Two Plead Guilty to Money Laundering Conspiracy in $10.5 Million Medicare Fraud Scheme

WASHINGTON—Two men from Miami have pleaded guilty to laundering millions of dollars obtained through a $10.5 million Medicare fraud scheme using shell companies they controlled.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, Acting U.S. Attorney for the Middle District of Florida A. Lee Bentley III, Special Agent in Charge Paul Wysopal of the FBI’s Tampa Field Office, and Special Agent in Charge Christopher B. Dennis of the U.S. Health and Human Services Office of Inspector General (HHS-OIG) region including all of Florida made the announcement.
Rafael Roche, 43, and Alain Remy, 35, pleaded guilty on October 24, 2013, and October 23, 2013, respectively, in the U.S. District Court for the Middle District of Florida to an indictment charging them with conspiracy to commit money laundering involving the proceeds of a health care fraud scheme. Remy is scheduled for sentencing on January 16, 2014; Roche’s sentencing date has yet to be scheduled. They each face a maximum penalty of 20 years in prison.
According to documents filed in the case, Roche, Remy, and others conspired to engage in financial and monetary transactions of health care fraud proceeds from Renew Therapy Center of Port St. Lucie LLC (Renew Therapy), a comprehensive outpatient rehabilitation facility. From November 2007 through August 2009, Renew Therapy submitted approximately $10,549,361 in fraudulent claims for reimbursement to Medicare for therapy services that were not legitimately prescribed and not legitimately provided to Medicare beneficiaries. As a result of those fraudulent claims, Medicare deposited approximately $6,248,056 into a Renew Therapy bank account. The fraud proceeds in that account were subsequently disbursed to various entities, including a combined total of $1,847,222 to Ariguanabo Investment Group Inc. and IRE Diagnostic Center Inc., shell companies that Roche and Remy controlled.
Court records indicate that more than $1.2 million was laundered through Ariguanabo Investment Group between February 5, 2009 and September 22, 2009. The money was subsequently removed from the Ariguanabo Investment Group bank account to various individuals and entities, including to Ibiza Future Planning Inc., a shell company that Remy established and controlled.
More than $600,000 was laundered through IRE Diagnostic Center from August 7, 2008 and January 29, 2009. The money was subsequently removed from the IRE Diagnostic Center bank account to various individuals and entities, including to A&R Medical Services of South Florida Inc., another shell company that Roche and Remy established and controlled.
This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and U.S. Attorney’s Office for the Middle District of Florida. This case is being prosecuted by Trial Attorney Christopher J. Hunter of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: www.stopmedicarefraud.gov.

Owner, Executives, and Physicians at Closed Sacred Heart Hospital Indicted in Alleged Medicare Referral Kickback Conspiracy

CHICAGO―The owner and three other executives of the now-closed Sacred Heart Hospital and four physicians affiliated with the former west side facility were indicted on federal charges alleging that they collectively paid and received hundreds of thousands of dollars in illegal kickbacks in exchange for the referral of hospital patients who were insured by Medicare and Medicaid. Sacred Heart allegedly paid physicians bribes and kickbacks to induce patient referrals and increase the patient census, which, in turn, increased hospital revenue.
Sacred Heart Hospital was a 119-bed acute care facility located at 3240 West Franklin Blvd. in Chicago. The hospital closed and filed for bankruptcy this summer after Medicare payments were suspended in the aftermath of criminal charges that were first filed in April. The indictment charges only conduct involved in the alleged kickback conspiracy while a broader investigation that was outlined in the earlier criminal complaint continues.
The eight defendants were charged in a 17-count indictment that was returned by a federal grand jury late yesterday and announced today by Zachary T. Fardon, United States Attorney for the Northern District of Illinois. Five of the eight defendants were charged and arrested on April 16 this year, while three new defendants were charged in the indictment for the first time. A fifth physician associated with Sacred Heart was indicted separately for illegally prescribing prescription medications. No new arrests occurred in connection with the indictments.
Mr. Fardon announced the charges with Lamont Pugh, III, Special Agent in Charge of the Chicago Region of the U.S. Department of Health and Human Service Office of Inspector General, and Robert J. Shields, Jr., Acting Special Agent in Charge of the Chicago Office of the Federal Bureau of investigation.
The five defendants charged previously in the conspiracy case are: Edward J. Novak, 58, of Park Ridge, Sacred Heart’s owner and chief executive officer; Roy M. Payawal, 64, of Burr Ridge, executive vice president and chief financial officer; and Drs. Percy Conrad May, Jr., 75, of Chicago, Subir Maitra, 73, of Chicago, and Shanin Moshiri, also known as “Shawni Moshiri,” 58, of Chicago. All five of these defendants remain free on various bonds after they were arrested in April.
The three new defendants are: Dr. Rajiv Kandala, 41, of Chicago; Anthony J. Puorro, 57, formerly of Chicago, who was Sacred Heart’s chief operating officer; and Noemi Velgara, 64, of Chicago, who was Sacred Heart’s vice president of geriatric services and was responsible for overseeing the Golden L.I.G.H.T. medical clinics, including managing employees responsible for marketing, and recruiting and transporting patients.
All eight defendants will be ordered to appear for arraignment in U.S. District Court.
Four defendants―Novak, Payawal, Puorro, and Velgara―were each charged with one count of conspiracy to violate the federal healthcare anti-kickback statute by offering and paying kickbacks and bribes, directly and indirectly, from Sacred Heart to Drs. May, Maitra, Moshiri, and Kandala and other physicians to induce them to refer patients to the hospital for services that would be reimbursed by Medicare and Medicaid. Sacred Heart’s chief operating officer before Puorro, identified as “Administrator A,” is named as an unindicted co-conspirator.
In addition, Novak and Payawal were each charged with eight substantive counts of paying kickbacks for patients, while Drs. May, Maitra, Moshiri, and Kandala were charged with two counts each of accepting kickbacks for patient referrals. The indictment also seeks forfeiture of illegal proceeds from Novak, Payawal, and the four physicians, including the unspecified total amount of Medicare and Medicaid reimbursements made on claims submitted on behalf of hospital patients whose referral involved kickbacks and the total amount of kickbacks paid to the four physicians.
According to the indictment, Sacred Heart’s owner, executives, and administrators conspired between 2004 and April 2013 to pay physicians bribes concealed as consulting, employment, and personal services compensation, rent, and instructional stipends in return for referrals of Medicare and Medicaid patients. Although styled as payments for legitimate services, the payments actually contained disguised bribes paid to and for the benefit of Drs. May, Maitra, Moshiri, and Kandala in exchange for patient referrals.
The indictment alleges that Novak, Payawal, Puorro, and Administrator A caused Sacred Heart to pay May hundreds of thousands of dollars in bribes disguised as rent and Moshiri more than $150,000 in bribes disguised as payments for purportedly teaching podiatric surgery residents. Novak, Payawal, and Puorro allegedly caused Sacred Heart to pay Maitra at least $68,000 in bribes disguised as payments for purportedly teaching medical students at the hospital; and Kandala at least $32,000 in bribes disguised as compensation for consulting and instructional services purportedly provided to the hospital and its staff.
Payawal, Puorro, and Velgara allegedly agreed to have Sacred Heart offer to pay bribes to the hospital’s transportation staff to recruit and refer patients to the hospital, and those three defendants, together with Novak, also caused Sacred Heart to pay individuals employed as “marketers” to recruit patients.
As part of the same investigation, a fifth physician associated with Sacred Heart was indicted separately this month for allegedly illegally prescribing hydrocodone or lorazepam to four different patients without having a valid license and registration to prescribe controlled substances. The defendant, Dr. Kenneth S. Nave, 51, of Chicago, who also was arrested and charged last April, allegedly illegally used the Drug Enforcement Administration registration number of another physician when he prescribed the prescription narcotics between October and December 2012. Nave pleaded not guilty at his arraignment this week.
Each count in the eight-defendant Novak indictment carries a maximum penalty of five years in prison and a $250,000 fine and restitution is mandatory. Each count in the Nave indictment carries a maximum penalty of four years in prison and a $250,000 fine. If convicted, the court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
The government is being represented by Assistant U.S. Attorneys Joel Hammerman, Ryan Hedges, and Terra Reynolds.
The public is reminded that an indictment is not evidence of guilt. The defendants are presumed innocent and are entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.
The case falls under the umbrella of the Medicare Fraud Strike Force, which expanded operations to Chicago in February 2011 and is part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Justice Department and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Dozens of defendants have been charged in health care fraud cases since the strike force began operating in Chicago.
To report health care fraud to learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

Man Who Posed as Wellsville Doctor Sentenced for Health Care Fraud

BUFFALO, NY—U.S. Attorney William J. Hochul, Jr. announced today that Fitzgerald Anthony Hudson, 53, formerly of Western New York, who was convicted of health care fraud for lying about his qualifications to practice medicine, was sentenced to 24 months in prison and three years’ supervised release by Chief U.S. District Chief Judge William M. Skretny. The defendant was also ordered to pay restitution in the amount of $227,548.35.
Assistant U.S. Attorney Aaron J. Mango, who handled the case, stated that in August 2008, the defendant submitted an application and was later accepted to work as a doctor in the Emergency Department at Jones Memorial Hospital in Wellsville, New York. In his August application, the defendant stated that (1) he had earned a degree from York University in Ontario, Canada; (2) he had never voluntarily withdrawn or resigned any employment or privileges at any healthcare facility in order to avoid the imposition of disciplinary measures; and (3) he had never been denied or suspended from any health care facility. In fact, the defendant did not have a degree from York; had been suspended from his duties as a resident and dismissed from the residency program due to academic incompetence at the Warren Hospital Family Practice Residency Program in Phillipsburg, New Jersey; and had resigned from the Claxton-Hepburn Medical Center in Ogdensburg, New York, after being told he would be terminated for poor performance.
During the course of this prosecution, the government presented evidence that while employed at Jones Memorial Hospital, Hudson treated a 5-year-old child who subsequently died shortly after being treated by the defendant. That case is now the subject of an ongoing wrongful death civil suit in state court. The government further introduced a New York State Board of Professional Medical Conduct investigation that concluded that the defendant obtained his medical license by fraud and while practicing medicine and engaged in gross negligence and gross incompetence with at least five patients.
“Each and every day, people across this country place their lives and their health—as well as the lives and health of their families—into the hands of those they believe to be trained medical professionals,” said U.S. Attorney Hochul. “Such medical visits are always accompanied by the highest level of trust and hope that the person we are seeing is actually qualified to provide the care for which we are seeking treatment. It is difficult to imagine a more egregious case of health care fraud than this—where a person lies in order to become an emergency room physician, had been twice previously cited for incompetence and poor performance, and in fact was not a legitimate doctor at all. This office will continue to crack down on all types of health care fraud and will vigorously prosecute those who lie about their qualifications to practice medicine.”
As for the defendant’s offense of conviction, the government established that once the defendant illegally obtained his medical staff appointment, Delphi Healthcare, Hudson’s employer, billed and received approximately $227,548.35 from Medicare, BlueCross BlueShield of Western New York, Univera Healthcare, and Independent Health for services rendered by the defendant.
The sentencing is the culmination of an investigation on the part of special agents of the Federal Bureau of Investigation, under the direction of Brian P. Boetig, Special Agent in Charge; special agents of the U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, under the direction of Thomas O'Donnell, Special Agent in Charge; and investigators with the Medicaid Fraud Control Unit of the New York State Attorney General’s Office.

Operators of Michigan Adult Day Care Centers Convicted in $3.2 Million Medicare Fraud Scheme

WASHINGTON—A federal jury in Detroit today convicted the owner and the program coordinator of two Flint, Michigan adult day care centers for their participation in a $3.2 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan; Acting Special Agent in Charge John Robert Shoup of the FBI Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations, Detroit Office made the announcement.
Glenn English, ­53­, was found guilty in U.S. District Court for the Eastern District of Michigan of one count of conspiracy to commit health care fraud and seven counts of health care fraud for directing a psychotherapy fraud scheme through New Century Adult Day Program Services LLC and New Century Adult Day Treatment Inc. (collectively known as New Century).
Richard Hogan, 67, an unlicensed social worker who worked as a program coordinator at New Century, was found guilty of one count of conspiracy to commit health care fraud.
The defendants were charged in a superseding indictment returned December 11, 2012. Another individual charged in the superseding indictment, Donald Berry, awaits trial at a later date.
According to evidence presented at trial, English owned and operated New Century as an adult day care center through which he billed Medicare for individual and group psychotherapy services. As shown at trial, New Century brought in mentally disabled residents of Flint-area adult foster care homes (AFCs), as well as people seeking narcotic drugs, and used their names to bill Medicare for psychotherapy that was not provided. The evidence showed that English and Hogan lured drug seekers to New Century with the promise that they could see a doctor there who would prescribe for them the narcotics they wanted if they signed up for the psychotherapy program. New Century used the signatures and Medicare information of these AFC residents and drug seekers to claim that it was providing them psychotherapy, when in fact it was not.
The evidence also showed that English directed New Century employees to fabricate patient records to give the false impression that psychotherapy was being provided. Social workers and untrained employees wrote fake progress notes for therapy sessions that never occurred. Further, English and New Century employees directed New Century clients to pre-sign sign-in sheets for months at a time, and used these signatures to claim to Medicare they had provided services. On multiple occasions, New Century billed Medicare as if its social workers had provided over 24 hours of care in a single day.
From March 2010 through April 2012, New Century billed approximately $3.2 million and received more than $988,000 from Medicare.
The health care fraud conspiracy count carries a maximum potential penalty of 10 years in prison; each count of health care fraud carries a maximum penalty of 10 years in prison. Sentencing for both defendants is scheduled for February 27, 2014.
The investigation was led by the FBI and HHS-OIG and was brought by the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Father and Son Who Owned/Operated a Physician House Call Company and Billed for Services Not Rendered Convicted on Conspiracy and Health Care Fraud Charges

DALLAS—A federal jury has convicted two local men on conspiracy and health care fraud charges related to their operation of a physician house call company in North Texas, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
On October 4, 2013, following a five-day trial before U.S. District Judge David C. Godbey, Lawrence Dale St. John, 66, and his son, Jeffrey Dale St. John, 41, both of Grand Prairie, Texas, were convicted on conspiracy and health care fraud charges related to their operation of A Medical House Calls, a physician house call company.
Specifically, each defendant was convicted on one count of conspiracy to commit health care fraud and 13 substantive counts of health care fraud. Each count carries a maximum statutory sentence of 10 years in federal prison and a $250,000 fine. Restitution could also be ordered. Judge Godbey remanded Jeffrey St. John into custody; Lawrence St. John was already in custody. Sentencing is set for January 27, 2014.
Co-defendant Dr. Nicolas Alfonso Padron, 54, of Garland, Texas, pleaded guilty on September 10, 2013, to one count of conspiracy to commit health care fraud. Dr. Padron, who joined A Medical as its medical director in December 2009, testified—as did a number of nurse practitioners, physician assistants, and company staff—that services billed had never been performed.
In a separate case, Dr. Padron also entered a guilty plea to one count of conspiracy to unlawfully distribute a controlled substance stemming from his operation of Padron Wellness Clinic, a pill-mill that he operated in Dallas. Dr. Padron has been in custody since his arrest in June 2012 on a related federal criminal complaint.
A Medical provided physician visits to Medicare beneficiaries in their homes rather than at a doctor’s office. A Medical, which was also known as A+ Medical House Calls and ANM Physician House Calls, was owned by Lawrence St. John; Jeffrey St. John ran its daily operations. A Medical had locations in Mesquite, Texas; Dallas; and Carrollton, Texas. Its primary purpose was to certify and re-certify Medicare beneficiaries for home health services, regardless of the true condition of the patient.
Once A Medical established a Medicare beneficiary for physician home visit services, A Medical would submit billing for fraudulent care plan oversight claims. The company did not provide primary care physician services to Medicare beneficiaries.
According to documents filed in the case and evidence presented at trial, from May 2010 to January 2012, the defendants conspired together and with others to defraud the Medicare program. A Medical, at the direction of Lawrence and Jeffrey St. John, submitted claims to Medicare using Dr. Padron’s unique Medicare number, with Dr. Padron’s permission, regardless of the claim’s merit.
The defendants conspired together to bill Medicare for care plan oversight by Dr. Padron for numerous beneficiaries when Dr. Padron was out of town, including dates when he was out of the country and on a cruise.
In total, the defendants billed taxpayers for $1.4 million of services that were either not medically necessary or not rendered at all. Through the fraudulent certifications, Medicare was billed an additional $9.7 million by home health agencies.
The investigation was conducted by U.S. Department of Health and Human Services-Office of Inspector General, the FBI, and the Medicaid Fraud Control Unit of the Office of the Attorney General of Texas. Assistant U.S. Attorneys Kate Pfeifle and J. Nicholas Bunch are in charge of the prosecution.

Hospice Owner Convicted in Multi-Million-Dollar Health Care Fraud

PHILADELPHIA—Matthew Kolodesh, a/k/a “Matvei Kolodech,” 51, of Churchville, Pennsylvania, was found guilty of conspiracy to defraud Medicare of more than $14 million through his home hospice business, announced United States Attorney Zane David Memeger. A federal jury delivered its verdict today. Kolodesh’s business, Home Care Hospice Inc. (HCH), located at 2801 Grant Avenue in Philadelphia, submitted claims totaling approximately $14.3 million for patients that were not eligible for or did not receive the hospice services billed to Medicare. Kolodesh also allegedly diverted $9.36 million dollars from HCH's operating account for his own personal use, such as extensive renovations to his house, travel expenses, college tuition for his son, and a luxury automobile. He siphoned substantial sums of cash from the HCH operating account through kickbacks from HCH vendors using a system of phony and inflated invoicing and a cash kickback scam through sham charitable donations made in the name of the hospice.
The jury found Kolodesh guilty of conspiracy to commit health care fraud, 21 counts of health care fraud, 11 counts of money laundering, and two counts of mail fraud. Kolodesh faces a statutory maximum sentence of 370 years in prison. The government will also seek restitution to Medicare in the amount of $14.3 million and proceeds from the money laundering.
“Cases like this involve the type of fraud and abuse that this office and the Department of Justice fights every day,” said Memeger. “The guilty verdict here bolsters our resolve to investigate and prosecute fraudsters who believe they can steal the public’s hard-earned tax dollars and government funds with impunity.”
“Criminals like Matvei Kolodech, who hide behind others in hopes of avoiding prosecution, should take notice of today’s jury verdict,” said Special Agent in Charge Nick DiGiulio, of the U.S. Department of Health and Human Services, Office of Inspector General. “We will continue to aggressively investigate ring leaders like Kolodech, whose fraudulent organizations rob Medicare of precious resources.”
Kolodesh and his co-conspirator, identified only as “A.P.,” would pay health care professionals, including doctors, for referring patients to HCH even when those patients were not eligible or appropriate for hospice services. In an effort to mask the alleged kickback scheme, HCH fraudulently represented that some of those health care professionals were paid for services as medical directors, advisers, or hospice physicians.
Among the ineligible patients were patients who were not terminally ill and patients who were on the service list for more than six months. At the direction of Kolodesh and A.P., HCH staff would routinely “doctor” or alter patient charts to make it appear on paper as though the patient’s medical condition was worse than it actually was. The staff was also allegedly directed to bill certain claims at a higher, more costlier rate of service than was actually provided to the patient.
In February 2007, HCH was notified that it was subject to a claims review audit. Kolodesh, through A.P., directed members of HCH staff to falsify documentation to be submitted for the audit. In September 2007, HCH was notified that it had exceeded its cap for Medicare reimbursement and would have to repay $2,625,047 to the government program. At that point, Kolodesh ordered a mass discharge of patients. In October 2007, A.P. had 79 hospice patients discharged and a total of 128 discharged by January 2008, some of whom had been ineligible for hospice or inappropriately maintained on hospice service in excess of six months. Of those discharged patients, 16 were admitted to Kolodesh’s other hospice business, Community Home Health in Bucks County. Once the Medicare cap was resolved, 11 of those patients were returned to HCH.
In August and September 2005, Kolodesh and A.P. applied for a low interest loan worth $2.5 million with the Philadelphia Industrial Development Corporation. The purpose of PIDC loan is to stimulate business investment and create jobs in the city of Philadelphia. Kolodesh indicated that the funds were to be used to acquire and renovate a property for his business and the creation of 50 jobs in Philadelphia at the 2801 Grant Avenue site of HCH. In reality, Kolodesh knew that between August 2005 and July 2009, the job quota was not being met, and in the summer of 2008, he set up a sham office for CHH (his Bucks County health care business) at that location and falsely identified 73 CHH employees as working at the office location on Grant Avenue who, in fact, had never worked there.
The case was investigated by the Federal Bureau of Investigation and the Department of Health and Human Services Office of Inspector General. It is being prosecuted by Assistant United States Attorney Suzanne B. Ercole and Trial Attorney Margaret Vierbuchen with the Department of Justice’s Criminal Section.

Former Los Angeles-Area Pastor Sentenced for Role in $11 Million Medicare Fraud Scheme

WASHINGTON—A pastor and owner of a Los Angeles-area medical supply company was sentenced today for his role in a power wheelchair fraud scheme that defrauded Medicare of more than $11 million.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney André Birotte, Jr. of the Central District of California; Special Agent in Charge Glenn R. Ferry of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG); Assistant Director in Charge Bill L. Lewis of the FBI’s Los Angeles Field Office; and Special Agent in Charge Joseph Fendrick of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse made the announcement.
Charles Agbu, 58, of Carson, California, was sentenced by U.S. District Judge George H. Wu to serve 87 months in prison and was ordered to pay $5,788,725 in restitution to Medicare. In December 2012, Agbu pleaded guilty to conspiracy and money laundering charges based on his role as owner and operator of Bonfee Inc., a fraudulent durable medical equipment (DME) supply company that Agbu operated with his daughter and co-defendant, Obiageli Agbu, and members of his family from a nondescript office building in Carson. Agbu admitted that he paid patient recruiters and doctors to provide him with fraudulent prescriptions for expensive, highly specialized power wheelchairs and other DME that he, Obiageli Agbu, and their co-conspirators used in submitting more than $11 million false claims to Medicare. Agbu billed the power wheelchairs to Medicare at a rate of approximately $6,000 per wheelchair even though he paid approximately $900 wholesale per wheelchair. In many cases, the Medicare beneficiaries to whom Agbu and his co-conspirators claimed they supplied the power wheelchairs and DME did not have any legitimate medical need for the medical equipment and, in some cases, never received the medical equipment from Agbu’s company. At the time Agbu engaged in this fraud, he was a pastor at Pilgrim Congregational Church in South Central Los Angeles.
On September 30, 2013 and October 2, 2013, Agbu’s co-defendants, Alejandro Maciel, 43, of Huntington Park, California, and Dr. Emmanuel Ayodele, 65, of Los Angeles, were sentenced to serve 41 and 37 months in prison and ordered to pay $5,388,755 and $6,355,949 in restitution to Medicare, respectively. Two other co-defendants, Dr. Juan Van Putten and Candelaria Estrada, have pleaded guilty to Medicare fraud charges and are scheduled for sentencing on December 12, 2013 and October 31, 2013, respectively. Obiageli Agbu was convicted by a jury on nine counts of conspiracy to commit health care fraud and health care fraud on July 19, 2013. Her sentencing date has not been set.
The case is being investigated by the FBI, HHS-OIG and the California Department of Justice and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The case is being prosecuted by Trial Attorneys Jonathan T. Baum and Alexander Porter of the Criminal Division’s Fraud Section.
The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.