On February 7, 2007, Betros Garabet was indicted on charges of healthcare fraud and false statements. Investigators believe that Garabet orchestrated a scheme to bill Medicare $260,842 for medically unnecessary treatments and services.
According to the indictment, Garabet, who was not a licensed physician, opened several medical clinics in the Los Angeles area. Esther Foliente, a licensed physician, permitted Garabet to use her medical license to operate one of the medical clinics and bill Medicare for services rendered at that clinic.
Garabet hired co-conspirators, known as "cappers" or "marketers," to recruit patients with Medicare coverage. Co-conspirators Terry Hill and Natasha Walker paid patients kickbacks in the form of cash in exchange for receiving medically unnecessary treatments and services at the clinics, which could then be billed to Medicare.
Garabet posed as a physician and purportedly examined the Medicare beneficiaries. He then billed Medicare as if Foliente provided the patients with medically necessary services, when in fact the medical services were not provided by Foliente and either were not medically necessary or not provided at all. In exchange for using her information to bill Medicare, Foliente received a portion of the payments from Medicare.
Foliente pleaded guilty to making false statements to FBI agents and was sentenced to 3 years home detention and ordered to pay over $146,000 in restitution. Both Walker and Hill pleaded guilty to healthcare fraud. Walker was sentenced to 2 years' probation and ordered to pay $5,571 in restitution, joint and several. Hill was sentenced to 1 year plus 1 week in prison. He was also ordered to pay $1,358,436 in restitution.
Garabet is also known as Bedros Mikail Garbet and Bedros Garabed. Investigators believe that Garabet fled the United States. He remains a fugitive at-large.
OIG Fugitive: Ashot Sanamian
On May 8, 2014, Ashot Sanamian was indicted on charges of conspiracy to distribute and divert oxycodone, a schedule II narcotic drug, and conspiracy to commit healthcare fraud. Investigators believe that Sanamian participated in a multi-million dollar pill mill scheme that involved diverting over one million OxyContin pills to the streets.
According to the indictment, Sanamian was the owner and CEO of A & A Billing Services (A&A) and also participated in this scheme as a "runner." Sanamian's co-conspirators operated a medical clinic in Los Angeles, California, which functioned as a "prescription mill." The clinic generated OxyContin prescriptions for patients who did not need the medication. The prescriptions were then given to runners, including Sanamian and other co-conspirators employed by the Clinic, who either took the recruited patients and/or the prescriptions and related documentation to cooperating pharmacies, which filled the prescriptions. Depending on the insurance plan, the runners then took the OxyContin and delivered it to the clinic administrator, who sold it on the streets.
During the Clinic's operation, more than 13,000 bottles of OxyContin were diverted to the streets. Because the Clinic almost exclusively prescribed 90 quantity pill bottles, more than 1.1 million OxyContin pills were diverted during the course of the conspiracy. Medicare paid approximately $2.7 million for OxyContin prescribed by the Clinic and its doctors.
Sanamian is believed to have departed the United States. He remains a fugitive at-large.
OIG Fugitive: David Kim
On October 21, 2015, David Y. Kim was indicted on charges of healthcare fraud, illegal remunerations, and aggravated identity theft. Investigators believe that Kim was involved in a scheme to fraudulently bill Medicare approximately $15.2 million for physical therapy services that were either not reimbursable or were not fully provided.
Kim was a licensed chiropractor and owner of New Hope Clinic (New Hope) in Los Angeles, California. According to the indictment, Kim was recruited by co-conspirators to solicit Medicare beneficiaries to receive alleged physical therapy services, which would then be fraudulently billed to Medicare. Kim recruited Medicare beneficiaries to his clinics, obtained their unique Medicare identification numbers and patient information, and supplied the information to his co-conspirators, Joseff Sales, a physical therapist, and Danniel Goyena, a physical therapy assistant.
Sales and Goyena hired physical therapists to evaluate clients and created physical therapy treatment plans. Ultimately, clients received services that were not reimbursable through Medicare, such as acupuncture or massage, and some clients never received any follow-up physical therapy services. Kim was aware that his partners submitted claims using clients' names and unique identification numbers to Medicare for reimbursement for physical therapy services, despite the clients having received other non-reimbursable services.
Between March 2012 and January 2014, Kim received $379,785 in kickback payments from companies owned by Sales and Goyena for the patients who were referred by Kim and purportedly received physical therapy services at New Hope. Goyena and Sales both pleaded guilty to healthcare fraud and illegal remunerations and were each sentenced to 4 years and 3 months in prison and held jointly liable for $7,896,007 in restitution.
Investigators believe that Kim, also known as Dai Yong Kim, fled the United States prior to his arrest and may be in South Korea, China, or Mexico. Kim has dual citizenship in South Korea and the United States. He remains a fugitive at large.
OIG Fugitive: Yervand Khachatryan
On August 24, 2011, Yervand Khachatryan was indicted on charges of healthcare fraud and money laundering. Investigators believe that Khachatryan billed Medicare over $4.3 million for durable medical equipment that was either medically unnecessary or was never provided.
Khachatryan owned Midvalley Medical Supply (Midvalley), a durable medical equipment company located in Van Nuys, California. Investigators believe that Khachatryan and his co-conspirator, former Midvalley owner George Hakopian, submitted false and fraudulent claims for motorized wheelchairs and orthotics that were not medically necessary and often never provided to the beneficiaries. Khachatryan and Hakopian also submitted claims for beneficiaries who were deceased.
According to the indictment, from approximately April 2009 until October 2009, Midvalley billed Medicare approximately $4,392,312 and Medicare paid Midvalley approximately $847,178.
On October 14, 2011, Hakopian pleaded guilty to one count of healthcare fraud and was later sentenced to 2 years in prison and ordered to pay $913,215 in restitution.
Authorities believe that Khachatryan, also known as Arthur Khachatryan, fled the United States in October 2009. He remains a fugitive at-large.
OIG Fugitive: Angel Lagoa
In January 2017, Angel Lagoa was indicted on charges of conspiracy to commit healthcare fraud and wire fraud. Investigators believe that, from 2010 to 2015, Lagoa and his co-conspirators submitted approximately $30 million in false or fraudulent claims to Medicare.
Lagoa owned Trinity Senior Care, Inc., located in Miami, Florida, but concealed his true ownership by using a nominee owner. According to the investigation, Lagoa and his co-conspirators paid illegal kickbacks to patient recruiters in exchange for beneficiary information. They then billed Medicare for services that were neither medically necessary nor ordered by a physician.
Investigators believe Lagoa is currently residing in Cuba.
OIG Fugitive: Amaury Perez
In May 2015, Amaury Perez was indicted on charges of conspiracy to commit healthcare fraud and money laundering. Investigators believe that Perez and co-conspirators were involved in a scheme to fraudulently bill Medicare approximately $2.5 million.
Perez co-owned Gold Care Home Health Services, a home healthcare company in Tampa, Florida. According to the investigation, Perez and a co-conspirator used Medicare beneficiary information to submit over $2.5 million in false home health claims to Medicare for services that were never performed or authorized by a physician. Proceeds from the fraud were then laundered through a number of fictitious shell companies in Florida.
Investigators believe Perez fled to Cuba.
OIG Fugitive: Ebong Aloysius Tilong
In November 2015, Ebong Aloysius Tilong was indicted on charges of conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to pay kickbacks, payment of kickbacks, and conspiracy to commit money laundering. Investigators believe that Tilong and his wife Marie Neba fraudulently billed Medicare millions for home health services that were either medically unnecessary or were not provided.
Tilong and Neba operated Fiango Home healthcare, Inc., a home health agency doing business in Houston, Texas. Trial evidence showed that Tilong paid illegal kickbacks to patient recruiters for referring Medicare beneficiaries to Fiango for purported home health services. Tilong also paid illegal kickbacks to Medicare beneficiaries and falsified medical records in order to bill Medicare for home health services that were, in actuality, not medically necessary or not provided. Tilong also attempted to destroy evidence, blackmail a witness, and suborning perjury from witnesses.
From February 2006 to June 2015, Fiango was paid over $13 million in fraudulent Medicare reimbursements.
In June 2017, Tilong pleaded guilty to filing fraudulent tax returns related to Fiango. In August 2017, Neba was sentenced to 75 years in prison. Tilong was scheduled for sentencing in October 2017, but failed to appear. In December 2017, Tilong was sentenced in absentia to 80 years in prison.
Investigators believe that Tilong fled the United States and is believed to be residing in Cameroon.
OIG Fugitives: Luis Emelio Deleon and Sevastion Deleon
In February 2014, complaints were filed charging Luis Emilio Deleon and Sevastion Deleon with healthcare fraud, conspiracy to commit healthcare fraud, and aggravated identity theft. Investigators believe that Luis and Sevastion received over $800,000 in reimbursement for wound care products that doctors never prescribed and that beneficiaries never ordered or received.
Luis and Sevastion owned and operated Clover Durable Medical Equipment, LLC (Clover), doing business in New Orleans, Louisiana. Luis and Sevastion used the names and NPI numbers of Louisiana doctors as prescribing physicians on Medicare claims for beneficiaries who lived outside the state of Louisiana, primarily in the state of Florida. Neither the Louisiana physicians nor the out-of-state beneficiaries had any knowledge of Clover.
Prior to purchase of the company in 2012, Clover billed Medicare for less than $100,000 per year in DME items. After Luis and Sevastion purchased the company, Medicare was billed for more than $2 million in wound care supplies in less than three months.
Investigators believe that Luis and Sevastion fled the United States and are believed to be residing in Cuba.
OIG Fugitive: Conrado Dizon Lopez, Jr.
On December 23, 2014, Conrado Lopez was indicted on charges of healthcare fraud, conspiracy to commit healthcare fraud, false claims, false statements related to healthcare matters, and falsification of records. Lopez is a licensed physical therapist and owner of Total Rehab in Brooklyn, NY.
Lopez confessed to OI Agents that he was knowingly involved and an active participant in a scheme to defraud Medicare and Medicaid whereby Total Rehab submitted claims to these programs for services that were either not rendered, not medically necessary, not appropriately supervised and/or performed by unlicensed individuals. He also stated that on several occasions he was outside the United States on vacation and when he returned, he signed back dated superbills for the dates of services when he gone, despite knowing this was wrong.
According to the indictment, between approximately March 2009 and November 2011, providers at Total Rehab submitted and caused to be submitted approximately $9.8 million in claims to Medicare and approximately $8.6 million in claims to Medicaid. During approximately that same period, Lope was identified as the rendering provider on claims submitted to Medicare totaling approximately $1.8 million and on claims submitted to Medicaid totaling approximately $1 million.
Flight records show that Lopez fled the United States and investigators believe that he is in the Philippines or the United Arab Emirates. He remains a fugitive at-large.
OIG Fugitive: Armando "Ana" Zamora
In July 2004, Armando "Ana" Zamora was indicted on charges of healthcare fraud conspiracy and healthcare fraud. Investigators believe that Zamora and her co-conspirators received approximately $550,000 in reimbursement from Medicare for the cost of durable medical equipment (DME) and other related items and services that were either medically unnecessary or were never provided.
Zamora and Aurora Estevez established Health South Medical Supply Corporation, a DME company in Miami-Dade County, Florida. According to the indictment, Zamora and Estevez used a nominee owner to conceal their control of Health South. Zamora and Estevez acquired, and enlisted a patient recruiter to acquire, Medicare beneficiary information, which Health South allegedly used to prepare fraudulent Medicare claims. The defendants also acquired the identification numbers of doctors to help further the fraud.
Zamora, Estevez, and their co-conspirators falsely represented that doctors had treated patients; that doctors had prescribed DME, including custom-fitted orthotics, and other related items and services for patients; and that such DME had been delivered to Medicare beneficiaries.
Estevez pleaded guilty and was sentenced in January 2005 to 2 years in jail and ordered to pay $505,704 in restitution, joint and several.
Zamora fled the United States and is believed to be residing in Central or South America. She remains a fugitive at large.
OIG Fugitive: Abayomi Onajobi
In October 2012, Abayomi Onajobi was indicted on charges of healthcare fraud and aggravated identity theft. Investigators believe that Onajobi and others acting at his direction caused the submission of about $585,000 in fraudulent claims to Medicare and Medicaid.
Onajobi owned and operated Medibay Medical Supply, a durable medical equipment company in Houston, Texas. From approximately September 2006 to February 2009, Onajobi marketed and supplied beneficiaries with power wheelchairs and "ortho kits" (braces, wraps, supports, heat pad, etc.) that were not prescribed by a physician. Onajobi and his co-conspirators submitted claims for approximately 171 beneficiaries located in Texas and Louisiana, and he received more than $105,000 from Medicare and Medicaid in reimbursement.
Investigators believe that Onajobi fled the country before a warrant could be issued for his arrest. He may be residing in Nigeria, the country of his birth.
On September 11, 2012, Firas Alky was indicted on charges of healthcare fraud conspiracy and conspiracy to pay and receive healthcare kickbacks. Investigators believe that Alky and his co-conspirators submitted millions in false claims to Medicare for home health services and other medical services that were either medically unnecessary and/or were not actually provided.
Alky jointly operated and controlled Associates in Home Care, Inc.; ABC Home Care, Inc.; and Swift Home Care, LLC. These Michigan-based companies were part of an even larger home healthcare fraud network that included over 30 companies that purportedly provided Medicare beneficiaries with home health services.
According to the indictment, Alky and his co-conspirators allegedly paid kickbacks and bribes to recruiters and others for information on Medicare beneficiaries that would be used to bill Medicare for services that were either medically unnecessary and/or not provided.
Alky and his co-conspirators received $31.2 million in reimbursement for these false claims and then transferred and disbursed the funds to themselves and others.
Investigators believe that Alky fled the United States in 2012 and may be residing in Iraq.
On October 7, 2013, an arrest warrant was issued for Errol Elrington, M.D., for racketeering, Medicaid fraud, and healthcare fraud. Investigators believe that Elrington falsely billed Medicare and Medicaid more than $400,000 for services that he never performed, and he employed an unlicensed physician who engaged in criminal sexual misconduct.
According to the Felony Complaint, Elrington was a licensed physician practicing in the Redford, Michigan, area, and was the owner of a private medical center, Elrington Medical Center PLLC (EMC). Elrington allegedly employed an unlicensed physician to treat patients at EMC when he was not there, then billed Medicare and Medicaid as if he performed the services. Though he was the owner of EMC, Elrington spent most of his time employed as the chief medical officer at another medical facility that was unaffiliated with EMC.
The unlicensed physician treated several patients and conducted multiple pelvic exams on a female patient, which resulted in charges of first degree criminal sexual conduct, racketeering, Medicaid fraud, healthcare fraud, and health profession unauthorized practice. The unlicensed physician is being held prior to trial.
Elrington fled the United States for Belize less than 24 hours after being interviewed by Federal and State agents. He remains a fugitive at-large.
Daniel Guerra and Aiza Rodriguez
In August 2006, couple Aiza Rodriguez and Daniel Guerra were indicted on charges of conspiracy to defraud the United States, commit healthcare fraud, and pay kickbacks; healthcare fraud; conspiracy to commit money laundering; and money laundering. Investigators believe that Rodriguez and Guerra received more than $9 million in Medicare reimbursement for durable medical equipment (DME) that either was medically unnecessary or was never delivered to a qualified Medicare beneficiary.
Rodriguez owned the DME company, Brickell Orthopedic Store, Inc., while Guerra owned the DME company, Stephanie Medical Supplies, Corporation. Both companies were based in Miami, Florida. According to the indictment, Guerra and Rodriguez paid kickbacks and bribes to patient recruiters in return for providing their companies with Medicare beneficiaries whom they could use to bill Medicare. The beneficiaries were also paid and bribed in exchange for their Medicare identification numbers along with their prescriptions for DME and related services.
The defendants fraudulently completed Medicare-required orthotic measurement forms for DME without an orthotist or orthotic fitter ever having measured a patient. Guerra and Rodriguez then forged the signatures of doctors on DME prescriptions and paid doctors to sign blank certificates of medical necessity.
Rodriguez and Guerra fled the United States shortly after a warrant was issued for their arrest. They resided outside Madrid, Spain, until they were incarcerated. U.S. authorities are currently working with the Spanish Government to have the couple extradited to the United States to face charges stemming from their indictment.
OIG Fugitives: Ilya Slepak
In October 2011, Ilya Slepak and his co-conspirators were indicted on charges of conspiracy to commit mail fraud and healthcare fraud. Investigators believe that Slepak and his co-conspirators billed Medicare and private insurance companies millions of dollars for medical care and equipment that was never provided or was medically unnecessary.
Slepak worked as a manager for several "no-fault" medical clinics in New York City, which were owned by Leonid Kaplan. All vehicles registered in New York State are required to have no-fault automobile insurance, which enables drivers and passengers of a registered vehicle to obtain benefits for injuries sustained in a car accident, regardless of fault. Kaplan's no-fault clinics purportedly provided medical care and durable medical equipment (DME) to automobile accident victims. However, these clinics were in fact medical fraud mills that routinely billed Medicare and automobile insurance companies under the no-fault program for medical treatments that were never provided or were medically unnecessary.
Investigators believe that the Kaplan clinics used and paid "runners" to refer "patients" who were in vehicle collisions to the clinics. Often, these patients suffered few or no injuries and yet obtained weeks or months of medically unnecessary treatments and tests at Kaplan's clinics. The Kaplan clinics also partnered with a medical supply company to bill Medicare and the insurance companies for purportedly providing durable medical equipment (DME) to patients, even though the DME was medically unnecessary and even though Medicare and the insurance companies were overcharged for the DME.
Slepak and other managers oversaw the daily operations of the clinics, including recruiting and paying corrupt medical practitioners who worked at the clinics, paying runners and patients, supervising the submission of fraudulent billing to insurance companies, and coaching patients on how to describe their injuries in order to maximize insurance payments and legal settlements based upon bogus claims of "serious bodily injury."
Kaplan pleaded guilty to conspiracy to commit healthcare fraud, was sentenced to 7 years and 10 months of incarceration, and was ordered to pay $2.3 million in forfeiture and restitution. Seven other defendants also pleaded guilty in relation to this fraud scheme. Slepak remains a fugitive and is believed to be residing in Russia.
OIG Fugitives: Miguel Angel Hernandez and Maria Del Pilar Moreira
On November 18, 2014, Miguel Angel Hernandez and Maria Del Pilar Moreira were indicted on charges of conspiracy and healthcare fraud. Investigators believe that the married couple caused the submission of nearly $7 million in false claims to Medicare.
Hernandez and Moreira owned and operated East Point Medical Center and Family First Medical Center in Georgia, which purportedly provided physical therapy, occupational therapy, massage therapy, and pain management through trigger point injections. According to the indictment, Hernandez and Moreira caused the submission of false claims to Medicare and Medicaid for medical services that were either medically unnecessary or were not provided. They also billed for expensive trigger point injections (for which Medicare pays between $58 and $60) when, in fact, they actually provided vitamin B-12 shots (for which Medicare pays around $0.66). In addition, the couple billed for medical services on days when they actually drove patients to restaurants for parties.
Hernandez and Moreira directed clinic employees to transport patients by van to the clinics. Beneficiaries were offered massages, cash, gift cards, food, dollar prizes, and raffles for televisions to induce them to visit the clinic on a regular basis. Instead of receiving medical treatment, the patients often participated in group exercises, such as riding a stationary bike, holding a bar and kicking to the left and right, and waving their arms. To further the fraud, the couple hired a medical doctor so they could falsely bill services under his provider name and number. They then caused the submission of false claims for services not rendered by the provider or for services on days when the provider was not at the clinic.
Investigators believe that Hernandez and Moreira fled the country after they became aware of the investigation. Warrants have been issued for their arrest. They are believed to be residing in Spain.
Other Wanted Fugitives
Barbaro Ortega and Raul Camejo
In November 2009, Barbaro Ortega and Raul Camejo were indicted on charges of conspiracy to commit healthcare fraud and healthcare fraud. Investigators believe that Ortega, Camejo, and their co-conspirators filed and caused to be filed approximately $3.3 million in false Medicare claims for durable medical equipment (DME) that was medically unnecessary or was not provided to beneficiaries.
Ortega, Camejo, and Secundino Perez operated and controlled Maidelyn Medical Equipment Corporation, based in Virginia Gardens, Florida. Maidelyn Medical purportedly provided DME, including wound therapy pumps, to beneficiaries. According to the indictment, the three defendants submitted and caused the submission of claims to Medicare using the identification information of physicians who had not examined, treated, or prescribed DME to the beneficiaries for whom the claims were being submitted. Consequently, Medicare provided $972,413 in reimbursement.
On May 7, 2010, Perez was sentenced to 2 years and 7 months in prison and ordered to pay $972,413 in restitution. Ortego and Camejo remain fugitives at large. Investigators believe that they may be residing in Cuba.
OIG Fugitive: Syed Jawed Akhtar-Zaidi
On August 27, 2014, Syed Jawed Akhtar-Zaidi was indicted on charges of conspiracy to distribute controlled substances, healthcare fraud, distribution of controlled substances, and money laundering. Investigators believe that Akhtar-Zaidi and his co-conspirators billed Medicaid, Medicare, and private insurance providers more than $10 million for false medical office visits and prescription drugs that were dispensed without a legitimate medical purpose and outside the usual course of professional practice.
Akhtar-Zaidi was a physician who operated a medical office called Pain Management of Northern Ohio. According to the indictment, from around September 2009 to around October 2013, Akhtar-Zaidi and his co-conspirators illegally distributed and dispensed thousands of doses of prescription painkillers to customers in the Northern District of Ohio and elsewhere. These prescriptions, primarily for oxycodone, oxymorphone, hydrocodone, hydromorphone, and morphine, were dispensed without adequately verifying the patient's identity or medical complaint, without an adequate and reliable medical history, without performing a complete or adequate mental or physical examination, without maintaining complete medical records, without establishing a true diagnosis, and without assessing the risk of abuse for the patients.
Akhtar-Zaidi used pre-signed blank prescription forms upon which his staff filled in the controlled substance and dosage to be prescribed. Investigators related that he and co-conspirators distributed the controlled substances to patients, knowing that the patients were addicted to drugs, were misusing or abusing drugs, or were requesting additional quantities in order to divert the drugs to others. Akhtar-Zaidi instructed staff at his office not to report customers to law enforcement whom they suspected of being "drug seeking" and/or "doctor shopping."
Investigators believe that Akhtar-Zaidi fled the United States around December 2013 and may be residing in Pakistan. He remains a fugitive at-large.
OIG Fugitive: Uche Chukwudi
On December 19, 2013, Dr. Uche Chukwudi was indicted on charges of healthcare fraud and conspiracy to commit healthcare fraud. Investigators believe that Dr. Chukwudi was involved in a scheme to fraudulently bill Medicare approximately $7.3 million for durable medical equipment (DME) that was never provided and was medically unnecessary.
Co-conspirator Adeline Ekwebelem owned Adelco Medical Distributors, a DME supplier in Gardena, California. According to the indictment, Ekwebelem paid marketers to solicit Medicare beneficiaries and offer them free DME, such as power wheelchairs, hospital beds, and orthotics, that they did not need. In return for the free products, the beneficiaries agreed to visit certain physicians, including Dr. Chukwudi, who would then use their beneficiary information to create false patient files and false statements in "face-to-face examination" forms. Dr. Chukwudi and other physicians then wrote prescriptions for the DME to be filled at Adelco.
Dr. Chukwudi referred more than 200 Medicare beneficiaries to Adelco for expensive, medically unnecessary DME, which enabled Ekwebelem to falsely bill Medicare for approximately $1.18 million. Dr. Chukwudi allegedly received cash kickbacks in return for writing the fraudulent prescriptions.
Ekwebelem was convicted on charges of conspiracy to commit healthcare fraud, healthcare fraud, and paying kickbacks for the recruitment of Medicare beneficiaries. Dr. Charles Okoye, a physician who referred more than 200 beneficiaries to Adelco, pleaded guilty to conspiracy to commit healthcare fraud. Both are awaiting sentencing. Patient recruiters Cindy Santana, Maritza Hernandez, and Romie Tucker, Jr., each pleaded guilty to illegal remunerations for healthcare referrals. Hernandez received 9 months in jail, while Santana and Tucker are awaiting sentencing.
Dr. Chukwudi fled the United States prior to his trial in September 2014. His whereabouts are currently unknown, and he remains a fugitive at-large.
On February 18, 2014, Nuritsa Grigoryan was convicted on charges of healthcare fraud conspiracy, aggravated identity theft, conspiracy to misbrand pharmaceutical drugs, false statements to the Federal Government, and conspiracy to use other persons' identification documents in furtherance of fraud. Grigoryan, along with co-conspirators Dr. Kenneth Johnson and Artak Ovsepian, were found guilty for their roles in a $20 million healthcare fraud scheme involving fraudulent prescriptions for expensive antipsychotic drugs.
According to the indictment, Grigoryan and her co-conspirators operated Manor Medical Imaging, Inc. (Manor), which functioned as a "prescription mill" that generated thousands of prescriptions for expensive antipsychotic medications. These drugs purportedly were prescribed by Johnson upon examining the patients. However, Johnson did not examine the patients, but rather presigned thousands of blank prescription forms that were used by Grigoryan and the others associated with Manor to submit fraudulent claims for prescriptions to Medicare and Medi-Cal. Grigoryan pretended to be an American doctor when she saw the patients at Manor and presigned the prescriptions forms.
Medicare and Medicaid beneficiaries were brought to Manor by patient recruiters and received prescriptions for antipsychotic medications in exchange for cash or other inducements. Drivers employed by Manor then drove the beneficiaries to pharmacies to have their prescriptions filled. The drivers then took the medications from the beneficiaries and delivered the drugs to Manor. Manor also generated prescriptions for beneficiaries who never visited Manor and whose identities were stolen.
Grigoryan was scheduled to be sentenced in June 2014. She was released after trial and ordered to wear an ankle monitor. Investigators believe that Grigoryan removed her ankle monitor. Grigoryan may be residing in a hidden location in the greater Los Angeles area or may have fled to Armenia after recently obtaining travel documents from the Armenian Consulate. Ovsepian is currently in custody and awaiting sentencing while Johnson is being monitored before being sentenced.
Dixan Barcelo-Castro and Alfredo Barcelo-Rodriguez
On May 3, 2013, brothers Dixan Esteban Barcelo-Castro and Alfredo Barcelo-Rodriguez were indicted on charges of conspiracy to commit healthcare fraud and healthcare fraud. Investigators believe that the brothers, along with their co-conspirators, received more than $2.5 million from Medicare for medical procedures and services that were either not performed or were not reimbursable under Medicare rules.
Barcelo-Castro operated and controlled four purported healthcare clinics in Tampa, Florida: Palmetto General healthcare Inc. (Palmetto), United Healthcare Center Inc., New Imaging Center Inc., and Lord Physical Rehabilitation Center, Inc. (Lord Physical). Barcelo-Rodriguez participated in the establishment and operation of these clinics and was listed as the President of Palmetto and Lord Physical.
According to the indictment, all four clinics allegedly billed Medicare Part C Health Maintenance Organizations for endovenous ablation therapy that was never performed or not medically necessary. This therapy is a minor surgical procedure used to treat problems with blood circulation, such as in the main veins in the legs. It offers a relatively high rate of Medicare reimbursement. However, Medicare only covers this procedure when it is medically necessary, not for purely cosmetic procedures, such as the treatment of non-symptomatic varicose or spider veins.
All four clinics supposedly operated at the same address, and at the same time billed Medicare for the same procedures for the same patients. Barcelo-Castro, Barcelo Rodriguez, and their co-conspirators allegedly recruited and enrolled Medicare beneficiaries to visit the clinics, and in some cases, submit to minor cosmetic procedures that were not reimbursable by Medicare. The defendants then fraudulently billed Medicare $4,872,239 and used the reimbursed funds for their personal gain.
Authorities believe that Barcelo-Castro and Barcelo-Rodriguez fled the United States after a warrant was issued for their arrest. They remain at-large.
OIG Fugitive: Poul Thorsen
From approximately February 2004 until February 2010, Poul Thorsen executed a scheme to steal grant money awarded by the Centers for Disease Control and Prevention (CDC). CDC had awarded grant money to Denmark for research involving infant disabilities, autism, genetic disorders, and fetal alcohol syndrome. CDC awarded the grant to fund studies of the relationship between autism and the exposure to vaccines, the relationship between cerebral palsy and infection during pregnancy, and the relationship between developmental outcomes and fetal alcohol exposure.
Thorsen worked as a visiting scientist at CDC, Division of Birth Defects and Developmental Disabilities, before the grant was awarded.
The initial grant was awarded to the Danish Medical Research Council. In approximately 2007, a second grant was awarded to the Danish Agency for Science, Technology, and Innovation. Both agencies are governmental agencies in Denmark. The research was done by the Aarhaus University and Odense University Hospital in Denmark.
Thorsen allegedly diverted over $1 million of the CDC grant money to his own personal bank account. Thorsen submitted fraudulent invoices on CDC letterhead to medical facilities assisting in the research for reimbursement of work allegedly covered by the grants. The invoices were addressed to Aarhaus University and Sahlgrenska University Hospital. The fact that the invoices were on CDC letterhead made it appear that CDC was requesting the money from Aarhaus University and Sahlgrenska University Hospital although the bank account listed on the invoices belonged to Thorsen.
In April 2011, Thorsen was indicted on 22 counts of Wire Fraud and Money Laundering.
According to bank account records, Thorsen purchased a home in Atlanta, a Harley Davidson motorcycle, an Audi automobile, and a Honda SUV with funds that he received from the CDC grants.
Thorsen is currently in Denmark and is awaiting extradition to the United States.
OIG Fugitive: Abubakar Durrani
In October 2013, Abubakar Durrani was indicted on charges of healthcare fraud, false statements related to healthcare matters, mail fraud, and illegal drug distribution. Investigators believe that Durrani, an orthopedic spine surgeon, billed Medicare, Medicaid, and private insurance companies millions for spinal surgeries and related services that were not medically necessary and were potentially harmful to patients.
Durrani owned the Center for Advanced Spine Technologies (CAST), which had offices in Ohio and Kentucky. According to the indictment, Durrani falsely diagnosed Medicare patients with spinal-related medical conditions and then persuaded the patients to undergo surgery, even though the patients did not need surgery. Durrani often told patients that the medical situation was urgent and that surgery was needed right away or they would be at risk of suffering from grave injuries. For cervical spine patients, Durrani often told patients that there was a risk of paralysis or the head would fall off if the patient was in a car accident because there was almost nothing attaching the head to the patient's body.
Durrani either ignored or never read patient radiology reports; rather he provided his own reading, which was either inconsistent with or contrary to the reports written by the radiologists. Durrani also ordered pain injections that were inconsistent with either the pain stated by the patient or from the imaging reports.
Durrani dictated his operative reports and other patient records months after the actual treatments. These reports and records contained false statements about the diagnoses of the patients, the procedures performed, and the instrumentations used in the procedures. In addition, Durrani failed to inform his patients of complications experienced during the surgeries.
According to the indictment, many patients treated by Durrani for back and neck pain were left in worse shape because of the unnecessary surgeries he performed.
Investigators believe that Durrani fled the United States while awaiting trial after the court denied his request for permission to travel outside the country. He may be residing in Pakistan.
Ji Hae Kim
In November 2011, Ji Hae Kim was charged for conspiracy to commit healthcare fraud. According to the criminal information, Ji Hae Kim (Kim), a registered nurse, worked for Greatcare Home Health, Inc. (Greatcare), a home health agency located in the Los Angeles area. Kim pleaded guilty in November 2011; she was released and was waiting to be sentenced when she fled.
Medicare paid Greatcare approximately $5.1 million for home health services that were purportedly provided.
According to the criminal information, Kim prepared false forms for Medicare patients receiving home health services from Greatcare, making it appear as though the patients' medical conditions and lack of willing caregivers made them eligible for home health services. Kim also falsified daily route sheets and skilled nursing notes to make it appear as though she had visited patients whom she had never visited.
Kim fled the United States while waiting for sentencing. She is a fugitive at large and maybe residing in South Korea.
Jahaziel Garcia Gonzalez
On July 7, 2009, Jahaziel Garcia Gonzalez was indicted on charges of healthcare fraud and forfeiture. Investigators believe that through his company, Gonzalez submitted nearly $2.4 million in false claims to Medicare for durable medical equipment (DME) items and services that were not prescribed by doctors or provided as claimed.
Gonzalez controlled and operated A & L Professional, Inc., a DME company based in Miami, Florida. According to the indictment, from around October 2008 to around March 2009, Gonzalez allegedly submitted or caused the submission of numerous false claims to Medicare on behalf of A & L Professional for powered air mattresses, non-disposable pump canisters, and other DME that was not prescribed by doctors or provided as claimed.
Medicare reimbursed A & L Professional nearly $1 million for these false claims. Gonzalez allegedly transferred these funds from A & L Professional's corporate bank account to himself and others.
An arrest warrant for Gonzalez was issued in July 2009, but he could not be located. Gonzalez remains at large.
On November 7, 2012, Patricia Mubanga Chisanga was indicted on charges of healthcare fraud and conspiracy to commit healthcare fraud. Previously, Chisanga's co-conspirator Uche Ben Odunzeh plead guilty one count of conspiracy to commit healthcare fraud and was sentenced to 19 months in prison.
Emerald Medical Services (Emerald) is a durable medical equipment company operating in the District of Columbia and purportedly providing wheelchairs and other medical equipment to Medicaid patients.
Chisanga is listed as the Vice President of Operations on the business records for Emerald.
Investigators believe that authorization forms necessary for the submission of claims to Medicaid were altered after they were signed by the prescribing physician. These forms were allegedly used by Emerald to bill Medicaid for more expensive equipment than was actually provided to the patients.
Emerald would provide patients with a lower level power wheelchair when, in fact, a higher level wheelchair was authorized.
From approximately January 2008 through March 2011, Emerald collected $480,000 from Medicaid for durable medical equipment that was never provided.
OIG Special Agents confronted Chisanga about her participation in the scheme. After this confrontation, she fled the United States to Ethiopia, then took a flight to her native Zambia.
Chisanga remains at large.
OIG Fugitive: Janaki Chettiar
In August 2011, Janaki Chettiar was indicted on charges of conspiracy to commit healthcare fraud and money laundering.
Chettiar, a resident of Oakland County, Michigan, in suburban Detroit, was a registered physical therapist who allegedly performed physical therapy services for Physicians Choice Home healthcare, First Care Home healthcare, and Quantum Home Care, Inc., all located in Livonia, Michigan, also in the Detroit area. Medicare paid Chettiar and her co-conspirators approximately $13.8 million in false claims for services that were never provided.
According to the indictment, Chettiar and her co-conspirators submitted false and fraudulent claims to Medicare, using Medicare patient numbers, which they used to bill for services that were never provided. They obtained the numbers by offering and paying kickbacks and bribes to Medicare patients.
Chettiar and her co-conspirators fabricated medical documents (home health certifications, plans of care, therapy notes, evaluations, recertifications, discharges, and other records) to bill Medicare for therapy.
Chettiar was arrested on September 1, 2011. After her initial court appearance, she fled the country. Investigators believe that Chettiar maybe be in Canada or India.
OIG Fugitive: Ike Okeke
On October 15, 2008, Ike Okeke was indicted on charges of conspiracy to defraud the United States and to cause the submission of false claims, healthcare fraud, and money laundering. Investigators believe that through his company, Okeke billed Medicare for more than $1.5 million for durable medical equipment (DME) that was either medically unnecessary or was never provided.
Okeke owned and operated RAMA Medical Supplies Inc., a DME company located in Raleigh, North Carolina, that purportedly provided motorized wheelchairs, scooters, ankle gauntlets, rigid support braces, and other supplies to Medicare beneficiaries. According to the indictment, Okeke allegedly recruited, trained, or had others recruit and train salespersons to establish relationships with Medicare beneficiaries to obtain their Medicare numbers and other personal information. Once they obtained it, the salespersons allegedly processed "prescriptions," which were purportedly signed by physicians from outside the State and billed to Medicare.
However, investigators interviewed several physicians whose names were used as the referring physicians, and all but one had never heard of RAMA, did not know the patients for whom RAMA was submitting claims, and never ordered any DME from RAMA.
In cases where DME may have been provided to a beneficiary, even if there was no medical need, Okeke allegedly billed Medicare for more expensive DME than was supplied, such as billing Medicare for a power wheelchair and then providing a scooter.
Okeke may be residing in Nigeria and he remains a fugitive.
OIG Fugitive: Joan Noalles
On May 5, 2010, Joan Noalles was indicted on charges of conspiracy to commit healthcare fraud, healthcare fraud, aggravated identity theft, conspiracy to commit money laundering, money laundering, and forfeiture. Investigators believe that Noalles and his co-conspirators falsely billed Medicare for more than $36 million for the cost of prescription drug items that were not prescribed by doctors or provided as claimed.
According to the indictment, Noalles and co-conspirator Jhon Barcelo allegedly installed nominee owners for Paradise Pharmacy, AC Pharmacy, Allswell Medical Supply, and Asis Pharmacies to hide their participation in the fraud. These nominee owners agreed to have their names placed on the ownership paperwork of corporate entities to conceal the involvement of the true owners. Paradise, AC, and Asis were located in or around Miami, Florida, while Allswell was located in Doraville, Georgia.
The investigation revealed that Noalles and Barcelo billed Medicare for prescription medications, durable medical equipment, and other items and services, including Arformoterol, Budesonide, and Formoterol Fumarate inhalation solutions and collagen dressings, which were not prescribed by physicians and/or provided to Medicare beneficiaries as claimed. Consequently, Medicare paid more than $10.6 million in reimbursement to these four companies for these alleged fraudulent claims.
In August 2010, Barcelo pleaded guilty to conspiracy to commit healthcare fraud and aggravated identity theft and was sentenced to 14 years of incarceration and ordered to pay $13.3 million in restitution.
Noalles remains at large.
OIG Fugitive: Ram Rajulapati
On November 29, 2012, Ram Naresh Rajulapati was indicted on charges of healthcare fraud conspiracy, healthcare fraud, and criminal forfeiture. Investigators believe that Rajulapati and co-conspirators received approximately $2.3 million from Medicare in reimbursement for physical therapy and nursing services that were not rendered and/or were not medically necessary.
According to the indictment, Rajulapati was a licensed physical therapist who worked at Acure Home Care, Inc., a Michigan-based home health agency that purportedly provided in-home physical therapy, occupational therapy, speech pathology, and/or skilled nursing services to patients. Acure was owned and operated by Mehran Javidan, and physical therapist Vishnu Pradeep Meda also worked at Acure. Both Javidan and Meda were convicted at trial on April 2, 2013, for their participation in the Medicare fraud scheme, and they are awaiting sentencing.
According to evidence presented at their trial, Javidan paid doctors to refer non-homebound patients for physical therapy treatment that was medically unnecessary. The evidence showed that she also paid patient recruiters to obtain Medicare information and pre-signed physical therapy documents from Medicare beneficiaries. The recruiters obtained the Medicare information and pre-signed forms by paying patients in cash and by promising that the referring doctors would prescribe narcotics for them. Javidan allegedly paid co-conspirators more than $140,000 in kickbacks and bribes for the patients and patient information.
Rajulapati, Meda, and other physical therapists and physical therapy assistants employed by Acure allegedly created false physical therapy files to make it appear as if physical therapy services were actually rendered, when in fact, the services had not been rendered. They then submitted false claims to Medicare for the cost of physical therapy and other services purportedly provided to beneficiaries.
Authorities believe that Rajulapati fled the country and may be residing in India. He remains a fugitive at-large.
OIG Fugitive: Gurgen Tsaturyan
In October 2009, a California State arrest warrant was issued for Gurgen Tsaturyan on charges of grand theft, identity theft, and false or fraudulent claims.
Tsaturyan was the owner and operator of Sun Valley Medical Supply, a durable medical equipment (DME) company based in Los Angeles, California.
From December 2008 until February 2009, Tsaturyan, through Sun Valley Medical Supply, allegedly billed Medicare for approximately $1.1 million and was paid over $500,000 for orthotic supplies that were never provided to Medicare patients.
Interviews with doctors whose identities were used by Sun Valley Medical Supply revealed that they did not write prescriptions or refer patients for DME.
Investigators also interviewed Medicare patients whose identities were used to bill for orthotics by Sun Valley Medical Supply. Patients stated that they had never heard of Sun Valley Medical Supply or the referring doctors or received any of the items Sun Valley billed for.
In September 2010, Lilit Galstyan, Julieta Ghazaryan, and Marine Movsisyan were indicted on charges of healthcare fraud, conspiracy to commit mail fraud, wire fraud, and conspiracy to commit money laundering. Galstyan, Ghazaryan, and Movsisyan, along with their co-conspirators, allegedly billed Medicare, using stolen provider identities, for more than $40 million in false claims for services that were never rendered.
According to the indictment, Galstyan, Ghazaryan, Movsisyan and their co-conspirators allegedly stole personal identifying information of physicians and Medicare beneficiaries to submit claims to Medicare for equipment for beneficiaries whom the physicians never saw. They also allegedly employed visa holders from eastern European countries and used the visa holders' identities to submit false claims to Medicare for services never rendered.
Although the crime ring was based in the Los Angeles area, investigators believe that the trio and their co-conspirators traveled throughout the country to open fake businesses. These "false fronts" were opened in over 40 States and were located far from the physicians' actual practices in order to conceal the false billings from the physicians. The locations served as "mail drops" so that the conspirators could receive documents used to further the scheme, including Medicare correspondence and bank checks, according to the indictment.
Investigators believe that the trio and their co-conspirators received more than $19 million in reimbursements from Medicare for services that were never provided. A large portion of the profits from the alleged schemes were laundered through shell businesses owned by the visa holders, according to the indictment.
Co-conspirators Eduard Oganesyan and Karen Chilyan previously pled guilty and were sentenced to 11 years' and 8 years' incarceration, respectively. In addition, Oganesyan and Chilyan were ordered to pay joint and several restitution in the amounts of $10.6 million and $7.7 million, respectively. A third co-conspirator, Arus Gyulbudakyan, also previously pled guilty and was sentenced to 13 months' imprisonment and ordered to pay $500,000 in restitution, joint and several. Gyulbudakyan will be deported to Armenia after she has served her time in jail.
Galstyan, Ghazaryan, and Movsisyan remain at large.
Osman E. Yousif, Amir Bala Elamin, Mudar A.M. Ismail, and Elsiddig H. Elfaki
In March 2008, Osman E. Yousif, Amir Bala Elamin, Mudar A.M. Ismail, and Elsiddig H. Elfaki were indicted on charges of conspiracy to defraud the United States, healthcare fraud, wire fraud, mail fraud, and aiding and abetting. According to the indictment, the co-conspirators were paid approximately $970,000 by Medicaid.
These co-conspirators created six ambulette companies in Youngstown, Ohio, that appeared to be distinct, separate companies. However, they acted as a single ambulette transportation company, sharing provider billing information, business and/or residential addresses, transportation services, patient lists, and money.
Yousif was the owner of ON Time Transportation, Elamin was the owner of Niles Transportation, Ismail was the owner of Nobility Express Transportation, and Elfaki was the owner of Townjet Transportation.
These co-conspirators allegedly shared or rotated Medicaid patients to create the impression that the patients were receiving ambulette transportation from different providers.
Ismail was convicted after a jury trial and sentenced. He fled before reporting to prison. Yousif, Elamin, and Elfaki fled prior to trial. All the co-conspirators remain at large.
Investigators believe that they are residing in Sudan.
In September 2007, Jose Argos was indicted on charges of conspiracy to defraud the United States, healthcare fraud, submission of false claims, money laundering conspiracy, and money laundering. According to court documents, Argos allegedly caused the submission of approximately $2.7 million in claims to Medicare for durable medical equipment (DME) that his company never provided to Medicare patients.
Argos was president and registered agent of MedStar Services, a DME company in Miami, Florida. Investigators believe that Argos conspired with OIG Most Wanted Fugitive Gustavo Smith and others to defraud Medicare by submitting false claims for reimbursement.
Argos, Smith, and their co-conspirators acquired MedStar and obtained a Medicare provider number to submit claims to Medicare for DME that the company purportedly provided. The defendants received approximately $1.5 million in reimbursements from Medicare for DME that was never prescribed or provided to Medicare patients. Smith and Argos then attempted to transfer the proceeds to a foreign country.
Both Argos and Smith remain fugitives from justice.
In May 2007, a State criminal complaint was filed against Jorge Caro, charging him with grand theft, scheming to defraud, filing false and fraudulent insurance claims, criminal use of personal identification information of a deceased individual, and money laundering. According to the criminal complaint, Caro falsely billed Medicare for more than $5 million for medical services that either were never provided or were unnecessary.
In May 2006, Jorge Caro became the registered agent and president of Karem Medical Center, Inc., a medical clinic based in Miami, Florida. Investigators believe that the physicians who were purportedly providing services at Karem Medical Center had never heard of Karem and had never seen any of the patients. Interviews of patients revealed that they had never been to Karem and that the treatment or services billed to Medicare had never been provided.
According to the criminal complaint, Karem Medical Center billed Medicare for approximately $5.2 million in false claims and was paid approximately $1.63 million.
Caro is a fugitive at large. Authorities believe that Caro may be residing in Cuba.
OIG Fugitive: Pedro Luis Perez
In June 2012, Pedro Luis Perez was indicted on charges of healthcare fraud and aggravated identity theft.
RP Best Choice Corp., a durable medical equipment (DME) company, owned by Pedro Luis Perez, fraudulently billed for Medicare patients who lived out of State and had never been to Texas. The majority of the patients were from Florida. Perez's company billed Medicare by falsely claiming that doctors in McAllen, Texas, whose billing information he had stolen, had referred their patients to RP Best Choice for DME.
From January 2010 through August 2011, RP Best Choice Corp. was paid over $520,000 in fraudulent Medicare reimbursements for equipment never provided to patients.
Investigators believe that Perez never resided in McAllen, Texas, and operated his business from Miami, Florida.
Perez remains at large and is believed to be in Cuba.
In June 2009, an arrest warrant was issued for Gevork Aidinian on charges of Grand Theft, Identity Theft, Insurance Fraud-False Wiring, and Health Benefits Fraud. Investigators believe that Aidinian fraudulently billed and received money from Medicare for clinical laboratory work that was either not prescribed by a doctor or was not provided to patients.
Aidinian was the president and owner of American Premier Laboratory (American Premier), located in Reseda, CA, in the Los Angeles area. Aidinian was also listed as the Chief Executive Officer of Labx, which was at the same location as American Premier. According to court records, Aidinian allegedly used the identities of physicians to bill Medicare for laboratory work that was never provided or never prescribed.
From June 2008 through June 2009, American Premier and Labx were paid more than $2 million in fraudulent Medicare reimbursements for clinical laboratory services.
Investigative interviews with doctors whose identities were used by American Premier and Labx revealed that the doctors did not refer patients to either establishment.
Investigators also interviewed Medicare patients whose identities were used to bill for laboratory services. Patients said they never went to either American Premier or Labx, and had not heard of either establishment.
Investigators believe that Aidinian fled the country in 2009, and he remains at large.
In July 2008, an arrest warrant was filed on Tigran Asaryan on charges of fraudulent schemes and artifices, theft, and aggravated taking identity of another.
From October 2007 until approximately July 2008, Asaryan was the owner and operator of Core Medical Group located in Phoenix, Arizona.
Core billed Medicare for over $600,000 and was paid over $460,000 for durable medical equipment that was never ordered or delivered or medically necessary.
None of the Medicare patients who reportedly received equipment resided in Phoenix.
All the referring physicians that Core used were based in California and none were from Phoenix.
Asaryan is currently a fugitive and his whereabouts are unknown.
In October 2009, a felony complaint was filed in California against Ekaterina Shlykova for a total of 67 charges, including Identity Theft, Money Laundering, Forgery, and Theft.
Shlykova was the office manager of Lazarus Jewelry, an alleged "shell" company based in Los Angeles. During a search conducted at Lazarus Jewelry, agents found hundreds of bank accounts and monetary instruments as well as dozens of pieces of stolen personally identifiable information.
Shlykova is known to use multiple identities, including the name Marina Ruslanovna Sekinaeva. According to the felony complaint, this name was obtained at the same time that fraudulent information was obtained by Evgeny Lyadov, who is charged separately with Grand Theft and Making Fraudulent Claims Against Medicare.
Investigators believe that Shlykova and her co-conspirators were involved in a scheme in which various Durable Medical Equipment companies submitted false Medicare claims for dead beneficiaries and beneficiaries who lived out of the local area. These companies then allegedly used Lazarus Jewelry to launder approximately $53 million that they fraudulently obtained from Medicare.
Shlykova remains at large.
OIG Fugitives: The Benitez Brothers:
Carlos Benitez, Luis Benitez, Jose Benitez
Carlos, Luis, and Jose Benitez, commonly referred to as the Benitez brothers, allegedly schemed to submit false and fraudulent claims to Medicare, pocketing approximately $110 million from Medicare, according to a Federal indictment.
The Benitez brothers owned and directed a string of medical clinics in the Miami area, purportedly providing infusion treatments to HIV-infected Medicare beneficiaries. But the medication the brothers provided to patients either was allegedly medically unnecessary or was never actually administered.
The brothers allegedly paid kickbacks to patients in exchange for the patients’ Medicare information, which they then used to submit false claims to the Federal Government for reimbursement.
More than 20 co-conspirators of the Benitez brothers have been charged in the Southern District of Florida with involvement in the HIV-infusion conspiracy. Most of them have pleaded guilty or have been convicted by a jury. A physician involved in the conspiracy was sentenced to a record-setting 30 years in prison.
Enrique Gonzalez, an OIG Most Wanted fugitive extradited on July 25, 2012, was connected to the Benitez Brothers.
OIG Fugitive: Raed Awad Almasri (aka Elmasri)
In October 2007, Raed Almasri was indicted on conspiracy charges related to healthcare fraud. Investigators believe that Almasri and his co-conspirators falsely billed Medicare more than $20 million for providing Medicare patients with regularly scheduled nonemergency ambulance transports to dialysis treatments, when in fact the beneficiaries did not qualify for the transports.
Almasri jointly owned and operated Americare Medical Service (AMS), a Houston, Texas, company that transported Medicare and Medicaid dialysis patients to and from their dialysis treatments. According to court documents, Almasri and his co-conspirators allegedly bribed nurses and emergency medical technicians to refer dialysis patients to AMS. Almasri and his co-conspirators also provided kickbacks in the form of cash, gift cards, and "loans" to dialysis patients in exchange for ambulance transportation by AMS. In addition, the defendants presented fake prescriptions to staff in nursing homes to secure staff physicians' signatures for ambulance transports of dialysis patients who had never been under the care of the nursing home or who had not been a patient at the nursing home for several months or years.
Co-conspirators Mazen Abdallah and Wesam Abdallah have each been sentenced to 17 months of incarceration and ordered to pay $637,425 in restitution, joint and several, while two other co-conspirators, Murad Almasri and Ayad Fallah, were each sentenced to 20 months and ordered to pay $1.6 million in restitution, joint and several.
Raed Awad Almasri remains a fugitive.
In May 2009, an arrest warrant was issued for Anupal Gayen on charges of healthcare fraud and healthcare fraud conspiracy.
According to court documents, Gayen and his codefendants controlled several medical therapy and medical services companies in Michigan and allegedly paid Medicare beneficiaries to sign Medicare reimbursement forms for treatment and services that were not provided. Gayen and his co-conspirators then allegedly filed the reimbursement forms with Medicare, fraudulently seeking payment.
Through their scheme, Gayen and his co-conspirators are believed to have submitted more than $18 million in fraudulent claims to Medicare.
When Gayen was confronted about his participation in the scheme, he fled the United States and remains at large.
Andrei (aka Andre) Vulpe & Valentin Munteanu
In February 2007, Andrei (aka Andre) Vulpe and Valentin Munteanu were charged in the State of Arizona with fraudulent schemes, theft, and aggravated identity theft. According to charging documents, between January and November 2007, Vulpe and Valentin Munteanu attempted to defraud Medicare of over $3.5 million by billing for durable medical equipment that was either not medically necessary or not provided to Medicare beneficiaries in Arizona.
Munteanu owned Pride Medical Supplies in Scottsdale and Vulpe owned AV Medical Supplies in Mesa. It is believed that through their companies, Munteanu and Vulpe conspired with others to submit false and fraudulent claims to Medicare and launder the unlawfully obtained proceeds.
Munteanu and Vulpe allegedly obtained Medicare beneficiaries' information and used physicians' information without their knowledge to bill Medicare. In addition, Munteanu allegedly stole the identity of another individual in this fraudulent scheme.
Munteanu and Vulpe have fled the country, and their whereabouts are unknown.
Maricel B. Hernandez & Eugenio R. Hernandez
In December 2007, a 38-count indictment was filed charging Eugenio R. Hernandez, Maricel B. Hernandez, and Jorge Ramirez with conspiracy to commit healthcare fraud, healthcare fraud, money laundering conspiracy, and money laundering.
According to court documents, Eugenio Hernandez was the reported owner of S.L. Medical Center, Inc.; Maricel Hernandez was the reported owner of Care Medical Office, Inc.; and Jorge Ramirez was the reported owner of the Rehabilitation Institute and Science Clinic, Inc. All three companies operated in the greater Miami area and purportedly provided infusion therapy to Medicare patients suffering from blood disorders and other conditions.
Investigators believe that these companies billed Medicare more than $110 million between April and December 2005 for infusion therapy services that were never provided to patients. After receiving payments from Medicare, the defendants allegedly laundered the fraudulently obtained funds through various shell companies to conceal the scheme to defraud and use the funds for their personal benefit.
Eugenio and Maricel Hernandez fled the country and are believed to be residing in Cuba.
Ramirez was captured in December 2008 at Miami International Airport. He pleaded guilty to one count of healthcare fraud and is serving his nearly 6-year jail sentence. Ramirez was also ordered to pay over $4 million in restitution.
OIG Fugitive: Manuel B. Aneiros Lopez
In March 2008, Manuel B. Aneiros Lopez was indicted on charges of healthcare fraud and forfeiture allegation. Investigators believe that through his company, Lopez falsely billed Medicare for medical equipment and services that were never provided to Medicare patients.
In January 2008, Lopez became the sole officer and registered agent of H&O Medical Supply Corporation based in Miami Lakes, Florida. According to court documents, Lopez submitted approximately $600,000 in Medicare claims for healthcare benefits, items, and services that were not medically necessary, not prescribed by a doctor, and were not provided to patients.
Lopez received approximately $250,000 in reimbursements for his false claims and he transferred the funds from H&O's bank account to himself and others.
Investigators believe that Lopez fled the United States in March 2008 and may be residing in Cuba.
OIG Fugitive: Gautam Gupta
On June 13, 2011, an arrest warrant was issued against Gautam Gupta, charging him with healthcare fraud, mail fraud, and conspiracy to commit fraud. Dr. Gupta and his associates allegedly received approximately $25 million in reimbursements from Medicaid and private health insurers for medical services that were either unnecessary or not performed.
Dr. Gupta owned and operated the Nutrition Clinic, a weight loss clinic with several locations in Northern Illinois and the Chicago metropolitan area. According to the arrest warrant, the clinic required new patients to undergo medical tests, such as thyroid ultrasounds and echocardiograms, without regard to medical necessity for the tests. The Nutrition Clinic would then submit claims to Medicaid and private insurance companies, indicating that these tests were related to a specific medical diagnosis.
The clinic also allegedly submitted claims for "evaluation and management" services performed by Dr. Gupta, when in actuality neither Dr. Gupta nor any other medical doctor saw these patients. In addition, investigators found that Dr. Gupta directed office staff to enlist insured patients for additional procedures, such as "nuclear stress tests" that were not medically necessary. The clinic would then bill the patients, Medicaid, and private insurers for those services.
Authorities believe that Gupta is currently residing in India.
OIG Fugitives: Iyaye Ishmael & Tom Henderson Alabraba
In April 2010, Iyaye Ishmael, Tom Henderson Alabraba, and their co-conspirators were indicted on charges of conspiracy, healthcare fraud, and identify theft.
From approximately July 2004 to November 2009, Ishmael, Alabraba, and others allegedly defrauded the Medicare program by billing Medicare more than $8.5 million for reimbursement for durable medical equipment that was either never provided, not legally prescribed, or not medically necessary.
Ishmael was reported to be president of United Medical Services and co-owner of Central Medical, Inc. Alabraba was reportedly president of Tal-MED. All three were durable medical equipment supply companies in the Kansas City, Kansas area. According to the indictment, Ishmael, Alabraba, and others would fraudulently use the stolen identity of physicians in order to submit claims for equipment for beneficiaries whom the physicians had never seen. The companies would either not provide the equipment or would provide a relatively inexpensive piece of equipment compared to the cost of the equipment billed to Medicare.
Ishmael, Alabraba, and their co-conspirators would allegedly share beneficiary information in order to submit additional Medicare billings.
One of Ishmael and Alabraba's co-conspirators has pleaded guilty to Conspiracy to Commit healthcare Fraud and healthcare Fraud. Another is awaiting trial.
Authorities believe that Ishmael may be residing in Nigeria. Alabraba's whereabouts are unknown; he was last reported to be in Katy, Texas.
In October 2008, an arrest warrant was issued for Rodolfo Bouza on healthcare fraud charges for allegedly billing Medicare for more than $750,000 in false claims.
Bouza owned and operated Newburg Services, Inc., based in Louisville, Kentucky, that purportedly provided bandages and durable medical equipment (DME) to Medicare beneficiaries.
Investigators believe that Bouza, through his company, billed Medicare for DME that was never provided to beneficiaries or prescribed by a physician. Bouza allegedly stole the provider numbers of physicians, as well as the names and personally identifiable information of Medicare beneficiaries.
Investigators interviewed staff of two physicians whose names were on the DME billing records as prescribing physicians. Both practices said they never heard of Newburg Services, and none of the beneficiaries on the lists were patients of the physicians. Investigators also contacted beneficiaries purported to have received DME supplies from Newburg Services, and the beneficiaries said they never heard of the company and never received DME supplies from the company.
Bouza remains at large.
Aliyevich Armiran Abukov
In July 2008, Aliyevich Abukov was indicted on charges of Wire Fraud, Aggravated Identity Theft, healthcare Fraud, and Criminal Forfeiture.
Abukov purchased an Oregon corporation known as Quickmed Supply, LLC, and arranged for the location to falsely appear to be engaged in the sale of medical equipment mainly orthotics. As a part of the scheme, Abukov fraudulently obtained and used medical doctors' Unique Physician Identification Numbers as well as patient information to bill Medicare for , medical equipment that were never provided to Medicare beneficiaries.
Investigators believe that from 2007 to 2008, Abukov and others submitted approximately $1.1 million in fraudulent claims to Medicare. As a result, Abukov received $759,340 in fraudulent payments by interstate wire transfer. He opened a bank account designated to receive Medicare reimbursement by wire transfer from a Medicare program contractor in Baton Rouge, Louisiana.
Shafiulla Abdul Hanif
In May 2009, Shafiulla Abdul Hanif was indicted on charges of healthcare Fraud Conspiracy, healthcare Fraud, Money Laundering Conspiracy, and Criminal Forfeiture. Investigators believe that Hanif and his co-conspirators submitted over $18 million in fraudulent claims to Medicare for medical treatments and services that were not provided or were medically unnecessary.
According to court documents, Hanif was a co-owner and controller of TriStar Rehab Services, Inc. (TriStar); S.U.B. Rehabilitation & Physical Therapy Center, Inc. (S.U.B); Hands-On Rehab Services, Inc. (HOR); and M&M Management, Inc. (M&M). All companies were located in the Detroit Area. TriStar and S.U.B. allegedly provided outpatient physical therapy, occupational therapy, and speech pathology services to patients. M&M and HOR allegedly hired and maintained licensed and unlicensed therapists to provide physical and occupational therapy to patients.
Investigators believe that from January 2003 through March 2007, Hanif and his co-conspirators paid Medicare beneficiaries to sign Medicare reimbursement forms for medical treatments and services at their businesses that were actually not provided or were medically unnecessary. Through their companies, Hanif and his co-conspirators then fraudulently filed reimbursement forms with Medicare, seeking over $18 million in payment for these false medical services and treatments.
Hanif fled the United States once he was confronted about his participation in the scheme, and he remains at large. Co-conspirators Muhammad Azeem and Anupal Gayen also fled the United States and remain fugitives. Co-conspirators Suresh Chand, Jaquita Lovelace, Syed Aziz, Solomon Nathaniel, Jay Jha, Baskaran Thangarasan, and Sandeep Aggarwal each pleaded guilty and were sentenced to a combined 22 years in prison and ordered to pay more than $9.7 million in restitution, joint and several.
In February 2010, Luciano Velazquez was indicted on charges of healthcare Fraud, False Statements Related to healthcare Fraud Matters, and Aggravated Identity Theft. Investigators believe that through his fraudulent companies, Velazquez billed Medicare more than $8 million in false claims, collecting approximately $2.9 million.
Velazquez owned and operated Luciano Medical Center and S & A Rehabilitation Center (SARC), both located in Hialeah, Florida, just outside of Miami. Both centers purported to provide medical services, including rare outpatient HIV infusion and cancer drug therapies.
According to the indictment, Velazquez submitted false Medicare Enrollment Applications in order to fraudulently receive claim payments for services allegedly provided by Florida physicians. Additionally, Velazquez allegedly used the identifying information of Medicare beneficiaries to submit claims for services that were never provided.
Velazquez also owned and controlled Velazquez Development of Florida, an alleged shell company by which proceeds from the fraudulent scheme were moved.
Approximately $175,000 was seized from SARC's bank account through a warrant in November 2007.
Velazquez is currently at large.
OIG Fugitive: Jose Garcia-Suarez
In October 2008, Jose Garcia-Suarez was indicted on charges of conspiracy, healthcare fraud, and aggravated identity theft.
From May 2007 to March 2008, Garcia-Suarez and others allegedly billed Medicare for $333,000 for intravenous infusion cancer treatments that were never performed.
Garcia-Suarez was president of Continuum Care Solutions, a company that purportedly provided infusion therapy services. According to the indictment, Garcia-Suarez applied to be a Medicare provider using the illegally obtained identification of four physicians who had Medicare provider numbers. He then used the doctors' names as the company's physicians in order to submit at least nine fraudulent bills for reimbursement from Medicare for intravenous infusion cancer treatments that were never performed.
Authorities believe that Garcia-Suarez may be residing in the Dominican Republic.
OIG Fugitive: Pablo Sanu-Yasell
In October 2008, Pablo Sanu-Yasell was indicted on charges of conspiracy to commit healthcare fraud, healthcare fraud, and aggravated identity theft.
From September 2007 to March 2008, Sanu-Yasell and others allegedly defrauded the Medicare program by submitting $120,000 in fraudulent claims for intravenous infusion cancer treatments that were never performed.
Sanu-Yasell was president of Longer Life Services, a company that purportedly provided infusion therapy services. According to court papers, Sanu-Yasell applied to be a Medicare provider using the illegally obtained identification of four physicians who were Medicare providers. Sanu-Yasell then used the doctors' names as the company's physicians in order to submit fraudulent bills for reimbursement from Medicare for intravenous infusion cancer treatments that were never performed.
Authorities believe that Sanu-Yasell may be residing in the Dominican Republic.
OIG Fugitive: Muhammad Azeem
In May 2009, an arrest warrant was issued for Muhammad Azeem on charges of healthcare fraud conspiracy, healthcare fraud, and money laundering conspiracy. It is believed that through their alleged scheme, Azeem and his accomplices submitted over $18 million in fraudulent claims to Medicare.
According to court documents, from January 2003 through March 2007, Azeem and his co-defendants controlled several medical therapy and medical services companies in Michigan and paid Medicare beneficiaries to sign Medicare reimbursement forms for medical treatment and services that were not provided.
After receiving the signed Medicare forms, it is alleged that Azeem and his accomplices filed the forms with Medicare, seeking payment for services and treatment that were not actually provided to the beneficiaries.
Azeem and his co-conspirators also established several fictitious companies in an effort to conceal the money and assets gained from the scheme.
Azeem fled the United States after being confronted by authorities about his participation in the scheme, and he remains at large.
OIG Fugitive: Ezechukwu "Dr. Joshua" Ohaka
Ezechukwu Ohaka, along with co-conspirators, allegedly submitted more than $3.1 million in fraudulent claims to Medicare for durable medical equipment (DME), according to a Federal indictment. The "gross proceeds of the fraud" allegedly totaled approximately $1.08 million, the indictment stated.
Through his Houston-based company, Luant & Odera, Inc., Ohaka and others allegedly billed for medically unnecessary power wheelchairs, motorized scooters, and wheelchair accessories that were either not medically necessary or were not provided. In some instances, Ohaka and others purportedly would bill Medicare for more expensive wheelchairs than they provided to beneficiaries.
The beneficiaries who received the scooters and wheelchairs had either not been to a doctor, did not have a prescription, as required by Medicare, and/or did not meet medical necessity requirements as defined by Medicare.
Falsely referring to himself as a doctor ("Dr. Joshua Ohaka"), Ohaka and co-conspirators targeted Medicare beneficiaries who were living in the paths of Hurricanes Katrina and Rita.
Ohaka, originally from Nigeria, allegedly paid kickbacks to individuals to recruit Medicare beneficiaries so that Luant could file bogus claims with Medicare for DME.
OIG Fugitive: Gustavo Adolfo Smith
In April 2008, Gustavo Adolfo Smith was convicted on charges of conspiracy to defraud the United States, healthcare fraud, submission of false claims, and money laundering.
According to court records, from February 2005 to May 2007, Smith owned and operated MedStar Services, a durable medical equipment (DME) company in the Miami area. Smith was responsible for submitting more than $2.9 million in bills to Medicare for medical equipment that was never provided to Medicare beneficiaries. From these claims submissions, Smith received approximately $1.5 million from Medicare.
Smith persuaded his associates to register as the president and registered agents of MedStar so he could remain hidden to operate the fraudulent scheme. Smith maintained the majority of control over MedStar and he attempted to launder proceeds from his fraudulent claims by withdrawing and wire-transferring approximately $200,000 to a bank in Canada.
After being convicted, Smith was ordered to wear an electronic monitoring device while awaiting sentencing. On June 14, 2008, Smith's monitoring device set off an alert; authorities responding to the alert were unable to locate Smith. Later on the same day, authorities learned that Smith had boarded a flight from Miami to Santo Domingo, Dominican Republic.
OIG Fugitive: Oleg Kheyson
Between September 2006 and July 2010, in the Eastern District of New York and elsewhere, Oleg Kheyson and others participated in a scheme to defraud Medicare, a U.S. Government-sponsored healthcare program. It is alleged that during the time of the conspiracy and scheme to defraud Medicare, Best Equipment submitted fraudulent claims in the amount of approximately $1.28 million.
Kheyson was a co-owner of Best Equipment, a medical provider certified (or otherwise authorized) to provide medical supplies to Medicare patients at a location on West 1st Street in Brooklyn. In 2008, Kheyson and others requested to add a second Best Equipment site on Brighton 13th Street; Medicare rejected this application, and thus Kheyson was never authorized to treat patients from the Brighton 13th Street site. However, despite this rejection, our evidence shows that from 2006 through July 2010, Kheyson and others billed Medicare for thousands of services from the unauthorized Brighton 13th Street site by submitting the claims through his certified location on West 1st Street.
Kheyson and others also defrauded Medicare by submitting fraudulent claims for orthopedic insoles. In order for Best Equipment to receive reimbursement for orthopedic insoles, the Medicare patient had to have a shoe that was an integral part of a leg brace that was covered by Medicare.
However, upon review of billing data for whom Best Equipment claimed it provided orthopedic insoles, none of the patients received orthopedic shoes or leg braces from Best Equipment or any other Medicare provider; therefore, all of the claims for orthopedic insoles were considered fraudulent.
OIG Fugitive: Tarek Wehbe
Between January 2002 and January 2007, Wehbe, a physician, allegedly submitted fraudulent claims to Medicare, Medicaid, and private health insurance carriers in order to obtain reimbursement for services that were either not provided, medically unnecessary, and/or over-charged.
Wehbe allegedly perpetrated this fraud through the Renaissance Medical Group (RMG), based in Providence, Rhode Island, of which Wehbe was the president and owner. Health insurance carriers reimbursed RMG over $1.8 million by either depositing payments into RMG's bank account or sending reimbursement checks to RMG through the mail .
These funds were deposited into and transferred between Wehbe's personal bank accounts and those of RMG, which he controlled. Wehbe allegedly laundered money through an account in a foreign country.
Also, on more than 100 occasions, Wehbe allegedly issued prescriptions for controlled substances, such as Oxycodone and Hydrocodone, without medical justification.
OIG Fugitive: Eduardo Moreno
According to an April 2007 Federal indictment, Eduardo Moreno allegedly stole hundreds of thousands of dollars from the Medicare program, submitting false and fraudulent claims for durable medical equipment (DME) “and related healthcare benefits, items and services” that were medically unnecessary.
Moreno used a “straw owner” and other methods to hide the money and property he obtained through these fraudulent schemes, the indictment alleged. (A straw owner is an individual who maintains the appearance of owning property in order to disguise the identity of the real owner.)
He was arrested by the Miami Police Department on an open warrant. He failed to appear in court and his current whereabouts are unknown.