft.
On three occasions, Aug. 8, 2012, Aug. 15, 2013, and Aug. 20, 2014, Aybar misrepresented his social security number and identity when registering as a sex offender with the Everett Police Department.
The charge of Social Security fraud provides for a sentence of no greater than five years in prison, three years of supervised release, and a fine of $250,000. The charge of aggravated identity theft provides for a mandatory minimum sentence of two years in prison, to be served consecutively to any sentence imposed on the Social Security fraud count. Aybar will be subject to deportation upon completion of his sentence. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.
Acting United States Attorney William D. Weinreb; Matthew J. Etre, Special Agent in Charge of Homeland Security Investigations in Boston; and Scott Antolik, Special Agent in Charge of the Social Security Administration, Office of Inspector General, Office of Investigations, Boston Field Division, made the announcement today. Assistant United States Attorney Anne Paruti of Weinreb’s Major Crimes Unit is prosecuting the case.
The details contained in the charging documents are allegations. The defendants are presumed to be innocent unless and until proven guilty beyond a reasonable doubt in a court of law.
District Man Found Guilty of First-Degree Murder While Armed in 2015 Slaying in Southeast WashingtonRead the Press Release
WASHINGTON - Eugene Burns, 25, of Washington, D.C., has been found guilty by a jury of first-degree murder while armed and related weapons offenses for killing a man in a Southeast Washington apartment, U.S. Attorney Channing D. Phillips announced today.
Burns was found guilty by a jury on July 12, 2017, following a trial in the Superior Court of the District of Columbia. The Honorable Hiram E. Puig-Lugo scheduled sentencing for Sept. 29, 2017. Burns faces a potential sentence of life in prison for the crimes.
According to the government’s evidence, Burns had been in a drug-related dispute with the victim, Onyekachi Emmanuel Osuchukwu III, of Woodland Hills, Calif., and began planning to kill him. On Nov. 14, 2015, Mr. Osuchukwu flew into the Washington, D.C. area. That day, Burns lured Mr. Osuchukwu to Burns’s mother’s apartment in the 2900 block of Second Street SE. He confronted Mr. Osuchukwu and shot and killed him before fleeing the scene.
The next day, the defendant, along with two relatives, returned to the apartment and Burns supposedly “discovered” that his best friend had been killed. After a call to 911, Mr. Osuchuwku, 24, was found on the living room floor with multiple gunshot wounds. An investigation led to Burns’s arrest in December 2015, and he has been in custody ever since.
In announcing the verdict, U.S. Attorney Phillips commended the work of the detectives, officers, and mobile crime technicians who worked on the case from the Metropolitan Police Department. He also expressed appreciation for the assistance provided by the U.S. Postal Inspection Service, Washington Division, the FBI’s Cellular Analysis Survey Team, and the Washington Metropolitan Area Transit Authority. He acknowledged the efforts of those who worked on the case from the U.S. Attorney’s Office, including Michael Ambrosino, Special Counsel for DNA and Forensic Evidence Litigation; Supervisory Paralegal Specialist Sharon Newman; Paralegal Specialists Kelly Blakeney and Lashone Samuels; Diana Lim, David Foster; M. Laverne Perry, Tanya Via and Debra Cannon, all of the Victim/Witness Assistance Unit; Investigative Analyst Zachary McMenamin; Litigation Technology Specialists Leif Hickling, and William Henderson; former Litigation Technology Specialist Aneela Bhatia; Forensic Operations/Program Specialist Benjamin Kagan-Guthrie; Computer Forensics Criminal Investigator John Marsh, and Law Clerk Alexandra Maher.
Finally, U.S. Attorney Phillips commended the work of Assistant U.S. Attorneys Charles Willoughby, Jr. and Kevin Flynn, who investigated and prosecuted the case.
Cross Lanes felon sentenced to federal prison for gun crimeRead the Press Release
CHARLESTON, W.Va. – A Cross Lanes man was sentenced today to four years and nine months in federal prison for a gun charge, announced United States Attorney Carol Casto. Fred Wallace Hammon, Jr., 36, previously pleaded guilty to being a felon in possession of a firearm.
Hammon admitted that on September 1, 2016, he possessed a Remington, Model 742 Woodsmaster, .30-06 caliber rifle. Hammon was prohibited from possessing any firearm under federal law because of felony convictions in Kanawha County Circuit Court in 2000 for two counts of aggravated robbery and in 2011 for wanton endangerment, being a felon in possession of a firearm, and possessing a firearm on the grounds of an educational facility.
The Kanawha County Sheriff’s Office, the Charleston Police Department, and the Bureau of Alcohol, Tobacco, Firearms and Explosives conducted the investigation. Assistant United States Attorney Clint Carte is responsible for the prosecution. United States District Judge Joseph R. Goodwin imposed the sentence.
This case was brought as part of Project Safe Neighborhoods. Project Safe Neighborhoods is a nationwide commitment to reduce gun crime in the United States by networking existing local programs targeting gun crime.
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Criminal Complaint Charges North Carolina Resident with Firearms, Drug Trafficking ChargesRead the Press Release
PROVIDENCE – A North Carolina resident arrested by Rhode Island State Police on June 20, 2017, following a traffic stop which resulted in the seizure of a cache of loaded, high-powered firearms, camouflage equipment, night-vision goggles, and 443 grams of suspected methylenedioxymethamphetamine (MDMA, with street names of Molly and Ecstasy) was charged today by way of a federal criminal complaint in U.S. District Court in Providence with firearms and drug trafficking charges.
Acting United States Attorney Stephen G. Dambruch and Colonel Ann C. Assumpico, Superintendent of the Rhode Island State Police, announced today the filing of a federal criminal complaint charging Anthony Mondrez Thompson, 39, of Charlotte, NC, with being a felon in possession of firearms, possession with the intent to distribute 50 grams or more of MDMA, and possession of a firearm in furtherance of a drug trafficking crime.
According to an affidavit filed with the court in support of the criminal complaint, during the traffic stop it is alleged that Thompson, the only person in the vehicle, denied having firearms or illicit drugs in the vehicle, and denied having been previously convicted of a crime. During a check of the driver’s license and car registration provided by Thompson, and a criminal history check, the trooper learned that in fact Thompson has a lengthy criminal record, including convictions in federal and state courts in North Carolina on firearms and drug trafficking charges.
According to the affidavit, after agreeing to exit the vehicle and while being questioned by a trooper outside of the rear of the vehicle, it is alleged that Thompson shoved a trooper into a travel lane of the highway, and then he ran into the highway and began running in a travel lane opposite the direction of oncoming traffic. After ignoring verbal warnings to stop and repeated warnings of the possible use of a Taser, the trooper discharged his Taser causing Thompson to fall to the ground where he was placed under arrest.
According to the affidavit, it is alleged that searches of the vehicle at the scene of the traffic stop and later at the State Police barracks troopers discovered and seized eight high-powered pistols, a revolver, two AR-15-style assault rifles, numerous high-capacity rifle and pistol magazines, boxes of ammunition, military-issued smoke grenades, holsters, camouflage gear and masks, night vision goggles and a Taser. It is alleged that troopers also seized approximately 443 grams of MDMA.
Thompson, who is presently being held in state custody on firearms, drug, assault and resisting arrest charges, will make an initial appearance in U.S. District Court at a later date.
Acting United States Attorney Stephen G. Dambruch and Colonel Ann C. Assumpico thank the Bureau of Alcohol, Tobacco, Firearms and Explosives and the Rhode Island Department of Attorney General for their assistance with this matter.
The case is being prosecuted by Assistant U.S. Attorney Milind M. Shah.
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Covington Man Pleads Guilty to Possession of Child PornographyRead the Press Release
Acting U.S. Attorney Duane A. Evans announced that DARRELL RICKS, age 66, of Covington, pled guilty today to crimes involving the sexual exploitation of children.
According to court documents, beginning at an unknown time to on or about October 21, 2016, RICKS knowingly downloaded and received images and videos depicting the sexual victimization of minors.
RICKS faces a maximum sentence of up to twenty years imprisonment, followed by up to a lifetime term of supervised release, and a $250,000 fine. U.S. District Judge Nannette Jolivette Brown will sentence RICKS on October 19, 2017.
This case was brought as part of Project Safe Childhood, a nationwide initiative launched in May 2006 by the Department of Justice to combat the growing epidemic of child sexual exploitation and abuse. Led by the United States Attorneys' Offices and the Criminal Division's Child Exploitation and Obscenity Section, Project Safe Childhood marshals federal, state, and local resources to locate, apprehend, and prosecute individuals who sexually exploit children, and to identify and rescue victims. For more information about Project Safe Childhood, please visit www.usdoj.gov/psc. For more information about internet safety education, please visit www.usdoj.gov/psc and click on the tab "resources."
Acting U.S. Attorney Evans praised the work of the U. S. Department of Homeland Security, Homeland Security Investigations, the Louisiana State Police, St. Tammany Parish Sheriff’s Office, and the Louisiana Bureau of Investigation in investigating this matter. The prosecution of this case is being handled by Project Safe Childhood Coordinator and Fraud Section Chief, Assistant U. S. Attorney Brian M. Klebba.
Chicago Resident Convicted of Conspiring to Manufacture Marijuana in Rockford WarehouseRead the Press Release
ROCKFORD — A Chicago man was found guilty of conspiracy to manufacture and distribute marijuana following a four-day jury trial in federal court in Rockford.
YOUSIF Y. PIRA, 64, was found guilty of conspiring to manufacture, possess and distribute 1,000 or more marijuana plants.
The conviction was announced by Joel R. Levin, Acting United States Attorney for the Northern District of Illinois; Celinez Nunez, Special Agent-in-Charge of the Chicago Field Division of the U.S. Bureau of Alcohol, Tobacco, Firearms & Explosives; Derek Bergsten, Chief of the Rockford Fire Department; and Anthony Scarpelli, Chief of the Skokie Police Department. The Winnebago County Sheriff’s Department Narcotics Unit and the Rockford Police Department Narcotics Unit assisted in the investigation.
According to the indictment and the evidence at trial, between Jan. 2, 2013, and Jan. 6, 2015, Pira conspired with JEREMIAH N. CLEMENT, 39, of Des Plaines, GEORGE H. BACUS, 53, of Niles, JUSTIN T. PAGLUSCH, 36, of Ingleside, SHLIMON SHIMON, 49, of Chicago, and CASEY WILLIAMS, 30, and DESTINY FREEMAN, 23, both of Great Falls, Mont., to illegally grow, store and distribute marijuana in a warehouse at 1916 11th Street in Rockford. The warehouse was destroyed by a fire on Jan. 6, 2015.
As part of the conspiracy, among other things, Pira purchased grow lights and other equipment and supplies for the illegal operation to grow marijauna in the warehouse, and installed wiring for the lights used to grow marijuana.
Conspiring to manufacture 1,000 or more marijuana plants carries a maximum sentence of life imprisonment, and a statutory mandatory minimum sentence ten years’ imprisonment. The charge also carries a term of supervised release following imprisonment of at least five years and up to life, and a maximum fine of $10 million.
Clement pleaded guilty and was sentenced to ten years’ imprisonment on June 3, 2016. Pagluach pleaded guilty and was sentenced to ten years’ imprisonment on June 23, 2016. Bacus, Williams and Freeman have pleaded guilty and are awaiting sentencing. An arrest warrant was issued for Shimon, who is still at large.
The government is represented by Assistant U.S. Attorneys Joseph C. Pedersen and Margaret J. Schneider.
Charleston felon sentenced to over six years in federal prison for assault and gun crimeRead the Press Release
CHARLESTON, W.Va. – A Charleston man was sentenced today to six years and three months in prison for a gun charge and assaulting a federal officer, announced United States Attorney Carol Casto. Taurean Amadeus Johnson, 30, previously pleaded guilty to being a felon in possession of a firearm and assaulting a federal officer after a court appearance.
Johnson admitted that on January 16, 2017, law enforcement executed a search warrant at his residence and on a vehicle parked in front of his residence. Officers found a Lorcin L380 semiautomatic pistol in the vehicle. Johnson admitted that the gun belonged to him. Johnson also admitted in a statement to law enforcement that he acquired at least two other handguns, which were also recovered. Johnson was prohibited from possessing any firearm under federal law because of convictions in Cabell County Circuit Court in 2009 for first degree robbery, transporting a controlled substance into the state, and delivery of crack.
Johnson further admitted to assaulting a federal officer. On January 17, 2017, Johnson appeared before the United States Magistrate Judge in Charleston for an initial appearance. When the hearing ended, Johnson became combative leaving the courtroom. Johnson admitted that while being placed in a holding cell, he began choking a deputy of the United States Marshals Service by pulling on his neck tie. The Marshals Service regained control of Johnson through physical restraint.
The Drug Enforcement Administration, the Bureau of Alcohol, Tobacco, Firearms and Explosives, and the United States Marshals Service conducted the investigation. Assistant United States Attorney Timothy D. Boggess is in charge of the prosecution. United States District Judge Joseph R. Goodwin imposed the sentence.
This case was brought as part of Project Safe Neighborhoods. Project Safe Neighborhoods is a nationwide commitment to reduce gun crime in the United States by networking existing local programs targeting gun crime.
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Charges Filed Against Northern California Physician for Unlawfully Dispensing OxycodoneRead the Press Release
SAN FRANCISCO — Christopher Owens, a physician licensed to practice in California, was indicted on Tuesday with unlawfully prescribing oxycodone, announced U.S. Attorney Brian J. Stretch and Drug Enforcement Administration Special Agent in Charge John J. Martin. The indictment alleges that between September of 2012 and June of 2015, Owens, 50, now of Indianapolis, IN, intended to act outside the course of usual professional practice and without a legitimate medical purpose when he prescribed oxycodone on numerous occasions. In sum, Owens is charged with 36 counts of distributing oxycodone, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C).
Owens was arrested on Tuesday, July 11, 2017, in Indianapolis, Ind., and is currently scheduled to appear in Indiana before a U.S. Magistrate Judge for a detention hearing on Monday, July 17th.
An indictment merely alleges a crime has been committed. Owens, as well as all defendants, must be presumed innocent unless and until proven guilty beyond a reasonable doubt.
Assistant U.S. Attorney Sheila Armbrust is prosecuting the case. The prosecution is the result of an investigation by the Drug Enforcement Administration with assistance from the University of California San Francisco Police Department.
Earlier today, federal officials joined in Washington to announce the scope of the recent enforcement actions. Attorney General Jeff Sessions, Department of Health and Human Services (HHS) Secretary Tom Price, M.D., Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting FBI Director Andrew McCabe, Acting Drug Enforcement Administration (DEA) Administrator Chuck Rosenberg, Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG), IRS-Criminal Investigations Chief Jon Fort, CMS Administrator Seema Verma, and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS) described the program. The enforcement actions were led and coordinated by the Criminal Division and staffed by the Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units. Of the more than 412 people charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics.