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13 July 2017
Three Arrested in the Fort Wayne Area as Part of the National Health Care Fraud TakedownRead the Press Release
HAMMOND- Acting United States Attorney Clifford D. Johnson announced today that a federal grand jury returned a ten -count indictment against Fort Wayne physician Dr. James E. Ranochak and two Fort Wayne area pharmacists, Brent A. Losier and Charles N. Ringger.
The indictment charges Ranochak, Losier and Ringger with conspiring to illegally distribute and dispense controlled substances (Methadone, Hydrocodone and Testosterone) outside the scope of professional practice and not for legitimate medical purpose. The three defendants also face eight separate counts of distributing and dispensing controlled substances to specific patients outside the scope of professional practice and not for legitimate medical purpose. Finally, all three defendants are charged in a health care fraud conspiracy aimed at defrauding the Indiana Medicaid program through the submission of thousands of dollars in fraudulent claims for medically unnecessary drugs and non-emergency supplies of controlled drugs issued to patients without the patients actually being seen by a physician.
The United States Attorney's Office emphasized that an Indictment is merely an allegation and that all persons charged are presumed innocent until and unless proven guilty in court.
If convicted in court, any specific sentence to be imposed will be determined by the judge after a consideration of federal sentencing statutes and the Federal Sentencing Guidelines.
This case was investigated by the Drug Enforcement Administration, the Food and Drug Administration, the Indiana State Police and the Indiana Office of the Attorney General Medicaid Fraud Control Unit. The case is being prosecuted by Assistant United States Attorney Diane L. Berkowitz.
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Ten Indicted in Dismantling of Plattsburgh Heroin Distribution RingRead the Press Release
PLATTSBURGH, NEW YORK – Ten people have been indicted for their involvement in a heroin distribution ring operating in the Plattsburgh area.
The announcement was made by Acting United States Attorney Grant C. Jaquith; Special Agent in Charge James J. Hunt, New York Division, U.S. Drug Enforcement Administration (DEA); and Clinton County Sheriff David Favro.
Two indictments charge the following people with conspiracy to distribute heroin:
- Kyle Touchstone, age 29, of Plattsburgh;
- Melissa Kusalonis, a.k.a. “Mel,” “Liss,” age 35, of Plattsburgh;
- Jimolo Coates, a.k.a. “Lo,” “Marlo,” “Brodie,” age 24, of Annapolis, Maryland;
- Tynaejah Thompson, a.k.a. “Naee,” age 19, of Annapolis, Maryland;
- Kiara Scott, age 28, of Annapolis, Maryland;
- Anthony DeFilippo, a.k.a “Flip,” age 35, of Schenectady, New York;
- Charles Adams, a.k.a. “Chuck, age 31, of Peru, New York;
- Travynn Ippolito, a.k.a “Trav,” age 29, of Plattsburgh;
- Luke Kiroy, age 32, of Saranac, New York; and
- Danielle Conners, age 31, of Plattsburgh.
The charges in the indictments are merely accusations. The defendants are presumed innocent until proven guilty.
According to the indictments and criminal complaints previously filed in the case, from June 2016 through May 2017, the defendants transported heroin from Annapolis, Maryland, and Schenectady, New York, and sold it in the Plattsburgh area. Kiroy, a New York State Corrections Officer, was working at Clinton Correctional Facility in Dannemora, New York, prior to his arrest on June 20, 2017.
Acting United States Attorney Grant C. Jaquith stated: “The deadly effects of heroin are felt in our communities, but the groups profiting from spreading this poison are often found elsewhere. As this case illustrates, we are committed to collaboration with federal, state, and local law enforcement agencies to combat the scourge of heroin in our area, and to pursue and dismantle drug trafficking organizations wherever they may be found.”
DEA Special Agent in Charge James Hunt stated: “Heroin has been a plague to public health causing record numbers of overdoses in New York State. This investigation highlights law enforcement’s commitment to dismantling opioid trafficking organizations responsible for fueling addiction and death in neighborhoods across the nation.”
Clinton County Sheriff David Favro stated: “The result of this lengthy investigation will remove elements from our community that have proven to be life-threatening. Let the message resonate to all that the Clinton County Sheriff will continue to partner with local, state, and federal agencies to provide a safe and healthy community for our residents and guests.”
If convicted, Touchstone and Coates would each face at least 10 years and up to life in prison. Kusalonis, Thompson, and Adams would each face at least 5 years and up to 40 years in prison. DeFlippo, Ippolito, Conners, Kiroy, and Scott would each face up to 20 years in prison. 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.
The indictments are the result of an investigation led by the DEA Task Force in Plattsburgh, which consists of law enforcement officers from the DEA, Homeland Security Investigations, United States Border Patrol, New York State Police, Clinton County Sherriff’s Office, Essex County Sheriff’s Office, and the Plattsburgh Police Department. The New York State Department of Corrections and Community Supervision also assisted in the investigation.
The case is being prosecuted by Assistant U.S. Attorneys Cyrus P.W. Rieck and Katherine Kopita.
Stockton Woman Sentenced to 3 Years in Prison for Bank Fraud, Mail Fraud and Aggravated Identity TheftRead the Press Release
SACRAMENTO, Calif. — Patricia Ramona Vasquez, 37, of Stockton, was sentenced today to three years in prison and ordered to pay $30,971 in restitution by U.S. District Judge Morrison C. England Jr. for bank fraud, aggravated identity theft, and mail fraud, U.S. Attorney Phillip A. Talbert announced.
San Francisco Division Inspector in Charge Rafael Nunez of the U.S. Postal Inspection Service stated, “Postal Inspectors work closely with the U.S. Attorney’s Office and our partners in law enforcement to arrest and prosecute those individuals responsible for mail fraud and identity theft crimes committed against the public.”
According to court documents, between February 3, 2016, and July 7, 2016, Vasquez targeted a woman with the same last name and obtained her mail to obtain documents and information to steal her identity. Vasquez created an email address for her new identity. On April 4, 2016, Vasquez entered a DMV branch in Sacramento and claimed her California driver’s license was lost or stolen. In doing so, Vasquez obtained a genuine driver’s license with her own picture and the identity theft victim’s personal identifying information. On April 15, 2016, Vasquez used the false identity to purchase a Nissan Altima from an auto dealership in Stockton. At the victim’s and creditors’ expense, Vasquez obtained a car loan from Well Fargo Bank for $16,703. On May 20, 2016, Vasquez opened accounts at Golden 1 Credit Union in Stockton using her phony California driver’s license number, the victim’s SSN, date of birth, true residence address, and signature. After opening the credit union accounts, Vasquez deposited stolen and altered checks to obtain cash.
This case was the product of an investigation by the United States Postal Inspection Service, with the assistance of the Stockton Police Department. Assistant United States Attorney Michelle Rodriguez prosecuted the case.
Statement of Acting U.S. Attorney Joon H. Kim on Second Circuit Decision in United States V. Sheldon SilverRead the Press Release
“While we are disappointed by the Second Circuit’s decision, we respect it, and look forward to retrying the case. Although finding that the Supreme Court’s McDonnell decision issued after Silver’s conviction required a different legal instruction to the jury, the Second Circuit also held that the evidence presented at the trial was sufficient to prove all the crimes charged against Silver, even under the new legal standard. Although this decision puts on hold the justice that New Yorkers got upon Silver’s conviction, we look forward to presenting to another jury the evidence of decades-long corruption by one of the most powerful politicians in New York State history. Although it will be delayed, we do not expect justice to be denied.”
Seventy-Seven Charged in Southern District of Florida as Part of Largest Health Care Fraud Action in Department of Justice HistoryRead the Press Release
Benjamin G. Greenberg, Acting United States Attorney for the Southern District of Florida; George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health & Human Services, Miami Regional Office, Office of Inspector General (HHS-OIG); and Pam Bondi, Florida Attorney General; 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. 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.
Acting U.S. Attorney Benjamin G. Greenberg said, “Health care fraud schemes have real, long-term consequences for our South Florida community. Patients are being denied the quality of care that they deserve, doctors are turning a blind eye to their oaths, and taxpayer money is being diverted into the pockets of the greedy. Today’s announcement highlights South Florida’s united and ongoing law enforcement effort, culminating in charges against more than twenty percent of the national defendants, to thwart evolving schemes and combat the unlawful distribution of opioids and prescriptions drugs.
“The number of arrests are staggering and the dollar losses immense,” said Tim Langan, Acting Special Agent in Charge, FBI Miami. “These health care fraudsters, driven by greed, sought to cheat their way to riches by bilking millions of dollars from Medicare and other health care programs. The victims are U.S. taxpayers. The FBI and our law enforcement partners will investigate and criminally prosecute such fraud to the fullest extent of the law.”
“Those who betray patients and commit health care fraud by either distributing or receiving thinly veiled bribes, steal from taxpayers and corrupt the integrity of our health care system,” said Special Agent in Charge Shimon R. Richmond, HHS OIG Miami. “This takedown reflects the dedication of OIG and our law enforcement partners to bring such fraudsters to justice.”
Florida Attorney General Pam Bondi stated, “This massive fraud takedown targeted people abusing our health care industry and, in some cases, profiting from patients trying to recover from opioid addiction. The arrests and recoveries announced today should serve as a warning to anyone scheming to commit health care fraud that we will find them and they will be held accountable."
The following are some of the cases included in the takedown:
SOBER HOMES FRAUD
1. United States v. Eric Snyder and Christopher Fuller, Case No 17-MJ-8268-Brannon
Eric Snyder, 30, of Delray Beach, Florida, an owner of sober homes and addiction treatment facilities, and patient broker Christopher Fuller, 32, of West Palm Beach, Florida, are charged in a criminal complaint with conspiracy to commit health care fraud for their involvement in a scheme to illegally recruit patients, pay kickbacks and defraud health care benefit programs.
According to the criminal complaint, Snyder established a sober home, Halfway There Florida, LLC (HWT), also known as A Safe Place LLC, in Palm Beach County, Florida, which was purportedly in the business of providing a safe and drug-free residence for individuals suffering from drug and alcohol addiction. The defendants referred the sober home’s residents to a treatment center, Real Life Recovery Delray, LLC, (RLR), which was also owned by Eric Snyder. This treatment center purportedly offered clinical treatment services for persons suffering from alcohol and drug addiction.
According to the criminal complaint, to obtain patients for the sober home and treatment center (collectively “HWT/RLR”), Synder and other members of the conspiracy provided kickbacks and bribes, in the form of free or reduced rent, airline tickets, and other benefits, to individuals who agreed to reside at the sober homes, attend drug treatment therapy sessions, and submit to regular drug testing that members of the conspiracy could bill to the residents’ insurance plans. These patient brokers, including Fuller, were also paid kickbacks themselves by Snyder and others for referring patients to HWT/RLR for purported treatment.
According to the criminal complaint, fraudulent billings were submitted by HWT/RLR for services that were not medically necessary and/or were never provided. Licensed health professionals who used to work at HWT/RLR describe treatment conducted by unqualified and non-licensed employees, and billings for treatment that never occurred. The licensed professionals were asked to sign for and/or backdate this treatment as though they had conducted it. In addition, licensed professionals at HWT/RLR were asked to complete intake forms and other documents for patients that they had not seen. In some instances, services were billed for residents who left the sober homes and were no longer receiving treatment at the treatment centers. In other instances, patients were billed for therapy sessions they never attended, and therapy sign-in sheets and other documents fraudulently reflected that these patients attended these sessions, when they did not. The defendants provided services meant solely to maximize insurance reimbursements, such as expensive urine drug screens. HWT/RLR fraudulently used urine drug screens as a profit-machine, including splitting samples to send them to different laboratories, improper duplicate testing, and fraudulently double billing for tests for the same patients at both HWT and RLR. In addition, samples were fraudulently comingled prior to testing to prevent identical test results from exposing the scheme. After a search warrant was executed at a different treatment facility in Palm Beach County, in September 2014, Snyder and others attempted to stop or modify these illegal practices, and evidence of this wrongful conduct was removed and destroyed.
Mr. Greenberg commends the investigative efforts of the Greater Palm Beach County Health Care Fraud Task Force. Agencies of the task force that assisted with this matter include the FBI, Internal Revenue Service, Criminal Investigation (IRS-CI), Amtrak Office of Inspector General (Amtrak-OIG), U.S. Department of Labor Employee Benefits Security Administration (DOL), U.S. Office of Personnel Management Office of Inspector General (OPM-OIG), Palm Beach County State Attorney’s Office Sober Home Task Force, Palm Beach County Sheriff's Office, Delray Beach Police Department, Martin County Sheriff’s Office and the National Insurance Crime Bureau (NICB). The case is being prosecuted by Assistant United States Attorney James V. Hayes.
DRUG AND PHARMACY FRAUD SCHEMES – Medicare Part D
2. United States v. Orlando Bustabad, et al., Case No. 17-20441-CR-Moore
Orlando Bustabad, 61, Orlando Olver Bustabad, 31, Idilsis Manresa, 30, Sara Fernandez Escobar, 61, Mirtha Carrion Jimenez, 58, Alejandro Mena, 21, and Alejandro Sierra, 47, all of Miami, Florida, are charged by indictment with conspiracy to commit health care fraud and health care fraud. Orlando Bustabad and Orlando Olver Bustabad are also charged with aggravated identity theft.
According to the indictment, Orlando Bustabad and his son Orlando Olver Bustabad were the true owners of eight pharmacies located in Miami Dade County, namely, Med Solution Pharmacy, 17th Street Pharmacy, Rapid Pharmacy, Euro Pharmacy, A&B Pharmacy, Maxi Pharmacy, Mariposa Pharmacy, and 49th Street Pharmacy. Orlando Bustabad and Orlando Olver Bustabad operated these pharmacies under their own names or enlisted co-conspirators Manresa, Escobar, Jimenez, Mena, and Sierra to appear as owners. These pharmacies purportedly provided prescription drugs to Medicare beneficiaries. From February 2013 until June 2017, the defendants submitted and caused the submission of approximately $10,183,031 in claims for reimbursement to the Medicare Part D program, via interstate wires, that falsely and fraudulently represented that various health care benefits, primarily prescription drugs, were medically necessary, prescribed by a doctor, and had been provided by the pharmacies. As a result of such false and fraudulent claims, Medicare prescription drug plan sponsors made payments funded by the Medicare Part D Program to the corporate bank accounts of the eight pharmacies in the approximate amount of $4,649,743.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Christopher J. Clark.
3. United States v. Victor Rocha, Case No. 17-20409-CR-Altonaga
Victor Rocha, 49, of Miami Lakes, Florida, was charged by indictment with six counts of health care fraud. The indictment charges Rocha with falsely and fraudulently submitting medical claims for prescription medications for reimbursement to Medicare Part D from September 2012 through May 2013, through his pharmacy, Med Express Pharmacy Discount, Inc. The Indictment charges that the claims were for prescription medications that were not provided and/or not medically necessary.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.
4. United States v. Alejandro Hernandez Rios, Case No. 17-20442-CR-Ungaro
Alejandro Hernandez Rios, 35, of Miami, Florida, was charged by indictment with five counts of health care fraud. The indictment charges Rios with falsely and fraudulently submitting medical claims for prescription medications for reimbursement to Medicare Part D from June through September 2014, through his pharmacy Independence Pharmacy and Discount, Inc. The indictment charges that the claims were for various prescription medications that were not provided and/or not medically necessary.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.
5. United States v. Pedro Mangano, Case No. 17-20408-CR-Martinez
Pedro Mangano, 52, of Miami, Florida, was charged by indictment with ten counts of Medicare fraud. The indictment alleges Mangano was the owner and operator of PVRX Pharmacy, located in Miami, Florida. Between March 2014 and June 2017, Mangano’s pharmacy submitted fraudulent claims for allegedly dispensing drugs to Medicare beneficiaries that the pharmacy never had in inventory to begin with. As part of the scheme, Mangano paid patient recruiters for fraudulent scripts used to defraud the Medicare Part D program. The fraudulent claims resulted in overpayments exceeding $1.1 million.
Mr. Greenberg commends the investigative efforts of HHS-OIG. This case is being prosecuted by Assistant United States Attorney Jon Juenger.
6. United States v. William Salazar Ortega, et al., Case No. 17-20454-CR-Gayles
On June 28, 2017, William Salazar Ortega and Oscar Alonso Gonzalez were indicted in connection with their roles at Latin Pharmacy, a pharmacy that defrauded Part D of the Medicare program of $2.38 million by billing for expensive prescription medications that were not prescribed to patients; were not necessary; and were not purchased. Salazar was the nominee owner of the pharmacy, and Gonzalez was its true owner. Each defendant was charged with one count of conspiracy to commit health care fraud and wire fraud and four counts of health care fraud. Gonzalez is also charged with one count of money laundering.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.
7. United States v. Yara Suarez, et al., Case No. 17-20453-CR-Moreno
On June 29, 2017, Yara Suarez, Jesus Sanchez, Anthony Moya and Yoel Concepcion were indicted in connection with their roles at Albe Pharmacy, a pharmacy that defrauded Part D of the Medicare program of $3.4 million by billing for expensive prescription medications that were not prescribed to patients; were not necessary; and were not purchased. Sanchez and Suarez were the owners of the pharmacy, and are each charged with one count of conspiracy to commit health care fraud and wire fraud, three counts of health care fraud and one count of conspiracy to commit money laundering. Moya and Concepcion owned and controlled shell corporations through which over $380,000 of the fraud proceeds were laundered. Moya and Concepcion are each charged with one count of conspiracy to commit money laundering and three counts of substantive money laundering.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.
8. United States v. Lisbet Cordova, Case No. 17-20450-CR-Cooke
On June 29, 2017, Lisbet Cordova, the owner of Jalvarez Pharmacy, Inc. (“Jalvarez”) was indicted on four counts of health care fraud. Through Jalvarez, Cordova billed Medicare, pursuant to Part D of the Medicare program, for prescriptions that were not medically necessary, prescribed or dispensed to Medicare beneficiaries. As part of the scheme, Jalvarez submitted approximately $730,000 in fraudulent claims to Medicare.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.
PRESCRIPTION DRUG DIVERSION
9. United States v. Jose De Jesus Rodriguez, Case No. 17-20486-CR-Scola
Jose De Jesus Rodriguez, 47, of Miami, Florida, was charged by indictment with one count of conspiracy to unlawfully distribute prescription drugs and three substantive counts of improperly distributing prescription drugs, also referred to as prescription drug diversion. The indictment charges Rodriguez with illegally distributing millions of dollars’ worth of prescription medications from August 2011 through March 2015.
Mr. Greenberg commends the investigative efforts of the U.S. Food and Drug Administration’s (FDA) Office of Criminal Investigations (OCI), and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.
10. United States v. Reynaldo Ocana, Case No. 17-MJ-02939-Otazo-Reyes
Reynaldo Ocana, 46, of Miami, Florida, was charged by criminal complaint with improperly distributing prescription drugs, also referred to as prescription drug diversion. The criminal complaint charges Ocana with illegally diverting prescription drugs in August 2016.
Mr. Greenberg commends the investigative efforts of HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.
HOME HEALTH CARE FRAUD – Medicare Part A
11. United States v. Hector Fajardo Ramirez, Case No. 17-20301-CR-Moreno
Hector Fajardo Ramirez, 48, of Miami, Florida, was charged by indictment with six counts of health care fraud. The indictment charges that Ramirez falsely and fraudulently submitted medical claims for home health therapy for reimbursement to Medicare from February through July 2015, through his clinic Longevity Home Health Services, Inc. The indictment charges Ramirez with submitting claims for home health services that were not medically necessary and not provided.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.
12. United States v. Duniesky Cruz and Carlos Gomez Bravo, Case No. 17-20401-CR-Scola
Duniesky Cruz, 50, of Miami, Florida, the owner of home health agency Life & Hope Healthcare, Inc., and an employee Carlos Gomez Bravo, 33, of Miami, Florida, were charged by indictment with conspiracy to defraud the United States and pay health care kickbacks and payment of kickbacks in connection with a federal health care program. The charges stem from their involvement in a home health fraud scheme involving kickback payments to patient recruiters, patients, and clinic owners in exchange for patient referrals and prescriptions.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Michael E. Gilfarb.
13. United States v. Vilma Alonso, Case No. 17-20468-CR-Ungaro
Vilma Alonso, 57, of Hialeah, Florida, an employee of South Florida Physician Care Network was charged by indictment with participating in a conspiracy to defraud the United States. Alonso was charged with conspiring with others to unlawfully enrich themselves by, among other things, submitting and causing the submission of false and fraudulent claims to Medicare and concealing the submission of false and fraudulent claims to Medicare. Alonso allegedly did this by causing the issuance of home health prescriptions that were not medical necessary and by paying recruiters for the referral of Medicare beneficiaries for home health services.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Michael E. Gilfarb.
14. United States v. Maria Blanco, Case No. 17-20474-CR-Williams
Maria Blanco, 50 of Cape Coral, Florida, was charged by information with five counts of receiving kickbacks in connection with a federal health care program. The information charges Blanco with receiving approximately $8,500 in kickbacks on at least five occasions in 2014.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.
15. United States v. Enrique Vilarello, et al., Case No. 17-20482-CR-Williams
On July 7, 2017, Enrique Vilarello and Alberto Ordaz were each indicted on one count of conspiracy to pay and receive illegal kickbacks. Ordaz was also indicted on two counts of receipt of kickbacks in connection with a federal health care program. The charges stem from their roles as patient recruiters, paying illegal kickbacks to obtain medical prescriptions from clinics and receiving illegal bribes for referring patients to pharmacies, and home health agencies in and around Miami, Florida. Several of these entities, such as Merfi and City Center, are now defunct as a result of their owners being charged and pleading guilty to multi-million dollar fraud schemes.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Trial Attorney Angela Adams.
16. United States v. Juan Rodriguez, Case No. 17-20347-CR-Scola
On May 25, 2017, Juan Rodriguez, President and Director of Good Home Care, Inc., a now-defunct home health agency located in Miami, Florida, was indicted on five counts of health care fraud for his role in a $4 million scheme. Good Home allegedly billed Medicare for home health services that were never prescribed by a licensed physician or provided to Medicare beneficiaries.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Trial Attorney David Snider.
17. United States v. Jesus Escobar Montero, Case No. 17-20439-CR-Williams
On June 22, 2017, Jesus Escobar Montero, President and Director of Better Care Home Health Services, Inc., a now-defunct home health agency located in Sunrise, Florida, was indicted on four counts of health care fraud for his role in a nearly $1 million scheme. The charges arise from Montero’s ownership of Better Care, which billed Medicare for home health services that were never prescribed by a licensed physician or provided to Medicare beneficiaries.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Trial Attorney David Snider.
18. United States v. Carlos Barroso, et al., Case No. 17-20432-CR-Martinez
On June 22, 2017, Carlos Barroso, Andres Perez, Rolando Perez and Reiniel Garcia were indicted in connection with their roles at Sweet Home Health, Inc., a home health agency that defrauded Part A of the Medicare program of $8.4 million by billing for home health services that were not prescribed to patients; were not necessary; and were not rendered. Barroso was the owner of Sweet Home Health and was charged with seven counts of health care fraud, as well as one count of conspiracy to commit money laundering. A. Perez, R. Perez and Garcia owned and controlled shell corporations through which the fraud proceeds were laundered. They are each charged with one count of conspiracy to commit money laundering, three counts of money laundering and three counts of structuring to avoid reporting requirements.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.
19. United States v. Jhony A. Alfau, et al, Case No. 17-20452-CR-Ungaro
On June 29, 2017, Jhony A. Alfau, Hector J. Garcia, and Sergio E. Santana were indicted on one count of conspiracy to commit health care and wire fraud, one count of conspiracy to make false statements relating to health care matters, and one count of making false statements relating to health care matters.The charges stem from the defendants’ role in a $50 million scheme to defraud Medicare where they falsely and fraudulently certified they provided home health care physical and occupational therapy services to Medicare beneficiaries, when in fact, they had not done so.
Mr. Greenberg commends the investigative assistance of the FBI and HHS-OIG. This case is being prosecuted by Fraud Section Attorneys Yisel Valdes and Alexander Kramer.
20. United States v. Ernesto Velasquez, Case No. 17-20462-CR-Martinez
On July 5, 2017, Ernesto Velasquez, was charged by information with one count of conspiracy to commit health care fraud. The charge stems from the defendant’s role as an employee of staffing agencies that sought to defraud the United States by billing Medicare for providing licensed physical and occupational therapy to home bound patients when, in fact, they had not rendered the services. As part of the scheme, these alleged services were billed to Medicare with a loss of over $3 million.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.
21. United States v. Suley Cao, Case No. 17-20451-CR-Martinez
On June 29, 2017, Suley Cao, the owner and operator of Good Friends Services, Inc. (“Good Friends”), a home health agency, was indicted on five counts of health care fraud; one count of conspiracy to defraud the United States and pay Health Care Kickbacks; and two counts of payment of kickbacks in connection with a federal health care benefit program. The charges stem from Cao’s role as owner and operator of Good Friends, which fraudulently billed Medicare for approximately $3,017,276.89 for home health services that involved a scheme whereby Good Friends made kickback payments to induce the referral of Medicare beneficiaries.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.
22. United States v. Rafael Arias et al., Case No. 17-MJ-02962-Garber
On July 13, 2017, Rafael Arias, Aylen Gonzalez, Ana Gabriela Mursuli Caballero, and Rafael Cabrera were charged by criminal complaint with conspiracy to commit health care fraud for their roles in an approximately $6 million Medicare fraud scheme involving various home health agencies in and around Miami, Florida. Arias was alleged to be the true owner of multiple home health agencies, such as Nestor’s Health Services, Inc. Arias hid the fact of his true ownership and instead directed others, like Cabrera, to fraudulently represent themselves as owners to Medicare, which allowed them to obtain Medicare provider numbers and submit claims for services purportedly provided to Medicare beneficiaries even though many of the services were medically unnecessary or were obtained as a result of illegal bribes and kickbacks. Gonzalez and Caballero were patient recruiters who facilitated kickback schemes with Arias by referring patients to home health agencies operated by Arias in exchange for bribes and kickbacks. Gonzalez and Caballero also purchased medically unnecessary prescriptions from fraudulent medical clinics. Caballero also owned and operated City of Angels Home Health Care LLC, a home health agency that she used to bill Medicare for home health services that were medically unnecessary or were obtained as a result of illegal bribes and kickbacks.
Mr. Greenberg commends the investigative efforts of the FBI. The case is being prosecuted by Fraud Section Trial Attorney Angela Adams.
ASSISTED LIVING FACILITY FRAUD
23. United States v. Bertha Blanco, Case No. 17-MJ-02949-Garber
On July 11, 2017, Bertha Blanco, who was employed for approximately 30 years by the State of Florida’s Agency for Health Care Administration (AHCA), was charged by complaint with bribery of a program receiving federal funds. AHCA is responsible for administering the Medicaid program in Florida, and is tasked with regulating and licensing health care facilities in Florida, including skilled nursing facilities (SNFs) and assisted living facilities (ALFs). The charge alleges that Blanco solicited and received cash bribes from Medicare and Medicaid providers in exchange for providing them with confidential, nonpublic AHCA reports and information, including patient complaints and the unannounced inspection schedules of AHCA surveyors. This information was ultimately used by the purchasers, some of whom were owners of skilled nursing facilities (SNFs) and assisted living facilities (ALFs), to fabricate and falsify medical paperwork and to temporarily remedy deficiencies so that AHCA would not discover lapses in patient care and revoke the licenses of these facilities. The owners of these SNFs and ALFs then submitted false and fraudulent claims to Medicare and Medicaid for patients named in the complaints and inspection reports sold to them by Blanco.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being handled by Trial Attorneys David Snider, Elizabeth Young and Drew Bradylyons.
CLINICS, MANAGED CARE, MEDICARE ADVANTAGE FRAUD –
Medicare Part C
24. United States v. Beatriz Carrasco, Case No. 17-20464-CR-Ungaro
On July 6, 2017, Beatriz Carrasco, 49, of Hialeah, Florida was charged by information with one count of conspiracy to commit health care fraud and wire fraud. The information charges Carrasco, a Florida licensed insurance agent, with conspiring to enroll others into Medicare Advantage plans and Florida Medicaid. These individuals resided in Nicaragua, outside of the Medicare Advantage plans coverage area. As a result of Carrasco’s and her co-conspirator’s actions, Medicare and the Florida Medicaid program paid over $1,013,244 in monthly capitation payments and premiums on behalf of individuals residing in Nicaragua, who were otherwise ineligible to receive these benefits.
Mr. Greenberg commends the investigative efforts of the FBI, HHS-OIG and the State of Florida Medicaid Fraud Control Unit. This case is being prosecuted by Special Assistant U.S. Attorney Hagerenesh Simmons from the Florida Attorney General’s Office, Medicaid Fraud Control Unit.
25. United States v. Greesy Misuraca, Case No. 17-20461-CR-Scola
On July 5, 2017, Greesy Misuraca, a licensed therapist, was charged by information with one count of conspiracy to commit health care fraud. The charge stems from the defendant’s alleged role in billing Medicare for licensed physical and occupational therapy that was given to home bound patients when, in fact, she did not provide the therapeutic services. As part of the scheme, these alleged services were billed to Medicare with a loss of over $650,000.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.
PRIVATE INSURANCE FRAUD (Non-Medicare)
26. United States v. Leopoldo Becerra, Case No. 17-20470-CR-Moreno
Leopoldo Becerra, 50, of Miami, Florida was charged by indictment one count of health care fraud. The indictment charges Becerra with using Doctor Jalal Taslimi Medical Center, Inc., to falsely and fraudulently submit medical claims for reimbursement to Blue Cross Blue Shield of Florida from November 25, 2014 through May 25, 2015. The indictment charges Becerra with submitting fraudulent claims for beneficiaries purportedly receiving various injections.
Mr. Greenberg commends the investigative efforts of the FBI. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.
27. United States v. Jorge A. Gonzalez and Lazaro La Paz Paz,
Case No. 17-20440-CR-Martinez
Jorge A. Gonzalez, 50, of Miami, Florida and Lazaro La Paz Paz, 50, of Hialeah, Florida are charged by indictment with one count of conspiracy to commit health care fraud and wire fraud. The indictment charges Gonzalez and La Paz Paz with using two companies, Xtra Health Center, Inc & Gold Medical Center, Inc, and fraudulently representing that medical services were prescribed by doctors and provided to private insurance beneficiaries by these businesses. Gonzalez and La Paz Paz then falsely and fraudulently submitted these medical claims for reimbursement to Blue Cross Blue Shield of Florida from April 2014 through February 2015.
Mr. Greenberg commends the investigative efforts of the FBI. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.
TRICARE FRAUD – Military Insurance
28. United States v. Michael Shane Matthews, Case No. 17-20463-CR-Gayles
On July 6, 2017, Michael Shane Matthews, 47, of Newberry, Florida, was charged by information with causing the misbranding of drugs while held for sale.
Mr. Greenberg commends the investigative efforts of Defense Criminal Investigative Service (DCIS), Southeast Field Office, U.S. Food and Drug Administration’s (FDA) Office of Criminal Investigations (OCI), the U.S. Army Criminal Investigation Command’s Major Procurement Fraud Unit, and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Kevin J. Larsen.
29. United States v. Asciano Serna, Case No. 17-20484-CR-Altonaga
On July 7, 2017, Asciano Serna, owner and operator of ASC Pharmacy, Inc., was charged by information with one count of conspiracy to commit health care fraud. The charge arises from Serna’s role in a compounding pharmacy scheme at ASC Pharmacy involving the submission of at least $3.4 million of false and fraudulent claims to private insurance companies, Medicare, TRICARE, and other federal programs.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Jon Juenger and Trial Attorney David Snider.
UNLICENSED MONEY TRANSMITTING AND MONEY LAUNDERING
30. United States v. Yisel Torres, Case No. 17-20477-CR-Moreno
Yisel Torres, 31, of Cape Coral, Florida was charged by information with one count of participating as an unlicensed money transmitter. The information charges Torres with cashing several checks totaling $135,000 from on or about May 22, 2014, through on or about March 11, 2015. The proceeds that Torres cashed were used to pay cash kickbacks to Medicare beneficiaries that were enrolled in R&N Professional Services.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.
31. United States v. Angel Rivero, Case No. 17-20475-CR-Cooke
Angel Rivero, 43, of Miami, Florida was charged by information with one count of participating as an unlicensed money transmitter. The information charges Rivero with cashing several checks totaling $100,000 from on or about May 22, 2014, through on or about March 11, 2015. The proceeds that Rivero cashed were used to pay cash kickbacks to Medicare beneficiaries that were enrolled in Happy Heart Home Health Care.
Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.
32. United States v. Yailyn Marimon, et al., Case No. 17-20492-CR-Martinez
On July 11, 2017, Yailyn Marimon and Yamilka Echeverria were indicted in connection with their roles laundering money four Orlando-area medical clinics stole from Part C of the Medicare program. The Clinics, which were owned by Yosbel Marimon – the defendants’ brother and ex-husband, respectively – billed Medicare for $13.8 million of expensive infusion therapy drugs and physical therapy that were not medically necessary, and were never provided. On June 26, 2017, Yosbel Marimon was sentenced to 90 months’ imprisonment for his role in the scheme. The indictment alleges that Yailyn Marimon and Yamilka Echeverria laundered over $2 million of the fraud proceeds through shell companies they owned and controlled. Each defendant was charged with one count of conspiracy to commit money laundering and one count of substantive money laundering.
Mr. Greenberg commends the investigative efforts of HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.
If convicted of a charged offense, a defendant faces a possible maximum statutory sentence of: five years in prison for participating in a conspiracy (to defraud the United States by paying and receiving health care kickbacks or by unlawfully distributing prescription drugs), in violation of Title 18, United States Code, Section 371; twenty years in prison for mail fraud, in violation of Title 18, United States Code, Section 1341; twenty years in prison for wire fraud, in violation of Title 18, United States Code, Section 1343; ten years in prison for health care fraud, in violation of Title 18, United States Code, Section 1347; twenty years for conspiracy to commit health care fraud and wire fraud, in violation of Title 18, United States Code, Section 1349; twenty years for money laundering or conspiracy to commit money laundering, in violation of Title 18, United States Code, Section 1956; and ten years in prison for money laundering, in violation of Title 18, United States Code, Section 1957; and five years in prison for conducting an unlicensed money transmitting business, in violation of Title 18, United States Code, Section 1960(b)(2). In addition, a defendant may be subject to one year in prison for misbranding a drug held for sale, in violation of Title 21, United States Code, Sections 331(t) (prescription drug marketing violations are subject to a maximum penalty of ten years in prison, in accordance with Title 21, United States Code, Sections 333(b)(1)(D), and 353(e)(1)(A)) and five years in prison for payment and receipt of kickbacks in connection with a federal health care program, in violation of Title 42, United States Code, Section 1320a. Furthermore, if convicted of aggravated identity theft, in violation of Title 18, United States Code, Section 1028A, a defendant faces a mandatory consecutive term of two years in prison.
A criminal complaint, information or federal indictment is a charging instrument containing allegations. All defendants are presumed innocent, unless and until proven guilty in a court of law.
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.
Sentencings for July 7 - July 11, 2017Read the Press Release
Harold Duane Friday, 20, of Fort Washakie, Wyoming, was sentenced by Federal District Court Judge Scott W. Skavdahl on July 11, 2017, on three counts of abusive sexual contact. Friday was arrested in Fort Washakie, Wyoming. He received 144 months of imprisonment, to be followed by 15 years of supervised release, and was ordered to pay a $300.00 special assessment and $952.36 in restitution. This case was investigated by the Bureau of Indian Affairs.
Carlos Daniel Jara-Tinoco, 25, of Durango, Mexico, was sentenced by Federal District Court Judge Scott W. Skavdahl on July 11, 2017, for illegal alien in possession of a firearm. Jara-Tinoco was arrested in Cheyenne, Wyoming. He received seven months of imprisonment, to be followed by one year of supervised release, was order to pay a $100.00 special assessment, and is subject to deportation upon release from custody. This case was investigated by the U.S. Department of Homeland Security, Immigration and Customs Enforcement.
Jeffery Mark Quigley, 32, of Cheyenne, Wyoming, was sentenced by Federal District Court Judge Alan B. Johnson on July 10, 2017, for conspiracy to distribute methamphetamine and for possession of a firearm by a person convicted of domestic violence. Quigley was arrested in Cheyenne, Wyoming. He received 135 months of imprisonment, to be followed by four years of supervised release, and was ordered to pay a $200.00 special assessment and $400.00 in restitution. This case was investigated by the Bureau of Alcohol, Tobacco, Firearms and Explosives.
Randi Nicole Gunderson, 30, of Thornton, Colorado, was sentenced by Chief Federal District Court Judge Nancy D. Freudenthal on July 7, 2017, for conspiracy to commit bank fraud and for aggravated identity theft. Gunderson was arrested in Cheyenne, Wyoming. She received 64 months of imprisonment, to be followed by four years of supervised release, and was ordered to pay a $200.00 special assessment and $17,247.29 in restitution. This case was investigated by the United States Postal Inspection Service.
John Todd Allen, 55, of Casper, Wyoming, was recently sentenced by Federal District Court Judge Alan B. Johnson for conspiracy to distribute in excess of one pound of methamphetamine. Allen received 120 months of imprisonment, to be followed by five years of supervised release, and was ordered to pay a $100.00 special assessment and $1,500.00 in restitution. This case was investigated by the Wyoming Division of Criminal Investigation and the U.S. Drug Enforcement Administration.
Scarborough Woman Charged with Embezzlement from a Health Care Benefit ProgramRead the Press Release
Portland, Maine: Acting United States Attorney Richard W. Murphy announced that Carrie Caporino, 45, of Scarborough, Maine, was arrested on Tuesday and charged in U.S. District Court by criminal complaint with embezzling from a health care benefit program.
According to court records, from December 2015 to June 2017, Caporino was employed as the office manager for a Falmouth physician. The complaint affidavit alleges that she took about 600 checks totaling about $250,000 payable to the physician or the practice, and deposited them into her personal bank accounts, instead of the practice’s bank account.
She faces up to 10 years in prison and a $250,000 fine.
This case was investigated by the Federal Bureau of Investigation. It was part of the Department of Justice’s (DOJs’) Health Care Fraud Takedown announced today by Attorney General Jeff Sessions and Department of Health and Human Services Secretary Tom Price, M.D., which is the largest health care fraud enforcement action in DOJ’s history.
A criminal complaint is merely an accusation and a defendant is presumed innocent unless proven guilty in a court of law.
Rocky Mount Man Sentenced to 262 Months for Heroin Distribution and Firearm OffenseRead the Press Release
GREENVILLE – The United States Attorney for the Eastern District of North Carolina John Stuart Bruce announced that yesterday in federal court, Senior U.S. District Court Judge Malcolm J. Howard, sentenced QUINCY ANDRE JONES, 38, of Pinetops, North Carolina to 262 months imprisonment followed by 5 years of supervised release. On August 8, 2016, JONES pled guilty to one-count of Conspiracy to Distribute and Possess with Intent to Distribute a Quantity of Heroin and to one-count of Possession of a Firearm in Furtherance of a Drug Trafficking Crime.
U.S. Attorney John Stuart Bruce commented, “Our office is working every day with federal, state, and local law enforcement to fight the nationwide plague of heroin/opioid abuse. Vigorous prosecution of the dealers of this poison is an essential part of this effort.”
“It is always a good day when a heroin dealer goes to prison for over 20 years,” said Rocky Mount Chief of Police James C. Moore. “Heroin addiction is an unwelcome habitual disease that is devastating our society. I hope that this sentence will make other dealers think twice before they decide to sell drugs in Rocky Mount.”
Investigation revealed that between January 19, 2016, and June 3, 2016, investigators from the Rocky Mount Police Department, conducted nine controlled purchases of heroin, or substances purporting to be heroin, from JONES or individuals working for JONES.
On June 3, 2016, following the controlled transactions detailed above, investigators initiated a traffic stop of JONES’ vehicle and he was taken into custody without incident. Following his arrest, JONES provided a statement to investigators. JONES advised that he obtained a handgun two weeks earlier from a heroin addict, in exchange for 30 bindles of heroin. He explained that he started selling heroin in December 2015, and that he purchased 1 to 2 bricks (1.2 to 2.4 grams) of heroin per day from his supplier. JONES went on to discuss his own drug trafficking and noted that he made approximately $800 per day.
The case was investigated by the Rocky Mount Police Department and the Drug Enforcement Administration. Special Assistant United States Attorney Boz Zellinger prosecuted the case.
Recording Artist and Performer DMX Charged with Tax FraudRead the Press Release
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, and James D. Robnett, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation (“IRS-CI”), announced the arrest of EARL SIMMONS, an internationally known recording artist, performer, and actor known professionally as “DMX” and “X,” for engaging in a multi-year scheme to conceal millions of dollars of income from the IRS and to avoid paying $1.7 million of tax liabilities. SIMMONS surrendered to law enforcement agents today and will be presented tomorrow in Manhattan federal court before United States Magistrate Judge Andrew J. Peck
Acting U.S. Attorney Joon H. Kim said: “For years, Earl Simmons, the recording artist and performer known as DMX, made millions from his chart-topping songs, concert performances and television shows. But while raking in millions from his songs, including his 2003 hit ‘X Gon’ Give it to Ya,’ DMX didn’t give any of it to the IRS. Far from it, DMX allegedly went out of his way to evade taxes, including by avoiding personal bank accounts, setting up accounts in other’s names and paying personal expenses largely in cash. He even allegedly refused to tape the television show ‘Celebrity Couples Therapy’ until a properly issued check he was issued was reissued without withholding any taxes. Celebrity rapper or not, all Americans must pay their taxes, and together with our partners at the IRS, we will pursue those who deliberately and criminally evade this basic obligation of citizenship.”
IRS-CI Special Agent in Charge James D. Robnett said: “While most individuals file truthful tax returns and pay their taxes, the indictment against Mr. Simmons alleges various tax crimes, including that he failed to file personal tax returns for several years and did not pay his fair share of taxes. IRS-Criminal Investigation will continue to focus our investigative efforts on those who try to conceal their income in order to evade their taxes.”
According to the allegations in the Indictment[1] unsealed today in Manhattan federal court:
SIMMONS, known professionally as “DMX” or “X,” worked as a recording artist, performer, and actor. Beginning in 1997, SIMMONS released a series of hip-hop albums that sold millions of records. Many of his albums went platinum and occupied the top positions on musical charts. During his career, SIMMONS has performed at venues across the United States and around the world, and has acted in motion pictures.
As a result of the income SIMMONS earned from sources including musical recordings and performances, from 2002 through 2005 he incurred federal income tax liabilities of approximately $1.7 million. Those liabilities went unpaid, and in 2005, the IRS began efforts to collect SIMMONS’s unpaid tax liabilities.
During the period from 2010 through 2015, SIMMONS earned over $2.3 million, but SIMMONS did not file personal income tax returns during that time period. Instead, he orchestrated a scheme to evade payment of his outstanding tax liabilities, largely by maintaining a cash lifestyle, avoiding the use of a personal bank account, and using the bank accounts of nominees, including his business managers, to pay personal expenses. For example, SIMMONS received hundreds of thousands of dollars of royalty income from his music recordings. SIMMONS caused that income to be deposited into the bank accounts of his managers, who then disbursed it to him in cash or used it to pay his personal expenses. SIMMONS also participated in the “Celebrity Couples Therapy” television show in 2011 and 2012 and was paid $125,000 for his participation. When taxes were withheld from the check for the first installment of that fee by the producer, SIMMONS refused to tape the remainder of the television show until the check was reissued without withholding taxes.
SIMMONS took other steps to conceal his income from the IRS and others, including by filing a false affidavit in U.S. Bankruptcy Court that listed his income as “unknown” for 2011 and 2012, and as $10,000 for 2013. In fact, SIMMONS received hundreds of thousands of dollars of income in each of those years.
* * *
SIMMONS, 46, of Yonkers, New York, is charged in 14 counts: one count of corruptly endeavoring to obstruct and impede the due administration of Internal Revenue Laws, one count of evasion of payment of income taxes, six counts of evasion of assessment of income tax liability, and six counts of failure to file a U.S. individual income tax return. Count One carries a maximum sentence of three years. Counts Two through Eight each carry a maximum sentence of five years. Counts Nine through Fourteen each carry a maximum sentence of one year. The statutory maximum sentences are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant would be determined by the judge.
Mr. Kim praised the investigative work of the IRS-CI.
This case is being prosecuted by the Office’s Complex Frauds and Cybercrime Unit. Assistant United States Attorney Richard Cooper is in charge of the prosecution.
The allegations contained in the Indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty.
[1] As the introductory phase signifies, the entirety of the text of the Indictment, and the description of the Indictment set forth herein, constitute only allegations, and every fact described should be treated as an allegation.
Raytown Man Sentenced for Stealing $86,000 from Two ChurchesRead the Press Release
KANSAS CITY, Mo. – Tom Larson, Acting United States Attorney for the Western District of Missouri, announced that a Raytown, Mo., man who worked or volunteered at two area churches was sentenced in federal court today for embezzling more than $86,000 from those parishes.
David Townley, 60, of Raytown, was sentenced by U.S. District Judge Gary A. Fenner to one year and one day in federal prison without parole. The court also ordered Townley to pay $86,297 in restitution.
On Feb. 14, 2017, Townley pleaded guilty to one count of wire fraud, one count of mail fraud and one count of tax evasion.
Nativity of Mary (Wire Fraud)
Townley admitted that he engaged in a scheme to defraud Nativity of Mary church and school in Independence, Mo., from 2007 through 2013.
Townley was employed by the Nativity of Mary church and school as the business manager from December 2006 through June 2013. Townley handled the payroll and had access to both cash and check collections/donations, and school tuition payments. From 2011 through 2013, Townley skimmed money from cash tuition payments made by parents. Townley recorded accurate tuition deposits in the school’s log but deposited a lesser amount into the church’s bank account.
Townley is responsible for a loss of $52,166, which includes $32,194 in unauthorized checks deposited into Townley’s personal account and $19,971 in cash from tuition payments deposited into Townley’s personal bank account.
Townley’s bank records revealed frequent cash deposits separate from his and his wife’s salary payments. Nativity of Mary banked at the Blue Ridge Bank and Trust in Kansas City, Mo. The processing of checks through the Federal Reserve System from Nativity of Mary constituted the wire fraud.
Sacred Heart of Guadalupe (Mail Fraud)
Townley stole $34,131 from Sacred Heart of Guadalupe church in Kansas City, Mo., in a fraud scheme that lasted from 2006 through 2013.
Townley was a volunteer at Sacred Heart of Guadalupe from 2002 through 2013. Townley was in charge of paying the church’s bills, making QuickBooks entries, reporting to the financial committee and filing the church’s tax returns. From 2006 through 2013, Townley negotiated more than 20 checks, totaling $47,705, and deposited them into his personal bank account. Some of these checks were unauthorized salary payments and others were made out to third parties, such as the “Society of the Precious Blood” and the Diocese of Kansas City.
Sacred Heart of Guadalupe banked at U.S. Bank in Kansas City, Mo., which mailed statements to the church and constituted the mail fraud charge.
The total loss amount from the two fraud schemes was $86,297. According to an analysis of his bank records, Townley used the money he embezzled mostly to pay off credit card debt.
Tax Evasion
Townley admitted that he failed to file federal income tax returns for tax years 2005 through 2013. During those years, Townley had taxable income that ranged from $54,633 to $115,721. The total federal tax loss for those years is $59,322. The total tax loss to the state of Missouri is $30,117.
Townley attempted to conceal his true sources of income at Nativity of Mary and Sacred Heart of Guadalupe. The acts of evasion in those years included making false entries in the accounts of Nativity of Mary and skimming cash from tuition payments made by parents at the Nativity of Mary school.
This case was prosecuted by Assistant U.S. Attorney Paul S. Becker. It was investigated by the U.S. Secret Service and IRS-Criminal Investigation.
Ohio man indicted for receiving and distributing images of children being sexually exploitedRead the Press Release
Keith Bollinger, 45, of McClure, was indicted for receipt and distribution of child pornography, said Acting U.S. Attorney David A. Sierleja.
Bollinger received and distributed images of child sexual exploitation between January and June 2017, 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 this case is the United States Secret Service. The case is being handled by Assistant U.S. Attorney Tracey Ballard Tangeman.
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.
Norwalk Doctors Charged with Operating "Pill Mill," Health Care Fraud and Money LaunderingRead the Press Release
Deirdre M. Daly, United States Attorney for the District of Connecticut, Michael J. Ferguson, Special Agent in Charge of the Drug Enforcement Administration for New England, today announced that two doctors who have operated a medical practice in Norwalk have been charged by federal criminal complaint with writing prescriptions outside the scope of legitimate medical practice, health care fraud and money laundering.
Dr. BHARAT PATEL, 70, of Milford, was arrested yesterday at his residence. He appeared before U.S. Magistrate Judge William I. Garfinkel in Bridgeport and is detained pending a detention hearing that is scheduled for July 17.
Dr. RAMIL MANSOUROV, 47, of Darien, is currently being sought by law enforcement.
As alleged in the criminal complaint, PATEL and MANSOUROV are physicians who operated out of Family Health Urgent Care, located at 235 Main Street in Norwalk. The medical practice was formerly known as Immediate Health Care, which was owned by PATEL. In approximately 2012, MANSOUROV purchased the practice from PATEL and renamed it Family Urgent Health Care, and PATEL continued to work at the practice. PATEL and MANSOUROV are participating providers with Medicare and the Connecticut Medicaid Program. Beginning in approximately 2013, the Drug Enforcement Administration received information that PATEL and MANSOUROV may be writing prescriptions for controlled substances outside the scope of legitimate medical practice.
The complaint alleges that PATEL regularly provided prescriptions for narcotics, including oxycodone and hydrocodone, to patients that he knew were addicted or had been arrested for distributing or possessing controlled substances. On numerous occasions, PATEL provided prescriptions to patients who paid him $100 in cash for each prescription. In certain instances, PATEL would write prescriptions for individuals who were not his patients in exchange for cash. At times, when PATEL was not available, MANSOUROV provided PATEL’s patients with unnecessary prescriptions. PATEL and MANSOUROV also regularly provided post-dated prescriptions to individuals, sometimes with dates that matched future dates when the doctors would be out of the country.
It is alleged that certain individuals who paid PATEL cash for prescriptions paid for the filled prescriptions by using a state Medicaid card, and then illegally distributed the drugs. The investigation revealed that in 2014 alone, more than $50,000 in cash deposits were made into PATEL and his wife’s bank accounts, and that some of these funds were used to purchase PATEL’s current residence.
The complaint further alleges that between November 2013 and December 2016, MANSOUROV defrauded the state’s Medicaid program of more than $4 million by billing for home visits that he never made, billing for nursing home visits that he never made, billing for office visits that never happened, and billing for visits that he claimed took place on dates on which he was actually out of state or out of the country. Billing records also reveal that, on some occasions, MANSOUROV and PATEL billed Medicaid for the same patient on the same day at two different locations.
It is alleged that MANSOUROV moved some of the stolen funds to a bank account in Switzerland.
“These two doctors are charged with violating their oaths and recklessly prescribing highly addictive painkillers,” said U.S. Attorney Daly. “Dr. Patel is alleged to have regularly sold to addicts solely for his own profit. Many of these patients filled the prescriptions using state healthcare benefits, and then turned around and sold the pills on the street, contributing to our devastating opioid epidemic. Some addicts referred to these defendants’ medical practice as ‘The Candy Shop.’ Dr. Mansourov is also charged with bilking state and federal governments of over 4 million dollars through a phony billing scheme. I thank the DEA’s Tactical Diversion Squad, the Norwalk Police Department and the Connecticut Attorney General’s Office for their excellent work in shuttering this medical practice.”
“The DEA is committed to enforcing the Controlled Substance Act (CSA) by ensuring that all registrants are in compliance and abide by DEA’s distribution regulations,” said Special Agent in Charge Ferguson. “The reckless actions by these two doctors by writing prescriptions outside the scope of their legitimate medical practice contributed to the widespread abuse of opiates, which is a gateway to heroin addiction and is devastating our communities. In response to the ongoing opioid epidemic DEA is committed to improve public safety and public health by working with our law enforcement and regulatory partners to ensure these rules and regulations are strictly followed. This investigation demonstrates the strength of collaborative law enforcement in Connecticut and our great partnership with the U.S. Attorney’s Office.”
The complaint charges PATEL and MANSOUROV with conspiracy to distribute and to possess with intent to distribute narcotics, an offense that carries a maximum term of imprisonment of 20 years; health care fraud, an offense that carries a maximum term of imprisonment of 10 years, and conspiracy to commit money laundering, an offense that carries a maximum term of imprisonment of 10 years.
U.S. Attorney Daly stressed that a complaint is only a charge and is not evidence of guilt. Charges are only allegations, and each defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt.
This investigation is being conducted by the DEA’s New Haven Tactical Diversion Squad and the Norwalk Police Department, with the critical assistance of the Connecticut Office of the Attorney General. The DEA Tactical Diversion Squad includes officers from the Bristol, Greenwich, Hamden, Milford, New Haven, Shelton, Vernon and Wilton Police Departments. The case is being prosecuted by Assistant U.S. Attorney Rahul Kale.
Ninth Circuit Denies Challenge to $122.5M Settlement for 2007 Moonlight FireRead the Press Release
SACRAMENTO, Calif. — In a unanimous opinion, the U.S. Court of Appeals for the Ninth Circuit today affirmed the denial of relief from judgment for Sierra Pacific Industries and the other defendants held responsible for the Moonlight Fire in a settlement they entered with the United States five years ago.[1]
U.S. Attorney Phillip A. Talbert said, “We are gratified but not surprised by today’s decision, which helps make an important point this fire season. When negligent logging operations cause massive forest fires, this Office will respond with exactly the kind of tenacious, professional advocacy shown by Assistant U.S. Attorneys David Shelledy, Kelli Taylor and the rest of the team. Consistent with the best traditions of the U.S. Department of Justice, our office will continue to hold the careless to account.”
The fire started on Labor Day 2007 and burned over 46,000 acres of the Plumas and Lassen National Forests before it could be extinguished. In a complaint filed in 2010, the United States alleged that the fire started and escaped due to the neglect by Sierra Pacific and one of its contractors in operating bulldozers on a remote logging site on a “red flag” warning day. The contractor’s employees abandoned the job site to get a soda and cellphone soon after completing work, without inspecting the area to ensure they had not started a fire, as required by company policy and state law. The same contractor started two other fires the same summer working on other projects for Sierra Pacific. Sierra Pacific knew the contractor had started one of those fires yet took no action to ensure fire safety.
After litigation commenced, the contractor formally admitted that the fire started in its work area where no one but its employees was seen all day. Sierra Pacific, however, engaged in extensive litigation in an effort to avoid responsibility.
In 2012, the district court in Sacramento ruled that Sierra Pacific could present at trial some of its claims that the government engaged in fraud in attributing blame for the fire. However, in July 2012, Sierra Pacific and the other defendants averted trial by entering a settlement.
In exchange for dismissal of the United States’ complaint, the defendants agreed to pay a total of $55 million in cash. Sierra Pacific’s share of the settlement was $47 million and a conveyance of 22,500 acres of undeveloped land for incorporation into the National Forest System.
With a total value of at least $122.5 million, the settlement is the largest ever received by the United States for damages caused by a forest fire. All of the settlement payments are now complete. Land transfers totaling more than 12,000 acres have been completed with the remainder ongoing.
In the settlement agreement, Sierra Pacific and the other defendants specifically agreed to release all claims—known or unknown. Nonetheless, in October 2014, they filed a motion for relief from judgment, seeking to back out of the settlement based on allegations of fraud. Almost all accusations in the motion repeated the baseless claims made by Sierra Pacific in litigation before the settlement.
In April 2015, U.S. District Judge William B. Shubb issued a detailed 63-page order denying the motion and emphatically rejecting every allegation by Sierra Pacific’s counsel that there was fraud on the court.[2] After an exhaustive review of the law and the record, Judge Shubb concluded that the defendants “failed to identify even a single instance of fraud on the court, certainly none on the part of any attorney for the government. They repeatedly argue that fraud on the court can be found by considering the totality of the allegations. . . . Stripped of all its bluster, defendants’ motion is wholly devoid of any substance.” This is the order affirmed today by the court of appeals.
In a unanimous, 34-page opinion the Ninth Circuit ruled that “[a]fter voluntarily settling this case and asking the district court to enter judgment based on that settlement,” the defendants’ allegations of newly discovered fraud failed to meet the high showing required for relief from judgment. The court ruled that all accusations of fraud discovered before the settlement were legally insufficient — whether those accusations were true or not — because Sierra Pacific and the other defendants “voluntarily settled instead of going to trial.” The settlement agreement also precluded all accusations that the defendants claimed to have discovered after settlement, the court explained, because under the express terms of the settlement agreement, the defendants “bound themselves not to seek future relief, even for fraud on the court.” And finally, the court ruled that even if the settlement terms did not bar relief, “we conclude [those accusations] do not constitute fraud on the court.”
The court specifically rejected Sierra Pacific’s claim that an Assistant U.S. Attorney encouraged perjury by telling a federal investigator the government’s lawyers considered Sierra Pacific’s core scandal claim (that a white flag at the fire investigation scene marked the initial, “concealed” point of origin) to be “a non-issue.” The court explained that this comment was “merely an opinion about the relative importance of an element of the case; . . . not an instruction to commit perjury.”
Despite Sierra Pacific’s inflammatory accusations against the Assistant U.S. Attorneys representing the government in this case, not one of the number of federal judges to have issued rulings before and after settlement have sustained any of those accusations.
[1] The case is United States v. Sierra Pacific Industries, et al., Ninth Circuit No. 15-15799.
[2] United States v. Sierra Pacific Industries, et al., No. 2:09-02445 (E.D. Cal. April 17, 2015).
New Orleans Men Sentenced in Seventh Ward Heroin and Firearm ConspiracyRead the Press Release
Acting U.S. Attorney Duane A. Evans announced that DARRYL LEWIS, a/k/a “Uncle Tom,” a/k/a “Poppa Tom,” age 63, and DEMOINDE ROWLEY, a/k/a “Chuck,” age 40, both of New Orleans, were sentenced today after previously pleading guilty to federal narcotics charges.
DARRYL LEWIS was a street-level dealer in the conspiracy. He sold heroin to customers in the Seventh Ward of New Orleans with several co-conspirators. LEWIS also stored firearms for his co-conspirators and served as a “tester” of heroin. He pled guilty to conspiracy to distribute heroin. U.S. District Judge Carl J. Barbier sentenced him to a term of time served (approximately 31 months) in prison, and a supervised release term of 3 years.
DEMOINDE ROWLEY likewise was a street-level dealer who purchased heroin from members of the Seventh Ward-based conspiracy. He also pleaded guilty to conspiracy to distribute heroin. U.S. District Judge Carl J. Barbier sentenced ROWLEY to five years of probation.
Acting U.S. Attorney Evans praised the work of the FBI New Orleans Field Office. Assistance was provided by the DEA New Orleans Field Division, the New Orleans Police Department, the Major Crimes Task Force, the FBI Kansas City Division (Jefferson City Resident Office), and the St. Louis County Police Department. Assistant United States Attorneys Matthew Payne, Shirin Hakimzadeh, and Andre Lagarde are in charge of prosecution.
New Orleans Man Sentenced to 10 Years for Operating Heroin Conspiracy in New Orleans EastRead the Press Release
Acting U.S. Attorney Duane A. Evans announced that MICHAEL DAVID SORINA, JR., age 38, resident of Slidell, was sentenced after previously pleading guilty to
conspiracy to distribute and possess with intent to distribute one kilogram or more of heroin.
U.S. District Judge Carl J. Barbier sentenced SORINA to 120 months incarceration, followed by 10 years of supervised release.
On July 25, 2014, SORINA, was one of 12 defendants charged in a 23-count indictment. According to court documents, this investigation targeted a heroin trafficking organization operating in New Orleans East. This organization was responsible for distributing at least 15 kilograms of heroin in New Orleans. Agents seized approximately $1,200,000 in assets (a combination of vehicles, currency, jewelry and real property) from members of this drug trafficking organization that were acquired with proceeds made from the sale of heroin.
Co-defendants include:
LARRY HARDY pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 90 months incarceration.
AMBROSE WILLIAMS pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 120 months incarceration.
ANTOINETTE KELLY pled guilty to distribution of heroin and was sentenced to 15 months incarceration.
CHRISTOPHER FRANCIS pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 240 months incarceration.
RODNEY MACK pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 120 months incarceration.
THOMAS HARRISON pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 144 months incarceration.
VINCENT P. JONES pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 180 months incarceration.
BETH MARIE NGUYEN pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and was sentenced to 36 months incarceration.
RICKY MARQUETTE BOZEMAN pled guilty to conspiracy to possess with intent to distribute 100 grams or more of heroin and was sentenced to 144 months incarceration.
TERRELL CARNEY pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and is scheduled to be sentenced on 7/20/2017.
ANTOINE SMITH pled guilty to conspiracy to possess with intent to distribute one kilogram or more of heroin and is scheduled to be sentenced on 9/21/2017.
Acting U.S. Attorney Evans praised the work of the Drug Enforcement Administration, Kenner Police Department, and Border Patrol in investigating this matter. Assistant United States Attorney Brandon Long is in charge of the prosecution.
New Orleans Man Sentenced for Violation of the Federal Gun Control ActRead the Press Release
Acting U.S. Attorney Duane A. Evans announced that SONNY SCOTT, age 37, of New Orleans, was sentenced today for his conviction stemming from a Federal Gun Control Act violation: possession of a firearm by a convicted felon.
U.S. District Judge Lance M. Africk sentenced SCOTT to 100 months incarceration, followed by 3 years of supervised release, and a mandatory $100 special assessment.
According to court documents, SCOTT was arrested on January 12, 2017. During a search of SCOTT’s person, SCOTT was found to be in possession of approximately $250 in U.S. currency, 3 grams of heroin, approximately 3 grams of cocaine, numerous unidentified pills individually wrapped in clear plastic bags and a loaded .38 caliber special Smith & Wesson revolver. SCOTT had three prior felony convictions, including one from 2002 for armed robbery and was therefore prohibited from possessing a firearm.
Acting U.S. Attorney Evans praised the work of the Drug Enforcement Administration for investigating this matter. Assistant United States Attorney James S. C. Baehr was in charge of the prosecution.
New Orleans Man Sentenced for Heroin Trafficking via MegabusRead the Press Release
Acting U.S. Attorney Duane A. Evans announced that DONALD EALY, a/k/a “Deebo,” age 38, of New Orleans, was sentenced today after previously pleading guilty to conspiring to distribute and possess with intent to distribute one kilogram or more of heroin.
U.S. District Judge Carl J. Barbier sentenced EALY to 60 months incarceration, followed by 5 years of supervised release.
EALY was one of eight defendants charged in a 21-count superseding indictment on September 18, 2015. According to court documents, the superseding indictment originated from an FBI investigation into a heroin-trafficking organization operating primarily around Loyola Avenue and Harmony Street in Central City, New Orleans. The sources of heroin for this organization traveled via Megabus from Houston to New Orleans, carrying half-kilogram quantities of heroin for distribution in the New Orleans area.
The group’s two Houston-based heroin suppliers, defendants MARTHA QUINONES and KEVIN GONZALEZ, each pled guilty to conspiring to distribute and possess with intent to distribute one kilogram or more of heroin, and were sentenced to 120 months and 57 months imprisonment, respectively. Defendant REGINALD WASHINGTON pled guilty to conspiring to distribute and possess with intent to distribute 100 grams or more of heroin, and was sentenced to 120 months imprisonment. Defendants EARL BROWN and WILBERT CLARK pled guilty to conspiring to distribute and possess with intent to distribute a quantity of heroin, and were each sentenced to 30 months imprisonment. Two other defendants, THOMAS GORDON and KENNETH HARRIS, have pled guilty to conspiring to distribute and possess with intent to distribute one kilogram or more of heroin, and will be sentenced on August 24, 2017.
Acting U.S. Attorney Evans praised the work of the Federal Bureau of Investigation New Orleans Gang Task Force (NOGTF), which includes FBI, the Saint Tammany Parish Sheriff’s Office, the Jefferson Parish Sheriff’s Office, and the New Orleans Police Department. Assistant United States Attorney Brandon S. Long was responsible for the prosecution.
Nebraska Men Indicted for Armed RobberiesRead the Press Release
Donald S. Boyce, United States Attorney for the Southern District of Illinois, announced today that two Nebraska men were indicted on July 12, 2017 for conspiracy to interfere with commerce by robbery, four counts of interference with commerce by robbery, and brandishing a firearm during a crime of violence and discharge of a firearm during a crime of violence.
Allen McCray, 19, and Victor Linton, 23, both of Omaha, Nebraska, were charged in a seven count indictment. The indictment alleges that beginning on or about April 12, 2017 and continuing through and including April 21, 2017, McCray and Linton conspired and did commit a series of four armed robberies of MotoMart, Circle K, and Casey’s General Store on April 15, 2017 and Prime Sole on April 19, 2017 within the Southern District of Illinois. The indictment also alleges that a firearm was brandished or discharged at each of these robberies.
The conspiracy and robbery offenses carry up to a maximum of 20 years of imprisonment, to be followed by up to three years of supervised release and a fine up to $250,000. Brandishing a firearm during a crime of violence carries a mandatory minimum sentence of seven years to life imprisonment, to be followed by five years supervised release, and a fine up to $250,000. For a second or subsequent conviction under this section, the minimum sentence is not less than 25 years of imprisonment up to life imprisonment. Discharging a firearm during a crime of violence carries a mandatory minimum sentence of ten years to life imprisonment, followed by five years of supervised release, and a fine up to $250,000. For a second or subsequent conviction under this section, the minimum sentence is not less than 25 years of imprisonment up to life imprisonment.
An indictment is a formal charge against a defendant. Under the law, a defendant is presumed to be innocent of a charge until proven guilty beyond a reasonable doubt to the satisfaction of a jury.
The ongoing investigation is being conducted by the Federal Bureau of Investigation, the Maryville Police Department, the O’Fallon Police Department, the Troy Police Department, the Effingham Police Department, Illinois State Police, Missouri State Highway Patrol and multiple law enforcement agencies in Illinois, Nebraska, Missouri, and Indiana.
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.
*********
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.
*********
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 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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