- On January 8, 2016, HHS OIG Most Wanted Fugitive Sandy De La Fe was apprehended at the Miami International Airport. De La Fe was indicted in July 2013 on 16 counts of health care fraud. Investigators believe that De La Fe participated in a prescription drug fraud scheme that bilked Medicare out of millions of dollars.
- De La Fe was the owner of record for Goldenway Pharmacy Discount, Inc., located in Miami, Florida. According to the indictment, De La Fe's co-conspirators paid Medicare beneficiaries to obtain prescriptions for pharmaceutical drugs. These false prescriptions, some of which were worth more than $1,000 per prescription, were then billed by Goldenway to Medicare Part D, falsely claiming that these drugs were medically necessary, had been prescribed by a doctor, and had been provided by Goldenway to Medicare beneficiaries.
- As a result of these false claims, Medicare paid Goldenway approximately $2.8 million in reimbursement. De La Fe and his co-conspirators diverted the proceeds from this scheme for their own use and to further the fraud.
- De La Fe fled to Cuba and remained a fugitive at large until his recent arrest. He is currently in custody and will face charges stemming from his indictment.
- On January 11, 2016, HHS OIG fugitive Maelis Yanet Porto Fernandez was apprehended in the Miami area. On October 9, 2015 Fernandez was charged by criminal complaint for offering and paying health care kickbacks. A warrant for her arrest was also issued on that day.
- Fernandez worked as a patient recruiter at many Miami area pharmacies, including O.M.G. Pharmacy Discount, Inc., Ultra Medical Services, Inc., and other Miami-Dade County pharmacies. Investigators believe that Fernandez participated in a prescription drug fraud scheme in which she was personally paid kickbacks, and also was in charge of the patient recruiters and would pay them for referring Medicare beneficiaries to the pharmacy.
- Fernandez is currently in custody and will face charges stemming from her criminal complaint.
- On October 9, 2015, HHS OIG Most Wanted Fugitive Ubert Guillermo Rodriguez was apprehended at Miami International Airport. Rodriguez was indicted in July 2013 on 14 counts of health care fraud. Investigators believe that Rodriguez submitted more than $2.5 million in false claims to Medicare for durable medical equipment (DME) that was never provided or was medically unnecessary.
- Rodriguez was the president, director, and registered agent of G.R. Services Equipment & Supplies, Inc., a company based in Florida that purportedly provided DME to Medicare beneficiaries. Rodriguez submitted claims to Medicare, fraudulently representing that the DME items and services were prescribed by a doctor and were provided to Medicare beneficiaries when, in fact, they were not. The DME items included collagen dressings, sterile packs, negative pressure wound therapy pumps, gauze, and catheters.
- Investigators interviewed the top referring physicians who supposedly wrote prescriptions for the DME and verified that no referrals to G.R. Services were actually made by these physicians. Investigators also interviewed beneficiaries, who confirmed that they never received any DME from G.R. Services.
- As a result of the false claims, Rodriguez received $918,402 in Medicare reimbursement. Rodriguez fled to Cuba and remained a fugitive at large until his recent capture. He is currently in custody and will face charges stemming from his indictment. News Release
- On May 15, 2014, William Acosta was arrested after being detained in Panama City, Panama. Acosta had been a fugitive for approximately 7 years.
- On January 16, 2015, Acosta pleaded guilty to charges related to health care fraud and filing false income tax returns. According to the investigation, Acosta falsely billed Medicare and private insurance companies for higher level office visits than actually occurred. Investigators also believed that Acosta billed for "routine" hearing and eye tests, even though Medicare does not pay for such tests unless they are deemed medically necessary.
- Following an undercover investigation and execution of a search warrant, Acosta was given until Monday April 3, 2006, to decide whether he would plead guilty. However, flight records show that on the Sunday before, on April 2, 2006, Acosta and his son left for the Dominican Republic. Acosta's practice was abruptly closed. As a result, the Medical Board indefinitely suspended his medical license for patient abandonment. Acosta is in jail and is awaiting sentencing.
- On March 10, 2015, Karo Gotti Blkhoyan was sentenced to 57 months incarceration. He was arrested on August 26, 2014, at San Francisco International Airport, and in November 2014 pleaded guilty to a charge of conspiracy to commit money laundering.
- In August 2012, Blkhoyan was indicted for conspiracy to commit health care fraud, health care fraud, conspiracy to commit money laundering, and money laundering. According to the indictment, Blkhoyan and his co-conspirators billed Medicare for approximately $1.1 million in false and fraudulent claims for services never rendered and were paid more than $300,000.
- According to the indictment, Blkhoyan and his co-conspirators conspired to defraud Medicare. Together, they owned and operated Pinnacle Group Services (PGS), a medical clinic located in Columbia, South Carolina, from October 2009 until August 2010. PGS was a sham entity; no patients ever went there and the identities of physicians were stolen to bill Medicare for services.
- The co-conspirators have been arrested and are awaiting the judicial process.
- On November 19, 2014, OIG Most Wanted Fugitive Luis Marin was captured in Florida by Miami-Dade Police. He is currently in custody and is awaiting charges stemming from his indictment.
- Marin was indicted in August 2014 on charges of conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to commit money laundering, and money laundering. Investigators believe that Marin and his co-conspirators falsely billed Medicare millions of dollars for physical therapy and other home health services that were never provided or were medically unnecessary.
- Marin was president of DD Quality Services Corp. in Sunny Isles, Florida, a company that purportedly provided physical therapy to Medicare beneficiaries. According to court records, Marin was involved in a scheme in which patient recruiters were paid kickbacks in exchange for referring Medicare beneficiaries to two purported home health companies in Florida, Sacred Health, Inc., and Marcialed Healthcare Corp. Marin and his co-conspirators falsified records to document the purported receipt of home health services from home health companies that, in reality, were not provided and were not medically necessary. The false documents were then used to bill Medicare more than $16 million.
- To date, six defendants involved in this scheme have been sentenced, including Alejandro Arcia-Ocampo, who pleaded guilty to conspiracy to commit health care fraud and conspiracy to pay and receive kickbacks and was sentenced to 10 years in prison.
- On April 16, 2015 in the Southern District of Florida, Felix Gonzalez was sentenced to 113 months imprisonment and ordered to pay $21 million in restitution, joint and several. Gonzalez was a fugitive who returned to the United States in September 2014 and was arrested at Miami airport. He pleaded guilty on January 9, 2015, for conspiracy to commit healthcare fraud.
- Investigators believe that Gonzalez and his co-conspirators caused the submission of approximately $32 million in false claims to Medicare. Gonzalez was indicted in May 2013 on charges of conspiracy to commit health care fraud, conspiracy to defraud the United States and pay health care kickbacks, and payment of kickbacks in connection with a Federal health care benefit program.
- Gonzalez owned and operated AA Advanced Care, Inc., a company based in Miami, Florida, which purportedly provided home health care and physical therapy services to eligible Medicare beneficiaries.
- According to the indictment, Gonzalez and his co-conspirators allegedly paid thousands of dollars in kickbacks to patient recruiters in exchange for recruiting Medicare beneficiaries to AA Advanced. Gonzalez and his co-conspirators then sent beneficiaries to doctors to obtain prescriptions for home health services that were not medically necessary and were not provided. Gonzalez and his co-conspirators caused patient documentation to be falsified to make it appear as if the beneficiaries qualified for and received home health services when, in fact, they did not.
- Between approximately January 2006 and March 2009, AA Advanced submitted claims to Medicare for home health services purportedly provided to around 900 beneficiaries, to which Medicare paid $22 million in reimbursement.
- On April 11, 2014, Pablo Piedra Perez was sentenced to 2 years and 7 months in jail and ordered to pay $679,715 in restitution after pleading guilty to a charge of health care fraud. Perez was arrested in September 2013 in Texas after reentering the United States from Mexico.
- According to court documents, Perez was the sole officer and registered agent of ECY Pharmacy Discount, Inc. (ECY), a community pharmacy in Miami, Florida. Perez fraudulently obtained the names, Medicare numbers, and other patient-identifying information of Medicare beneficiaries. He used this information to submit claims to Medicare for prescription drugs and other medical services that were never provided to the beneficiaries. Physicians who purportedly authorized the prescriptions denied ever having treated the beneficiaries.
- As a result of these fraudulent claims, Perez caused Medicare to make payments to ECY Pharmacy in the approximate amount of $969,245.
- On September 19, 2013, Keith Pullam was sentenced to 5 years and 8 months in jail and ordered to pay $2.7 million in restitution, joint and several, after pleading guilty to a charge of conspiracy to distribute controlled substances. Pullam was indicted in September 2011 and was a fugitive until his capture.
- According to court documents, Pullam was a runner for the clinic Lake Medical Group. Lake Medical functioned as a prescription mill that generated prescriptions for oxycontin that the clinic's purported patients did not need and submitted claims to Medicare and Medi-Cal for services that were medically unnecessary or were ordered by a doctor and not performed. Pullam often drove recruited Medicare beneficiaries to pharmacies in the greater Los Angeles area to obtain fraudulently prescribed oxycontin. These patients were previously recruited by Pullam's co-conspirators to receive unnecessary medical care, if any care at all, in exchange for cash kickbacks.
- The recruited beneficiaries were routinely issued prescriptions for 90 pills of oxycontin. After the fraudulent prescriptions were issued, Pullam and others took the filled prescription medication and delivered it to co-conspirators, who then sold it on the streets for approximately $17 to $23 per pill. In addition, Medicare Part D and Medicare PDPs paid approximately $2.7 million for oxycontin prescribed by the clinic and its doctors.
- Pullam was a fugitive until his capture and arrest in Los Angeles on May 3, 2012.
- On February 2, 2015, former Most Wanted Fugitive Vivian Yusuf was sentenced to 7 years and 3 months in jail and ordered to pay $1.6 million in restitution. Yusuf had been arrested on June 3, 2014, at Houston International Airport after arriving on a flight from Nigeria. In September 2014, .she pleaded guilty to conspiracy to commit health care fraud. News Release.
- In March 2011, Yusuf was indicted on charges of conspiracy to commit health care fraud, health care fraud, and aggravated identity theft. Investigators believe that Yusuf and her co-conspirators billed Medicare for more than $3.4 million for durable medical equipment (DME) that was neither medically necessary nor prescribed by a physician.
- Yusuf owned and operated Ivy Health Care Supply, a DME company based in Stafford, Texas. According to court records, Yusuf and her co-conspirators allegedly improperly acquired Medicare patient information to submit false claims to Medicare. The defendants then forged physicians' signatures on prescriptions and certificates of medical necessity (CMN). They also altered prescriptions and CMNs after they had been signed by physicians. The defendants then billed Medicare for power wheelchairs, orthotic equipment, and other medical supplies that were not prescribed or otherwise authorized by a physician, were not medically necessary, and were not requested by the beneficiaries.
- Investigators believe that Yusuf and her co-conspirators falsely billed Medicare for claims for nearly 800 Medicare patients, primarily located in Texas and Louisiana. Based on these claims, Ivy Health Care Supply was reimbursed approximately $1.6 million from Medicare. Yusuf and her co-conspirators allegedly diverted these funds from her business for their own personal use and benefit, as well as that of others.
- On February 18, 2014, Ernesto Hernandez was arrested after arriving at Miami International Airport on a flight from Cuba. He is currently being held in U.S. custody and will face charges stemming from his indictment.
- Hernandez was indicted in April 2008 on five counts of health care fraud. Hernandez was the sole officer and registered agent of La Numero 1 Farmacia Discount Corp, a Miami-based pharmacy that purportedly provided aerosol medications and other medical supplies to Medicare beneficiaries.
- Investigators believe that Hernandez, through his company, submitted nearly $4 million in false claims to Medicare, billing for various health care benefits, items, and services that were not medically necessary, not prescribed by a doctor, and/or were never provided to beneficiaries. Hernandez received approximately $1.4 million in reimbursement from Medicare for these fraudulent claims.
- After being interviewed by Federal agents in March 2008, Hernandez fled the United States for Cuba. Consequently, a warrant was issued for his arrest. He remained a fugitive at large for nearly 6 years.
- On September 19, 2014, Hector Hernandez was sentenced to 2-and-a-half years in jail and ordered to pay $1.4 million in restitution after pleading guilty to health care fraud and money laundering. Hernandez was arrested January 6, 2014 while traveling with Cuban immigrants in a vessel toward the coast of Key West, Florida.
- In July 2009, Hernandez was indicted on charges of health care fraud and money laundering. Investigators believe that Hernandez, through his company, submitted approximately $3.1 million in fraudulent Medicare claims for durable medical equipment (DME), such as sterile gauzes, appliance cleaners, urinary leg bags, and extension drainage tubings, which were not prescribed by a doctor and were never provided to Medicare beneficiaries.
- Medicare provided Hernandez's company, Complete Medical Center, Inc., based in Miami, Florida, with approximately $1.4 million in reimbursement for these false claims.
- Investigators believe that Hernandez left the United States after a warrant was issued for his arrest. A co-conspirator in the case, Alejandro Rodriguez, who was the original owner of Complete Medical Center, previously was arrested and pled guilty to charges of health care fraud. He was sentenced in February 2010 to 3 years and 5 months of incarceration and ordered to pay $1.5 million in restitution.
- On February 6, 2014, Peter Pedro Egede was sentenced to 7 years and 3 months in jail and ordered to pay $1.6 million in restitution after pleading guilty to a charge of health care fraud.
- In June 2006, Egede was indicted on charges of conspiracy to commit health care fraud and health care fraud. Egede admitted that he received approximately $1.7 million in reimbursement after falsely billing Medicare and Medicaid for power wheelchairs and other durable medical equipment (DME) that he did not provide and that were not medically necessary.
- Egede owned and controlled Houston Medical Clinic and Medical Supplies in Houston, Texas. According to court records, Egede and others under his employment located Medicare and Medicaid beneficiaries in Texas, Oklahoma, Arkansas, Louisiana, and Mississippi in order to obtain their names and Medicare and Medicaid identification numbers.
- Egede directed recruiters to notify beneficiaries that Medicare was "giving away motorized wheelchairs" and scooters, and Egede created false Certificates of Medical Necessity for the beneficiaries. Egede then submitted approximately $5 million in false claims to Medicare and Medicaid using the medical identification numbers of physicians whom he knew had not examined the beneficiaries. He then delivered less expensive scooters instead of the motorized wheelchairs that he falsely billed for.
- During the investigation, several Houston area physicians complained that their signatures and prescription pads had been compromised and were fraudulently forged for prescriptions for power wheelchairs. Beneficiaries also complained that they were billed for power wheelchairs but received either scooters or nothing at all.
- Egede fled the United States after a warrant was issued for his arrest in 2006. On November 1, 2012, he was arrested in Houston while attempting to re-enter the United States.
- On October 23, 2013, Most Wanted Fugitive Achor Hawkins Uluocha was arrested at George Bush Intercontinental Airport in Houston, Texas. Uluocha fled the country after a warrant was issued for his arrest, and was believed to be residing in Nigeria.
- Uluocha was indicted in September 2007 on a charge of aggregate theft (thefts over an extended period of time) by a government contractor.
- Uluchoa and his wife Bibian Chikere Uluocha co-owned Silver Hawk Healthcare Systems, Inc., a company that purportedly provided durable medical equipment (DME) to Medicare and Medicaid beneficiaries. Uluchoa and his co-conspirators allegedly billed Medicare and Medicaid for power wheelchairs and accessories, but provided beneficiaries with less expensive scooters. They were also suspected of forging doctors' signatures on certificates of medical necessity and paying recruiters and doctors for prescriptions for motorized wheelchairs.
- Uluocha and his co-conspirators received over $1.8 million in reimbursement from Medicare and Medicaid based on these fraudulent billings.
- Bibian previously pled guilty to the charge of aggregate theft by a government contractor and was sentenced to 5 years of probation and ordered to pay $70,000 in restitution.
- On December 20, 2013, Carmen Gonzalez was sentenced to 9 years in prison and ordered to pay more than $8.2 million in joint and several restitution. She was convicted at trial on charges of conspiracy to defraud the U.S., to cause the submission of false claims, and to pay health care kickbacks and conspiracy to commit health care fraud.
- Gonzalez had been arrested on September 3, 2013, by FBI agents in Cape Coral, Florida, and had been indicted in 2008 on charges of conspiracy to defraud the United States, to cause the submission of false claims, and to pay health care kickbacks; conspiracy to commit health care fraud; and criminal forfeiture. In Gonzalez's health care kickback scheme, more than $11 million in false claims was submitted to Medicare.
- According to the indictment, Saint Jude Rehab Center, Inc., was a purported medical clinic based in Miami, Florida. The owners of the medical clinic allegedly hired medical billers to make it appear that Saint Jude was a legitimate HIV infusion clinic providing bona fide therapy. However, they instead withdrew cash from Saint Jude's bank account in order to pay cash kickbacks to HIV patients who were Medicare beneficiaries.
- Gonzalez was a nurse at Saint Jude who, along with co-conspirators, paid HIV patients who were Medicare beneficiaries between $100 and $150 in cash kickbacks to sign patient logs at Saint Jude stating that they received treatments at the clinic. Saint Jude then used the beneficiary information to order unnecessary tests, sign medical analysis and diagnosis forms, and authorize treatments to make it appear that legitimate medical services were being provided.
- Saint Jude then billed Medicare for the costs of infusion, injection, and other treatments that were not medically necessary or were not provided. Medicare provided approximately $8 million in reimbursement for these false claims.
- Gonzalez is a cousin of the "Benitez Brothers," who owned and directed a string of HIV infusion medical clinics in the Miami area. Carlos, Luis, and Jose Benitez received approximately $110 million from Medicare in reimbursement for medical care that was unnecessary or never provided.
- On February 12, 2014, Francisco Chavez was sentenced to 5 years and 10 months in jail and ordered to pay $1.7 million in restitution after pleading guilty to health care fraud.
- On August 30, 2013, Chavez arrived at Atlanta International Airport under the custody of U.S. Marshals Service and then transferred to Miami. Chavez previously fled the United States, but was arrested on narcotics charges at the Barajas Airport in Spain. U.S. authorities worked with the Spanish Government to have him extradited to the United States to face health care charges stemming from his indictment.
- In February 2011, Chavez was indicted on charges of Health Care Fraud, Aggravated Identity Theft, and Criminal Forfeiture. Chavez is believed to have submitted more than $11 million in claims to Medicare for durable medical equipment that was never provided to Medicare beneficiaries.
- Chavez was the president and registered agent of World Class Medical Services, Corporation, a durable medical equipment company based in Miami, Florida, that sold supplies such as pressure support ventilators, standard motorized wheelchairs, and enteral formula. According to court documents, Chavez fraudulently obtained and used medical doctors' Unique Physician Identification Numbers to bill Medicare for durable medical equipment that was never provided.
- Investigators believe that from March through August 2006, World Class submitted more than $11 million in claims to Medicare for durable medical equipment supplies. As a result, World Class was paid approximately $1.7 million by Medicare. However, beneficiaries complained that they never received any of the items billed to Medicare by World Class.
- On November 6, 2014, Won Suk Lee was sentenced to 1 year and 5 months in jail, time served, and pay $100,000 in restitution after pleading guilty to health care fraud charges. Lee was arrested at Los Angeles International Airport June 1, 2013 after arriving on a flight from South Korea.
- In July 2012, Won Suk Lee was indicted on charges of health care fraud, aiding and abetting, and causing an act to be done. According to the indictment, Lee and his co-conspirators are responsible for approximately $2.1 million in false claims submitted to Medicare.
- Lee owned and operated Won Suk Lee Acupuncture and Herb, Inc. (aka Huntington Park Acupuncture Clinic and Variety Choice, Inc.), two clinics located in Huntington Park, a suburb of Los Angeles. Lee, an acupuncturist, and his staff allegedly provided acupuncture and massage services to Medicare patients from August 2009 through February 2011. However, these services were not covered by Medicare.
- Investigators believe that Lee provided Medicare beneficiaries' health identification cards and other personal and medical information to California Neuro-Rehabilitation Institute, Inc. (CNR), a clinic enrolled as a Medicare provider for physical therapy services.
- CNR then allegedly submitted false claims to Medicare for Medicare-covered services, such as physical therapy, even though the beneficiaries did not receive any services from CNR. Lee's co-conspirators created patient files for the beneficiaries that included false documentation for covered services allegedly provided at CNR to support the fraudulent Medicare claims. CNR received approximately $1.2 million from Medicare for these fraudulent claims.
- On February 20, 2013, Orisbel Espinosa Hernandez was arrested at Miami International Airport after arriving on a flight from Cuba. He was sentenced on September 25, 2013, to 2 years and 6 months of incarceration and ordered to pay $1.3 million in restitution.
- In July 2009, Hernandez was indicted on charges of health care fraud, mail fraud, aggravated identity theft, and false statements related to health care matters. Investigators believe that Hernandez caused his two companies to submit approximately $2.5 million in false claims to Medicare.
- Hernandez acquired the durable medical equipment company Active Medical Solutions (AMS) and the outpatient rehabilitation facility Total Care Therapy Specialists (Total Care), based outside of Miami and Jacksonville, respectively. According to the indictment, Hernandez obtained the Medicare numbers of beneficiaries as well as the names and Medicare provider numbers and names of physicians in order to submit fraudulent claims to Medicare.
- Between November 2005 and September 2008, the average monthly claims AMS submitted to Medicare was approximately $4,871. After AMS was acquired by Hernandez and between October 2008 and December 2008, AMS submitted $1.5 million in false claims to Medicare for reimbursement. After Total Care was acquired by Hernandez, the facility billed Medicare for approximately $1 million for therapy services that were either never performed or were not necessary.
- In September 2012, Jorge Reyes was sentenced to 10 years of incarceration and ordered to pay $2.8 million in restitution, joint and several.
- On February 14, 2013, Jorge Reyes was captured in Ottawa, Canada. Reyes was indicted in June 2009 on charges of conspiracy to commit money laundering, money laundering, and forfeiture.
- Investigators believe that Reyes was involved in a health care fraud scheme involving Vazquez Pharmacy & Discount Corporation, a Miami-based company that purportedly provided durable medical equipment (DME) and other health care items to Medicare beneficiaries. Vazquez Pharmacy was owned by Benito Rodriguez.
- According to court documents, Rodriguez caused Vazquez Pharmacy to submit more than $9.5 million in false and fraudulent claims to Medicare for DME-related items that were either not prescribed or not provided as claimed. Medicare reimbursed Vazquez Pharmacy more than $3.2 million, which was then funneled to shell corporations. Investigators believe that Reyes formed two of these shell corporations, RYR Service Corporation and V.E.P. Corporation, and that these corporations also received funds from other pharmacies allegedly engaged in Medicare fraud.
- In August 2011, Rodriguez was sentenced to 3 years and 2 months of imprisonment and ordered to pay $3.3 million in restitution.
- Reyes is being detained by Ottawa police. U.S. authorities are working with the Canadian Government to have him extradited.
- On January 2, 2013, an OIG Most Wanted Fugitive, Leonard Nwafor, was captured in Toronto, Canada.
- Through his durable medical equipment (DME) company, Pacific City Medical Equipment, Nwafor and his co-conspirators billed Medicare for $1.1 million and collected $525,000 in fraudulent claims for DME such as motorized wheelchairs, scooters, and hospital beds for beneficiaries, according to a Federal indictment.
- Based in the Los Angeles area, Nwafor used physicians' unique provider identification numbers to bill Medicare for the DME, even though those doctors did not examine Nwafor's clients. OIG investigated Nwafor as part of the Medicare Fraud Strike Force, which was created to identify and prosecute fraudulent Medicare Fraud companies and laboratories in the greater Los Angeles area.
- In the fall of 2008, a jury convicted Nwafor of conspiracy and health care fraud. He was to be sentenced in January 2009, but failed to show up in court. In March 2010, he was sentenced in absentia to 9 years in Federal prison and ordered to pay back more than $525,000 to Medicare.
- On May 2, 2013, Nwafor was taken into U.S. custody and is currently being detained while awaiting his criminal prosecution.
- On April 26,2013, Elisabet Martinez was sentenced to 2 years and 3 months in prison and ordered to pay $2.4 million in restitution after pleading guilty to charges of conspiracy to commit health care fraud.
- Elisabet Martinez and her husband, OIG Most Wanted Fugitive Lazaro Raul Betancourt, were arrested on December 6, 2012, after they arrived at Miami International Airport.
- In June 2012, Elisabet Martinez was indicted on charges of health care fraud and conspiracy to commit health care fraud. Investigators believe that through her company, Martinez submitted false and fraudulent claims to Medicare for prescription drugs that were medically unnecessary, were not prescribed by a doctor, or were not provided to Medicare beneficiaries.
- Martinez was the manager and registered agent of Your Neighbor Pharmacy LLC, based in Miami-Dade County, Florida. Martinez and her co-conspirators allegedly paid Medicare patients for allowing them to use their personal information for the purpose of creating false and fraudulent prescriptions. Martinez and her co-conspirators then caused Your Neighbor Pharmacy to submit claims to Medicare that falsely and fraudulently represented that various health care benefits, primarily prescription drugs, were medically necessary, were prescribed by a doctor, and had been provided to Medicare patients.
- Your Neighbor Pharmacy was paid approximately $3.8 million by Medicare for these claims. Martinez allegedly used the proceeds from these claims for her own use, for the use of others, and for furthering the fraud.
- Lazaro Raul Betancourt and his wife, OIG Most Wanted Fugitive Elisabet Martinez, were arrested on December 6, 2012, after they arrived at Miami International Airport. Betancourt and Martinez are in custody and are awaiting criminal prosecution.
- In June 2012, Betancourt was indicted on charges of health care fraud, kickbacks, and conspiracy to commit health care fraud.
- Betancourt was an employee of Universal Scripts, Inc. (Universal), a Miami-based pharmacy.
- Betancourt and his co-conspirators allegedly defrauded the Medicare system by paying kickbacks and bribes for prescriptions that were used to submit fraudulent claims to Medicare.
- Universal was paid approximately $7 million from Medicare for medical items and services allegedly provided by Universal.
- On April 15, 2013, Betancourt pleaded guilty to charges of conspiracy to commit health care fraud. Betancourt was sentenced to 3 years and 10 months of incarceration and ordered to pay $4.4 million in restitution, joint and several.
- On September 3, 2013, Juan Manuel Heredia was sentenced to 2 years and 4 months of imprisonment and ordered to pay more than $1.2 million in restitution. Heredia previously plead guilty to charges of health care fraud. Heredia was arrested on December 4, 2012, after he arrived at Miami International Airport.
- Heredia was the owner and operator of San Diego Medical & Rehab Center, Inc. (San Diego Medical), a Miami-based medical clinic.
- Heredia is listed as the officer and director of San Diego Medical. San Diego Medical received a Medicare provider number in March 2005; however, no claims were submitted until January 2007.
- San Diego Medical submitted approximately $4.9 million in Medicare claims from January 2007 through March 2007. San Diego Medical was paid approximately $2.2 million during that time.
- According to investigators, San Diego Medical billed for services that were never prescribed by a physician or received by Medicare patients.
- Investigators believe that Heredia fled the United States in 2009.
- In July 2009, Juan Manuel Heredia was indicted on charges of health care fraud, false statements related to health care matters, and aggravated identity theft.
CAPTURED: Keilan Maria Fife
- On April 4, 2013, Keilan Maria Fife was sentenced to two-and-a-half years of incarceration and ordered to pay $845,000 in restitution after pleading guilty to charges of health care fraud.
- Fife was arrested along with her husband, captured Most Wanted fugitive Carlos Rodriguez, on November 27, 2012, after they arrived at Miami International Airport.
- Fife was indicted on charges of health care fraud in June 2012.
- Fife was the owner and operator of Millennium Rx, Inc. (Millennium), a Miami based pharmacy. She is listed as the sole officer, director and registered agent of Millennium.
- Fife, through Millennium, allegedly submitted prescriptions to Medicare that were never provided to Medicare patients. The patients were paid kickbacks to use their Medicare numbers.
- Millennium was paid approximately $1.3 million from Medicare.
- Fife used the monies she received from these fraudulent claims for her own personal use and to further the health care fraud.
CAPTURED: Carlos Rodriguez
- Carlos Rodriguez was arrested along with his wife, captured Most Wanted fugitive Keilan Maria Fife, November 27, 2012, after arriving at Miami International Airport. They are currently in custody and awaiting criminal prosecution.
- In June 2012, Rodriguez was indicted on charges of health care fraud, kickbacks, and conspiracy to commit health care fraud.
- Rodriguez was the owner and operator of Universal Scripts, Inc. (Universal,) a Miami based pharmacy. He is listed as the President of Universal.
- Rodriguez and his co-conspirators allegedly defrauded the Medicare system by paying kickbacks and bribes for prescriptions that were used to submit fraudulent claims to Medicare.
- Universal was paid approximately $7 million from Medicare for medical items and services allegedly provided by Universal.
- On April 12, 2013, Rodriguez pleaded guilty to charges of conspiracy to commit health care fraud. Rodriquez was sentenced to 4 years and 9 months of incarceration and ordered to pay $4.4 million in restitution, joint and several.
CAPTURED: Madelaine Schotoborgh-Nunez
- On May 6, 2013, Madelaine Schotborgh Nunez was sentenced to 2 years and 4 months of incarceration and ordered to pay $346,155 in restitution, joint and several, after pleading guilty to charges of conspiracy to commit health care fraud.
- On November 28, 2012, Madelaine Schotoborgh-Nunez was arrested in Miami, Florida. Agents discovered through a records check that she recently obtained a new drivers license with a new address in Miami, Florida. After verifying that she was living at the new address, agents arrested Nunez at her home.
- In September 2012, Nunez and her co-conspirators were indicted on charges of conspiracy to commit health care fraud, and health care fraud.
- Nunez was the president, director, and registered agent for Aurora Healthcare Inc. and Best Rehabilitation Center, Inc. Both companies are based in Miami, Florida.
- Nunez and her co-conspirators submitted approximately $42 million in fraudulent physical therapy and occupational therapy items and services to Medicare. They were paid approximately $18 million by Medicare for services that were never prescribed by a doctor or provided to Medicare patients.
CAPTURED: Bamidele Tola Abdulrahoof
- Bamidele Tola Abdulrahoof was arrested on September 8, 2012, after he arrived in San Ysidro, California, from Mexico. Abdulrahoof was scheduled to be sentenced in August 2013 but passed away prior to sentencing.
- In August 2009, Abdulrahoof was indicted on charges of conspiracy to commit health care fraud and subscribing to a false income tax return.
- Abdulrahoof was the owner and operator of Warz Medical Supply (Warz) located in Lawndale, California, a suburb of Los Angeles.
- Investigators believe that Abdulrahoof, on behalf of Warz, submitted approximately $7.3 million in false and fraudulent claims to Medicare for durable medical equipment that were not medically necessary, were not prescribed by a licensed provider, and were never provided. Warz was paid approximately $2.6 million by Medicare.
- Investigators believe that Abdulrahoof obtained patients' Medicare information from co-conspirators. The patients were promised free durable medical equipment for their Medicare information.
CAPTURED:
Xiomara Rodriguez, Orlando Mena, and Akim Mena
- After Federal arrest warrants were issued for Orlando Mena, Xiomara Rodriguez, and their son Akim Mena, the family members fled the United States to Cuba and later to Ecuador. Fugitives Rodriguez and Akim Mena were arrested on August 24, 2012, and Orlando Mena was arrested on September 5, 2012. All three were arrested after arriving in Miami International Airport from Ecuador.
- Rodriguez was sentenced on October 1, 2013 to 7 years in prison. Orlando Mena was sentenced November 19, 2013 to 10 years in prison. Akim Mena was sentenced on November 20, 2013 to 3-plus years in prison. Their joint and several restitution is $1,479,980.96.
- In September 2011, the three defendants were indicted on charges of conspiracy to commit health care fraud, health care fraud, conspiracy to distribute controlled substances, and criminal forfeiture. Investigators believe that the defendants billed Medicare for more than $2.28 million for office visits and tests that were medically unnecessary.
- According to court documents, Orlando Mena controlled and directed operations at two Detroit-area health care provider companies: World Health Care Medical Center, LLC (WHC), and Wyoming Medical Center, LLC (WMC). The three defendants, along with their co-conspirators, allegedly offered and paid kickbacks and bribes, including cash and prescriptions for Oxycontin, to Medicare beneficiaries in exchange for visiting their businesses and undergoing medically unnecessary tests, including nerve conduction tests. The conspirators then submitted false and fraudulent claims to Medicare for the medically unnecessary office visits and tests. Between August 2008 and June 2010, the defendants also caused the billing of more than 300,000 prescriptions for Oxycontin.
- Investigators believe that Orlando Mena recruited Medicare beneficiaries, Akim Mena assisted in the management and payment of beneficiary recruiters, and Rodriguez caused the submission of fraudulent claims to Medicare. The three defendants were also involved in transferring and disbursing Medicare funds from the WHC and WMC corporate accounts to themselves and others. Orlando Mena and Xiomara Rodriguez are the divorced parents of Akim Mena.
CAPTURED: Ordiel Gonzalez
- Ordiel Gonzalez was arrested on September 11, 2012, after he arrived at Fort Lauderdale International Airport from Panama City.
- On March 19, 2013, Gonzalez was sentenced to 2 years and 6 months of incarceration and ordered to pay more than $1.2 million in restitution, joint and several, pursuant to his guilty plea to conspiracy to commit health care fraud.
- In January 2012, Gonzalez was indicted on charges of conspiracy to commit health care fraud, health care fraud, and forfeiture. Investigators believe that Gonzalez and his co-conspirators submitted approximately $1.2 million in false and fraudulent claims to Medicare for home health services that were not medically necessary, not prescribed by a licensed provider, and were never provided.
- According to court documents, Gonzalez and his co-conspirators allegedly obtained the names and personally identifiable information (PII) of physicians and Medicare beneficiaries. They then opened G&A; Home Health Services Corp. in Miami, Florida, and used the PII to submit claims to Medicare for home health services that were never provided or rendered.
CAPTURED: Atalier Moncho Avila
- On December 6, 2012, Atalier Moncho Avila was sentenced to 2 years in prison and ordered to pay $894,959 in restitution after pleading guilty to health care fraud. Moncho Avila was arrested at Miami International Airport July 28, 2012 after arriving from Havana, Cuba.
- In March 2009, Moncho Avila was indicted on charges of health care fraud. Investigators believe that he billed Medicare more than $1.5 million for the cost of durable medical equipment (DME) items and services that were not prescribed by doctors or provided as claimed.
- Beginning around April 2008, Moncho Avila controlled and operated Southernmost Medical Supply, Inc. (Southernmost), a Florida-based company that purportedly provided DME equipment to Medicare beneficiaries. Moncho Avila was also listed as the sole signatory authority for Southernmost's corporate bank account.
- According to the indictment, Moncho Avila allegedly submitted, or caused the submission of, numerous false and fraudulent claims to Medicare on behalf of Southernmost, seeking reimbursement for DME items that either were not prescribed or were not provided as claimed. As a result of these submissions, Medicare deposited nearly $900,000 in reimbursements into Southernmost's corporate bank account. Moncho Avila then allegedly transferred and disbursed funds from Southernmost's corporate bank account to himself and others.
CAPTURED: Garik Khachatryan aka Garik Ryan
- On January 10, 2013, Garik Ryan was sentenced to 2 years and 2 months of incarceration.
- On June 26, 2002, Garik Khachatryan aka Garik Ryan was arrested at the Phoenix Airport by U.S. Immigration and Customs Enforcement agents, who turned him over to the Phoenix Police Department.
- In October 2008, an Arizona State arrest warrant was issued for Garik Khachatryan aka Garik Ryan on charges of fraud schemes and artifices and aggravated identity theft. Investigators believe that Khachatryan fraudulently billed and received money from Medicare for durable medical equipment items that were never supplied. According to Department of Homeland Security records, Khachatryan departed Los Angeles International airport to London on June 28, 2008.
- Khachatryan is listed as sole owner of Shirvan Inc., a durable medical equipment company operating in Phoenix, Arizona. Further, bank records show that "Garik Ryan" is the sole owner of the business bank account and is the only account signatory.
- From approximately April 2008 to approximately September 2008, Shirvan Inc. billed Medicare for over $1.9 million and was paid over $950,000. Shirvan Inc. billed Medicare mainly for orthotic supplies.
- More than half of the beneficiaries that Shirvan Inc. billed for were on the over-utilized patient list.
CAPTURED: Enrique Gonzalez
- Enrique Gonzalez Figueredo was extradited to the United States from Peru July 25 by the United States Marshals Service.
- In May 2008, Enrique Gonzalez (aka Enrique Gonzalez Figueredo) and co-conspirator Ronald Harris were indicted on charges of conspiracy to defraud the United States, to cause the submission of false claims, and to pay health care kickbacks; conspiracy to commit health care fraud; submission of false claims; money laundering; money laundering conspiracy; and false statements. Investigators believe that Gonzalez and Harris billed Medicare for over $26 million for medical services that were not provided or were not necessary.
- Also involved in the conspiracy but charged separately were OIG Most Wanted Fugitives Carlos, Luis, and Jose Benitez. The Benitez brothers allegedly owned approximately 11 medical clinics, including Physicians Med-Care and Physicians Health Med-Care. They were indicted in May 2008 for what investigators believe was a $100 million Medicare fraud scheme. Arrest warrants were issued for all three brothers, who remain at large.
- Gonzalez was the director of Physicians Med-Care and Physicians Health Med-Care, two Florida-based medical clinics that allegedly provided infusion therapy for HIV patients. Harris was a Miami physician who worked for the clinics as the medical director and whose identifying information was allegedly used to bill Medicare for services.
- According to the indictment, Gonzalez provided cash to his co-conspirators for the purpose of paying kickbacks to Medicare beneficiaries. In return, the beneficiaries signed documents stating that they received treatments at the clinics, even though the treatments were not provided or were not necessary. The clinics then billed Medicare for these treatments. Investigators believe that after receiving payments from Medicare, Gonzalez and his co-conspirators transferred approximately $3.4 million to sham management, marketing, and investment companies owned and operated by their co-conspirators.
- Gonzalez is also charged with making false statements after allegedly lying to Federal agents when interviewed during the investigation. Gonzalez was recently detained in Peru. In November 2008, Harris was sentenced to 84 months in prison and ordered to pay $9.8 million in restitution.
- Other conspirators in the scheme included: Thomas McKenzie, a physician's assistant who worked with the Benitez brothers at the clinics and who was sentenced in December 2008 to 14 years in prison and ordered to pay $84 million in restitution; Ana Alvarez-Jacinto, a physician who worked with the Benitez brothers at one of their clinics and who was sentenced in December 2008 to 30 years in prison; Sandra Mateos, a nurse (and ex-wife of Luis Benitez) who worked with the Benitez brothers at one of their clinics and who was sentenced to 7 years in prison; and Carmen Gonzalez, a nurse who was employed by the Benitez brothers and who has a bench warrant out for her arrest and remains a fugitive.
- On February 10, 2013, Gonzalez was sentenced to 5 years and 10 months of incarceration and ordered to pay more than $17.5 million in restitution, joint and several.
CAPTURED: Godwin Chiedo Nzeocha
- On May 22, 2013, captured Most Wanted Fugitive Godwin Chiedo Nzeocha was sentenced to 9 years and 1 month of incarceration and ordered to pay more than $26 million in restitution, joint and several, after pleading guilty to charges of conspiracy to commit health care fraud and money laundering.
- Nzeocha entered a plea to one count of conspiracy to commit health care fraud and one count of money laundering on October 19, 2012,. As part of the plea, he has also agreed to forfeit $1,098,320 to the United States. Press Release
- On June 27, 2012, the FBI extradited Nzeocha from Nigeria back into the United States. He was arrested upon his arrival into Houston, Texas.
- Nzeocha was indicted on charges of health care fraud, conspiracy, mail fraud, and money laundering in March 2010. Investigators believe that Nzeocha and his co-conspirators received more than $27 million from Medicare after submitting false or fraudulent claims for health care services that were never provided.
- According to the indictment, Nzeocha was in charge of the Houston-based clinic City Nursing, which purportedly provided physical therapy services. Nzeocha allegedly signed patient documents claiming that City Nursing provided physical therapy services to Medicare beneficiaries, even though the services were not provided. Nzeocha and his co-conspirators also allegedly paid cash to recruiters and marketers who brought Medicare patients to City Nursing and paid these patients for signing documents for physical therapy services not rendered.
- From approximately January 2007 until April 2009, City Nursing billed Medicare approximately $42 million in false and fraudulent claims, and the clinic received approximately $27 million in reimbursements.
- Co-conspirators Umawa Oke Imo, Christina Joy Clardy, and Joann White have either pleaded guilty to or been found guilty of charges related to the health care fraud scheme. They have been sentenced to a combined 42 years and 4 months of incarceration and ordered to pay more than $30 million in restitution, joint and several.
- Authorities believe that Nzeocha fled to Nigeria in June 2009. He was arrested by Nigerian authorities in June 2011.
CAPTURED: Irina Shelikhova
- On November 12, 2013, Irina Shelikhova was sentenced to 15 years in prison and ordered to pay $50.9 million in restitution, joint and several. Shelikhova previous plead guilty to conspiracy to commit money laundering. After serving her sentence, Shelikhova will face deportation from the United States.
- In October 2011, an indictment was handed down charging Shelikhova and co-conspirators with conspiracy to commit health care fraud, conspiracy to pay health care kickbacks, health care fraud, money laundering, and money laundering conspiracy. Investigators believe that Shelikhova was the primary player in a scheme to defraud Medicare of more than $70 million.
- According to the indictment, Shelikhova was an authorized signatory on the bank accounts of a conglomerate of medical clinics in the New York City area. Shelikhova managed the daily operations of the medical clinics and worked with co-conspirators to direct individuals who conducted financial transactions for the medical clinics.
- From approximately March 2005 until July 2010, Shelikhova and her co-conspirators allegedly paid cash kickbacks to Medicare beneficiaries to induce them to receive unnecessary physicians' services, physical therapy, and diagnostic tests at the medical clinics. The co-conspirators created fraudulent medical records for these beneficiaries and then filed false claims with Medicare for these medical services, which either were never provided or were not medically necessary.
- Shelikhova fled the United States in July 2010 and was suspected to be residing in Ukraine. On June 14, 2012, she was arrested by the Federal Bureau of Investigation as she attempted to enter the United States at JFK Airport in New York.
CAPTURED: Miguel Cabello
- Miguel Cabello was arrested by U.S. Customs and Border Protection on June 7, 2012, as he attempted to enter the United States through Champlain, New York. HHS agents took custody of Cabello there and transported him to his initial court appearance, where he waived identity and custody hearings. He was then transferred to the custody of U.S. Marshals for transport back to the Southern District of Florida.
- In July 2008, Cabello was indicted on charges of health care fraud. According to the indictment, Cabello submitted approximately $2.1 million in fraudulent Medicare claims on behalf of south-Florida-based OB Pharmacy, Inc., and he received approximately $1.3 million in Medicare payments. Before Cabello's involvement, OB Pharmacy, a durable medical equipment company that specialized in aerosol medications, submitted $151,572 in Medicare claims and was paid approximately $58,653.
- Around April 2008, Cabello became vice-president of OB Pharmacy. Investigators have concluded that OB Pharmacy submitted claims to Medicare for services that were not rendered, including approximately 10 claims for deceased beneficiaries. Investigators interviewed physicians who stated that they did not know the OB Pharmacy patients in question nor did they prescribe the medication purportedly provided to them.
- In July 2008, Cabello fled the United States to Cuba.
- On December 26, 2012, Miguel Cabello was sentenced to 2 years and 3 months of incarceration and ordered to pay $483,447 in restitution, pursuant to his guilty plea on charges of health care fraud.
CAPTURED: Jose Diego Calero
- On May 25, 2012, Jose Calero was sentenced to 2 years in prison and ordered to pay $867,539 in restitution after pleading guilty to charges of health care fraud.
- Jose Diego Calero, who is from Colombia, was captured in March 2012 by U.S. Border Patrol agents in Falfurrias, Texas, for alleged illegal entry into the United States.
- In August 2009, Calero was indicted on charges of health care fraud, money laundering, and forfeiture. Calero allegedly submitted more than $4.8 million in claims to Medicare for physical and occupational therapy services that either were not prescribed by doctors or were not provided as claimed.
- Calero was the Director of Premier Quality Physical Therapy, Inc., (Premier), a Florida-based company that purportedly provided physical therapy and occupational therapy services to Medicare beneficiaries. Investigators believe that from approximately September 2008 to February 2009, Calero caused Premier to submit more than $4.8 million in false claims to Medicare, for which he received more than $2.7 million in payments.
- The funds received from Medicare were allegedly deposited into the Premier corporate account and then transferred to the personal accounts of Calero and others.
- This case was investigated as part of the Medicare Fraud Strike Force, a coordinated effort by Federal, State, and local law enforcement entities aimed at quickly identifying and prosecuting those alleged to have committed health care fraud.
CAPTURED: Rafael Rodriguez Gonzalez
- Rafael Rodriguez Gonzalez was arrested in April 2012 at Miami International Airport, after arriving from Cuba.
- On September 15, 2012, Gonzalez was sentenced to 2 years and 3 months of incarceration and ordered to pay $247,707 in restitution.
- In April 2011, Gonzalez was indicted on charges of health care fraud and forfeiture. Investigators believe that Gonzalez, through his durable medical equipment (DME) company, submitted more than $1.7 million in Medicare claims for medical supplies that were either not provided to Medicare beneficiaries or not medically necessary.
- According to the indictment, Gonzalez operated Venus Medical Supply, Inc., a DME company based in Hialeah, Florida. From approximately November 2008 until March 2009, Gonzalez allegedly caused Venus Medical to submit more than $1.7 million in Medicare claims for wound care supplies, urinary catheter supplies, and other DME purportedly provided to Medicare beneficiaries, to which Medicare provided $247,844 in payments.
- However, investigators interviewed the top two referring physicians whose names were on the claims submitted by Venus Medical and learned that the physicians did not prescribe any of the services in question nor were they familiar with any of the beneficiaries listed on the claims. In addition, investigators determined that more than 20 beneficiaries filed complaints with Medicare alleging that they did not receive services that were billed by Venus Medical.
CAPTURED: Pedro E. Rivera
- On July 25, 2012, Pedro Rivera was sentenced to 2 years and 6 months in prison and ordered to pay $159,855 in restitution after pleading guilty to health care fraud charges
- Pedro E. Rivera was captured in March 2012 by U.S. Border Patrol Agents in Falfurrias, Texas, for alleged illegal entry into the United States.
- In August 2009, a Federal indictment was issued for Rivera, charging him with health care fraud and forfeiture. Investigators believe that Rivera caused his durable medical equipment (DME) company to submit more than $1.5 million in Medicare claims for DME that was neither prescribed by doctors nor delivered to patients.
- According to the indictment, in January 2009, Rivera became the President of A&M; Medical Equipment Services, Inc., in Miami, Florida. From January through April 2009, A&M; Medical allegedly submitted more than $1.5 million in false claims to Medicare for wound care supplies, urinary catheter supplies, and other DME purportedly provided to Medicare beneficiaries. However, these supplies were neither prescribed by doctors nor delivered to Medicare patients. Investigators believe that A&M; Medical submitted claims for at least six deceased beneficiaries during that timeframe.
- According to the indictment, A&M; received $159,855 in payments from Medicare, and Rivera allegedly transferred these funds from the A&M; Medical checking account to himself and others.
- This case was investigated as part of the Medicare Fraud Strike Force, a coordinated effort by Federal, State, and local law enforcement entities aimed at quickly identifying and prosecuting those alleged to have committed health care fraud.
CAPTURED: Eliezer Salgado
- On September 21, 2012, Eliezer Salgado was sentenced to 6 years in prison and ordered to pay $5.4 million in restitution, joint and several, after pleading guilty to charges of conspiracy to possess with intent to distribute oxycodone and oxymorphone and conspiracy to commit health care fraud.
- Eliezer Salgado, who is originally from Cuba, turned himself into U. S . Customs and Border Patrol at the Brownsville, Texas, port of entry on April 14, 2012.
- In December 2011, Eliezer Salgado was indicted on charges of conspiracy to possess with intent to distribute a controlled substance and conspiracy to commit health care fraud. Investigators believe that Salgado was part of a large health care fraud scheme that netted more than $90 million in false payments from Medicare and Medicaid.
- According to the indictment, Salgado's co-conspirators headed a drug trafficking organization, and operated pain clinics in Miami-Dade and Broward counties in South Florida. These pain clinics employed physicians who fraudulently prescribed oxycodone and oxymorphone for co-conspirator beneficiaries of Medicare and other prescription drug insurance plans. The beneficiaries then presented the fraudulent prescriptions to complicit pharmacies operated by co-conspirators. Once the prescriptions were filled, Medicare and other insurers were billed for the cost of the prescriptions. Pharmacy owners allegedly knew that the drugs were medically unnecessary and that they were then being re-sold by the beneficiaries to the drug trafficking organization. Investigators believe that these pharmacy owners also sold these drugs on the street for profit, often shipping the drugs out of State.
- Salgado and several other co-conspirators allegedly facilitated the drug trafficking and health care fraud by (1) recruiting and paying the corrupt health insurance beneficiaries to visit the pain clinics, (2) possessing and delivering the prescription drugs, and (3) acting as money couriers.
- As of April 2012, 22 defendants, including the owners of the pain clinics and pharmacies, have pleaded guilty to health care fraud-related charges and are awaiting sentencing in June and July 2012.
CAPTURED: Saqib Ali
- On November 14, 2011, Saqib Ali was sentenced in Federal court to 21 months in prison for defrauding the Medicare program of approximately $126,000. Press Release
- Ali was the owner of Medtechnology Inc, a purported clinical laboratory operating in Rutherford, New Jersey. From July to November 1997, Ali caused the submission of approximately $200,000 in false claims to be submitted to Medicare for services that were not performed.
- Ali fled the United States for Pakistan after his arrest in 1998, and he remained a fugitive for over a decade.
- In March 2011, Ali contacted U.S. officials in Pakistan and voluntarily agreed to return to the United States. He was taken into custody on May 30 and pleaded guilty on July 19 to 10 counts of an indictment that charged him with Health Care Fraud.
CAPTURED: Tariq Usman
- In May 2012, Tariq Usman was sentenced to 13 months in prison and 24 months of probation. He was also ordered to pay a $10,000 fine.
- Usman was taken into custody on November 21, 2011, in Chicago. Usman contacted OIG's hotline in late summer 2011 after discovering that he was on the OIG Most Wanted Fugitives list. He told agents that he wanted to return to the United States from Pakistan and surrender.
- Usman was indicted in May 2009 on charges of health care fraud and criminal forfeiture. He fled to Pakistan shortly after being implicated in the scheme.
- From July 2003 through March 2007, Usman and several accomplices allegedly committed health care fraud in the Detroit area by paying Medicare beneficiaries to sign Medicare reimbursement forms and paying doctors and therapists to sign fictitious files for treatment and services that were not provided.
- According to court documents, Usman and his accomplices then fraudulently filed reimbursement forms with Medicare, seeking payment for medical services and treatments that were not provided.
- Investigators believe that Usman and his accomplices submitted approximately $4 million in fraudulent claims to Medicare. Usman and his accomplices also allegedly established several fictitious companies in an effort to conceal the money and assets gained from the scheme.
CAPTURED: Maksim Shelikhov
- On November 22, 2013, Maksim Shelikhov was sentenced to 2-and-a-half-years in prison and ordered to pay $50.9 million in restitution, joint and several, after pleading guilty conspiracy to commit healthcare fraud and conspiracy to commit money laundering. Shelikhov was detained November 14, 2011 by law enforcement in Canada and transported to the United States to face charges.
- In October 2010, Shelikhov and co-conspirators were indicted on charges of conspiracy to commit health care fraud, conspiracy to pay health care kickbacks, and health care fraud for their part in an alleged scheme to defraud the Medicare program of over $71 million.
- Bay Medical Care PC, SVS Wellcare Medical PLLC, and SZS Medical Care PLLC all operated in Brooklyn, New York, and purported to provide physical therapy, nerve conduction tests, vestibular function tests, allergy services, and sleep studies.
- Shelikhov was the signatory of a bank account into which Medicare reimbursement was made for SZS Medical. According to the indictment, Shelikhov and his co-conspirators recruited and paid cash to Medicare beneficiaries for participating in medically unnecessary testing and procedures that were never actually provided. Shelikhov and his co-conspirators allegedly created fraudulent medical records for these beneficiaries and then billed Medicare for false and fraudulent claims.
CAPTURED: Rolando Cueto
- Rolando Cueto was captured on June 30, 2011 at Miami International Airport. Before his arrest, he was residing in Costa Rica using a fraudulent identity.
- In September 2008, an indictment was filed charging Rolando Cueto and Juan Carlos Garcia with one count of conspiracy to commit health care fraud and six counts of health care fraud.
- Cueto was the true owner and operator of E.O. Medical Enterprises, a durable medical equipment company operating in Hialeah, Florida. E.O. Medical submitted over $1.8 million in false claims to Medicare for medical equipment that was neither ordered by a physician nor provided to the beneficiary as claimed.
- Cueto attempted to use a nominee owner to hide his involvement in the scheme. Cueto also recruited individuals to cash checks drawn on E.O. Medical's bank account, who then returned the cash to Cueto.
- On November 10, 2011, Cueto was sentenced to 3 years and 1 month of incarceration and ordered to pay $510,126 in restitution, joint and several.
CAPTURED: Luis Perez Moreira
- Luis Perez Moreira was sentenced on September 15, 2011, to 63 months' incarceration. In September 2010, his co-conspirator Emilio Tain pled guilty to charges of conspiracy to commit health care fraud and was sentenced to 10 months' incarceration.
- Moreira is a subject in two separate criminal investigations involving E & E Medical Services Corporation (d/b/a Elbia's Pharmacy) and Rx Plus Medical Care (Rx Plus), both based in Miami.
- In April 2010, Moreira and co-conspirator Emilio Tain were indicted on charges of health care fraud and conspiracy to commit health care fraud. As operators of Elbia's Pharmacy, Moreira and Tain allegedly submitted or caused Elbia's Pharmacy to submit more than $770,000 in fraudulent billings to Medicare for prescription drugs and other items that were not medically necessary, not prescribed by a doctor, and not provided to Medicare patients.
- Moreira has also been indicted on charges of health care fraud and conspiracy to commit health care fraud for his role in the operation of Rx Plus, a durable medical equipment company.
- According to the September 2010 indictment, Moreira and a co-conspirator controlled and operated Rx Plus. From August 2008 through April 2009, they allegedly submitted more than $2.5 million in fraudulent claims to Medicare, of which Medicare paid approximately $383,000.
- Investigators believe that, in order to avoid detection, Moreira and his co-conspirator recruited a nominee owner (an individual who pretends to be the owner to conceal the actual owner's identity) to use his name on the corporation's paperwork, to open bank accounts, and to sign company checks.
- Moreira was captured on June 7, 2011, at Miami International Airport. Prior to his arrest, Moreira had been living in Cancun, Mexico.
CAPTURED: Clara Guilarte and Caridad Guilarte
- Clara and Caridad Guilarte were sentenced on November 3, 2011 in Miami. Each is to serve 14 years in prison followed by 3 years of supervised release. They were also ordered to pay approximately $6 million in restitution, jointly with co-defendants. Press Release
- Sisters Clara and Caridad Guilarte were captured in Colombia on March 13, 2011. They pleaded guilty in August 2011 to one count of conspiracy to commit health care fraud and one count of conspiracy to commit money laundering.
- Along with previously captured co-conspirator Reynel Betancourt, the Guilartes submitted $9.1 million in false and fraudulent claims to Medicare for services that were medically unnecessary or never provided.
- The Guilartes operated the Dearborn Medical and Rehabilitation Center (DMRC), an infusion therapy clinic in Michigan, where Betancourt was an employee.
- All three fugitives allegedly committed health care fraud, conspiracy, and money laundering. The trio recruited and paid cash and other inducements to Medicare beneficiaries to visit DMRC and sign forms indicating that they received legitimate medical services, including injections and infusions of expensive medications, although the services were never provided.
CAPTURED: Zoya Belov
- On June 30, 2014, Zoya Belov was sentenced to a year-and-a-half in jail and ordered to pay $1.5 million in restitution, joint and several, after pleading guilty to conspiracy to commit health care fraud. Belov, who with co-conspirators allegedly defrauded the Medicare program, was captured on March 23, 2011 at the San Francisco International Airport.
- The purported leader of the conspiracy, Vardges Egiazarian, owned three medical clinics in eastern California (specifically, in Sacramento, Richmond and Carmichael). From February 2006 to August 2008, these clinics allegedly submitted a total of nearly $5.2 million worth of false billings to Medicare, of which Medicare paid approximately $1.5 million. Belov, a medical assistant at the clinics, falsely claimed to have performed medical tests on patients, and requested reimbursements from Medicare, OIG alleges.
- The fraud was purportedly accomplished by recruiting and paying third parties to pretend to be "patients" who wished to receive medical treatment at one of the alleged conspirators' clinics. Normally, patients must pay for a certain portion of their medical expenses, and Medicare may pay the remainder. In this fraud, the individuals pretending to be patients were paid by the conspirators to state that they needed medical treatment when they did not.
- Belov would allegedly perform unnecessary medical tests on the patients, or fraudulently claim to have performed the tests when she had not. Belov and others then submitted the fraudulent claims to Medicare for medical services that were not performed, not performed as billed, or unnecessary, according to OIG.
- In an attempt to conceal the alleged fraud from Medicare representatives, Belov allegedly lied about the whereabouts and activities of the other conspirators.
CAPTURED: Reynel Betancourt
- Reynel Betancourt was sentenced on June 7, 2011, to 77 months in prison and ordered to pay approximately $6 million in restitution, joint and several, after pleading guilty to charges of conspiracy to commit health care fraud and conspiracy to commit money laundering.
- From about March 2006 to March 2007, Betancourt worked at the Dearborn Medical and Rehabilitation Center (DMRC), an infusion therapy clinic in Michigan, which was owned and operated by sisters Clara and Caridad Guilarte.
- Betancourt and his co-conspirators entered into an agreement to pay Medicare beneficiaries to receive treatments at DMRC. The infusion therapy clinic then submitted over $9 million in false and fraudulent claims to Medicare for services that were medically unnecessary or never provided.
- The Guilarte sisters were captured in Colombia on March 13, 2011. The Guilartes were sentenced on November 3, 2011 in Miami. Each is to serve 14 years in prison followed by 3 years of supervised release. They were also ordered to pay approximately $6 million in restitution, jointly with co-defendants.
- On November 30, 2010, authorities captured Betancourt in the Dominican Republic.
CAPTURED: Steven Moos
- On April 19, 2011, in the United States District Court, District of Oregon, Moos pleaded guilty to a single count of the Indictment (Title 18 U.S.C. 1001 and 2 - False Claims and Statements). Moos was sentenced to serve 4 months of home detention, 3 years of probation, and 200 hours of volunteer community service.
- Steven Moos is charged with drug possession, fraudulent internet marketing, and child endangerment.
- Formerly a general practice physician in Oregon, Moos lost his medical license after he repeatedly prescribed numerous prescription drugs over the Internet, despite warnings from the State medical authorities to stop such practices.
- According to the Oregon Board of Medical Examiners, Moos prescribed drugs and refilled prescriptions without physically examining patients or obtaining health record information from them or their primary care providers.
- After his medical license was revoked, Moos allegedly continued to practice medicine and prescribe drugs and made false statements on a Drug Enforcement Administration registration renewal application to conceal the fact that he no longer had a medical license to prescribe drugs, according to the indictment.
- The Federal indictment stated that in the summer of 2002, Moos allegedly ordered misbranded drugs (including human growth hormone) from China. The drugs did not have adequate directions for use or warnings and other required information.