Tag Archives: Health Care Fraud

Indictments Returned in Hammond Federal Court (USAO-NDIN)

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HAMMOND, IN—The United States Attorney’s Office announced that the following Indictments were returned on November 8, 2012:

  • Hoosier EMS Roy Dunn, 59, and Kahley Vergon-Mayotte, 27, both of Winimac, Indiana; and Anthony Bitterling, 39, of Monticello, Indiana, were charged in an indictment with conspiracy to commit health care fraud. These charges were filed as the result of an investigation by the Federal Bureau of Investigation, the United States Department of Health and Human Services, and the Indiana Medicaid Fraud Control Unit. This case has been assigned to and will be prosecuted by Assistant United States Attorney Diane Berkowitz.
  • Edwin Tollinchi-Rodriguez, 27, of East Chicago, Indiana, was charged in an indictment with aggravated sexual abuse. This case resulted from an investigation by members of the Indiana Internet Crimes Against Children Task Force, including the Federal Bureau of Investigation; the East Chicago Police Department; and the Lansing, Illinois Police Department. This case has been assigned to and will be prosecuted by Assistant United States Attorney Jill Koster.
  • Kevin Paul Brewster, 40, of Portage, Indiana, was charged in an indictment with four counts of production of child pornography, one count of receipt of child pornography, and one count of possession of child pornography. This case resulted from an investigation by members of the Indiana Internet Crimes Against Children Task Force, including the Federal Bureau of Investigation and the Portage Police Department. This case has been assigned to and will be prosecuted by Assistant United States Attorney Jill Koster.
  • Austin Nwaka, dba Service Above Self, of Canby, Indiana, and Phyllis Lark, dba Absolute Care, of Hammond, Indiana, were charged in an indictment with health care fraud. Lark was also charged with making false statements to a federal agent. These charges were filed as the result of an investigation by the Federal Bureau of Investigation and the Indiana Medicaid Fraud Control Unit. This case has been assigned to and will be prosecuted by Assistant United States Attorney Diane Berkowitz.
  • Daron Moten, 23, of Gary, Indiana, was charged in an indictment with possession of a firearm by a convicted felon. These charges were filed as the result of an investigation by the by the Bureau of Alcohol, Tobacco, Firearms, and Explosives and the Gary Police Department. This case has been assigned to and will be prosecuted by Special Assistant United States Attorney Armando Salinas, Jr.
  • Michael J. Plake, 47, of Lafayette, Indiana, and Paul Cardwell, 46, formerly of Monticello, Indiana, were charged in an indictment with conspiracy to commit mail fraud. These charges were filed as the result of an investigation by the Federal Bureau of Investigation. This case has been assigned to and will be prosecuted by Assistant United States Attorney Diane Berkowitz.

The United States Attorney’s Office emphasized that an indictment is merely an allegation and that all persons charged are presumed innocent until and unless proven guilty in court.

If convicted in court, any specific sentence to be imposed will be determined by the judge after a consideration of federal sentencing statutes and the Federal Sentencing Guidelines.

Detroit-area Physician Sentenced to 60 Months for Health Care Fraud (USAO-EDMI)

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11/6/2012

Jonathan Agbebiyi, 63, of Sterling Heights, Michigan, was sentenced yesterday for his role in a $5.4 million Medicare fraud scheme, announced United States Attorney Barbara L. McQuade. McQuade was joined in the announcement by Assistant Attorney General Lanny A Breuer of the Criminal Division in Washington, DC, Special Agent-In-Charge, Robert Foley, III, Federal Bureau of Investigation and Special Agent in Charge Lamont Pugh III of the Health and Human Services – Office of Inspector General’s (OIG) Chicago Regional Office.

Agbebiyi was sentenced by United States District Judge Arthur J. Tarnow to 60 months in prison, followed by 2 years supervised release, and ordered to pay $2,982,029.19 in restitution.

In May, 2012, Jonathan Agbebiyi, 63, of Sterling Heights, Michigan, was convicted of one count of conspiracy to commit health care fraud, and six counts of health care fraud. Agbebiyi was a staff physician at three clinics which operated in Livonia, Michigan, between 2007 and 2010: Blessed Medical Clinic, Alpha and Omega Medical Clinic, and Manuel Medical Clinic.

According to the evidence presented during the one week trial, Jonathan Agbebiyi, an obstetrician/gynecologist, joined a conspiracy to bill Medicare for medically unnecessary neurological tests. Some of the tests involved sending an electrical current through the arms and legs of the patients. Clinic employees, who lacked any meaningful training, administered the diagnostic tests. The patients never received any follow up treatment by neurologists.
Evidence at trial showed that the patients were not referred to the clinics by their primary care physicians, or for any other legitimate purpose, but rather were recruited with prescriptions for controlled substances, cash payments, and fast food. The three clinics then billed the Medicare program for various diagnostic tests that were medically unnecessary.

United States Attorney Barbara L. McQuade stated, “This doctor exposed patients to electrical currents for neurological testing solely to generate money for himself at the expense of the Medicare program. We hope that cases like this one will deter other doctors from using patients as commodities for personal gain.”

This case was prosecuted by Assistant U.S. Attorneys Frances Lee Carlson and Philip A. Ross of the Eastern District of Michigan, with assistance from Assistant Chief Gejaa T. Gobena of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & 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 their inception in March 2007, strike force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 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.

Two Former Hospital Execs Sentenced For Kickback Scheme

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FOR IMMEDIATE RELEASE
WEDNESDAY, OCTOBER 17, 2012
WWW.JUSTICE.GOV		 AT
(202) 514-2007
TTY (866) 544-5309

TWO FORMER HOSPITAL EMPLOYEES SENTENCED TO SERVE TIME IN
PRISON FOR PARTICIPATING IN KICKBACK SCHEMES AT NEW YORK CITY
HOSPITAL

WASHINGTON — Two former high-ranking employees of facilities operations at New York Presbyterian Hospital (NYPH) were sentenced in U.S. District Court for the Southern District of New York, in Manhattan, by Judge George B. Daniels today for their participation in two separate conspiracies involving kickbacks, the Department of Justice announced today.

Santo Saglimbeni, a former vice president of facilities operations at NYPH, was sentenced to serve 48 months in prison and ordered to pay a $250,000 criminal fine. Emilio “Tony” Figueroa, a former director of facilities operations at NYPH, was sentenced to serve 36 months in prison and ordered to pay a $25,000 criminal fine. Saglimbeni and Figueroa were ordered to jointly and severally pay $603,982 in total restitution to NYPH. Judge Daniels also entered a preliminary order of forfeiture for $2.3 million, which included certain bank accounts into which the kickback money from one of the schemes was deposited, as well as a parcel of land purchased with a portion of the kickback money, in Southampton, N.Y.

“Today’s sentences are consistent with the serious nature of the crimes for which the individuals were convicted,” said Acting Assistant Attorney General Joseph Wayland in charge of the Department of Justice’s Antitrust Division. “The division remains committed to holding accountable corrupt purchasing officials who undermine the competitive bidding process for their personal gain.”

On Feb. 2, 2012, after a four-week trial, Saglimbeni and Figueroa, along with Michael Yaron and two companies owned by him—Cambridge Environmental & Construction Corp., doing business as National Environmental Associates (Cambridge/NEA), and Oxford Construction & Development Corp.; Moshe Buchnik, the president of an asbestos abatement company doing business at NYPH; and Artech Corp., a sham company Saglimbeni created in the name of his mother, were each convicted of conspiracy to defraud NYPH. Additionally, Yaron, Cambridge/NEA, Oxford, Buchnik, Saglimbeni and Artech were also convicted of a wire fraud violation.

According to evidence presented at trial, the scheme to defraud NYPH centered on Saglimbeni, who with the assistance of Figueroa, awarded asbestos abatement, air monitoring and general construction contracts to Yaron, Buchnik and their companies in return for more than $2.3 million in kickbacks paid to Saglimbeni. A portion of those kickbacks were funneled by Yaron to Saglimbeni through Artech.

On July 31, 2012, Saglimbeni and Figueroa each pleaded guilty to additional mail fraud conspiracy and mail fraud violations. These charges were part of the same indictment but had been severed and were scheduled for a separate trial. According to the superseding indictment, the fraud scheme also centered on Saglimbeni, who with the assistance of Figueroa, awarded heating, ventilation and air conditioning (HVAC) contracts to an HVAC vendor in return for kickbacks in the form of cash goods and services paid to Saglimbeni and Figueroa.

On July 10, 2012, Yaron, Buchnik and the three companies were sentenced for their respective roles in the scheme. Yaron was sentenced to serve 60 months in prison and ordered to pay a $500,000 criminal fine. Buchnik was sentenced to serve 48 months in prison and ordered to pay a $500,000 criminal fine. Yaron’s companies, Cambridge/NEA and Oxford Construction, were each sentenced to pay a $1 million criminal fine. Artech was also sentenced to pay a $1 million criminal fine. Including Saglimbeni and Figueroa, 15 individuals and six companies have been convicted or pleaded guilty as a result of this investigation and have been sentenced to pay a total of more than $4 million in criminal fines and to serve more than 16 years in prison.

This antitrust investigation of bid rigging, fraud, bribery and tax-related offenses relating to the award of contracts by the facilities operations department of NYPH was conducted by the Antitrust Division’s New York Field Office with the assistance of the FBI and the Internal Revenue Service – Criminal Investigation’s New York Field Office. The Office of International Affairs in the Justice Department’s Criminal Division also provided assistance. Anyone with information concerning bid rigging, bribery, tax offenses or fraud related at NYPH should contact the Antitrust Division’s New York Field Office of the at 212-335-8000, visit www.justice.gov/atr/contact/newcase.htm, or call the FBI’s New York Division at 212-384-1000.