title: Eight charged locally as part of national health care fraud enforcement action

component: USAO - Texas, Southern

body_text: HOUSTON – Several local residents and others are now charged in six separate cases in the Southern District of Texas (SDTX) with varying counts related to the Justice Department’s 2024 National Health Care Fraud Enforcement Action , announced U.S. Attorney Alamdar S. Hamdani. “The enforcement actions, including one against a Houston-area lab that is alleged to have fraudulently billed Medicare hundreds of millions of dollars, represents our coordinated efforts to combat health care fraud and prosecute those who exploit vulnerable individuals for profit,” said Hamdani. Those charged in the SDTX include Houston residents Sharon Pickrom, 64, Darlene Burbridge, 65, and Carmalita Landry, 53; as well as Ijeoma Victoria Ehieze, 61, Katy; Michael Ogbebor, 43, Richmond; and Harold Albert “Al” Knowles, 56, Delray Beach, Florida, Chantal Swart, 49, Boca Raton, Florida, and Svitlana Meier, 50, Clearwater, Florida. The charges are part of a strategically coordinated, two-week law enforcement action that resulted in criminal charges against a total of 193 people nationwide for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. They allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets. In connection with the enforcement action, authorities seized over $231 million in cash, luxury vehicles, gold and other assets. A federal grand jury indicted Pickrom June 12 with one count of conspiracy to defraud the United States and paying and receiving kickbacks as well as receipt of kickbacks in connection with a $1.7 million health care fraud and kickback scheme. Pickrom allegedly controlled a purported nonprofit corporation, referred false and fraudulent prescriptions that prescribers issued without their knowledge in the name of Department of Labor - Office of Workers' Compensation Programs (DOL-OWCP) claimants, often without their knowledge, to Custom Care Pharmacy in exchange for illegal kickbacks. In a separate but related case, Burbridge and Landry were charged by information with one count of conspiracy to defraud the United States and paying and receiving kickbacks in connection with the same $1.7 million scheme. As alleged in the information, Burbridge owned Criterion Therapy Center, a physical therapy company that serviced DOL-OWCP claimants. She allegedly referred prescriptions to Landry, a pharmacist and owner of Custom Care Pharmacy, in exchange for illegal kickbacks and bribes. Ehieze was indicted June 5 with one count of conspiracy to commit health care fraud, five counts of health care fraud and one count of conspiracy to pay and receive kickbacks. The charges are in connection with an alleged scheme to fraudulently obtain over $1.5 million in Medicare and Medicaid funds. Ehieze, the owner of Sanctified Home Health Services Inc., allegedly billed Medicare and Medicaid for home health services that were not provided and/or not medically necessary and based on illegal kickback payments to marketers and patients. A federal grand jury indicted Ogbebor June 12 with health care fraud in connection with an alleged scheme to fraudulently obtain millions in private insurance funds. According to the charges, Ogbebor was the chief financial officer of Stafford Dialysis before being fired. Following his termination, the indictment alleges Ogbebor created a “phantom” business under the name “Stafford Renal” through which he billed private insurance for dialysis treatments that were never administered to people who were formerly patients of Stafford Dialysis. Ogbebor allegedly billed approximately $26 million to Cigna and Allegiance - private insurance companies - and caused them to pay over $5.1 million to Stafford Renal for services that were not rendered. A federal grand jury indicted Knowles and Swart June 25 with conspiracy to defraud the United States and paying and receiving kickbacks. Knowles is also charged with conspiracy to commit health care fraud, while Swart also faces a charge of receipt of health care kickbacks. The allegations are in connection with a $359 million scheme to bill Medicare for medically unnecessary genetic tests that were induced by kickbacks. As alleged in the indictment, Knowles was the owner of two Houston-area labs, Bio Choice and Bios Scientific. He allegedly entered an agreement with Swart for the referral of Medicare beneficiary DNA samples and signed doctors’ orders for genetic testing Knowles used to bill Medicare through his labs. Knowles allegedly concealed his kickback arrangement with Swart through sham flat fee contracts. The charges allege Knowles knew Swart used call centers and telemedicine doctors to obtain the DNA samples and signed doctors’ orders, and that providers Swart used to obtain these orders were not the beneficiaries’ treating physicians and did not use the genetic testing results to treat the beneficiaries. The final case against Meier was indicted June 12. She is charged with money laundering and unlawfully operating a money transmitting business in connection with a pharmacy at the center of a health care fraud scheme. Meier allegedly owned Kim Long Pharmacy in Houston that billed private insurance companies for medicines the pharmacy never provided to alleged patients. During the course of the conspiracy, the pharmacy received approximately $4.3 million of fraudulent funds from the insurance companies, according to the charges. At the direction of others, Meier then allegedly transferred approximately $3.6 million of the fraudulent proceeds to overseas accounts in Hong Kong and Singapore. Conspiracy to defraud the United States and conspiracy to pay and receive kickbacks carry possible five-year prison sentences. If convicted of conspiracy to commit health care fraud, paying and receiving kickbacks, health care fraud, receipt of health care kickbacks or money laundering, those charged face up to 10 years, while unlawfully operating a money transmitting business carries a possible five-year prison sentence. They could also be ordered to pay hundreds of thousands in fines. FBI, Department of Health and Human Services – Office of Inspector General (OIG), Texas Attorney General’s Office – Medicaid Fraud Control Unit, Department of Homeland Security, DOL-OIG, Veterans Affairs – OIG and U.S. Postal Service – OIG conducted the various investigations. Assistant U.S. Attorneys Kathryn Olson and Grace Murphy of the SDTX and Trial Attorneys Ethan Womble, Devon Helfmeyer, Andrew Tamayo and Monica Cooper of the Department’s Health Care Fraud Strike Force are prosecuting the respective cases. An information or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.


title: Superseding Indictment Charges Physician With Distributing A Controlled Substance And Related Offenses

component: USAO - North Carolina, Western

body_text: CHARLOTTE, N.C., Today, U.S. Attorney Dena J. King announced that a federal superseding indictment was filed in the Western District of North Carolina, charging Henry Ronald Emery, Jr., MD, 52, of Waxhaw, N.C., for the alleged unlawful distribution of a controlled substance. A federal criminal indictment filed in September 2023, charged Dr. Emery, with one count of conspiracy to distribute controlled substances outside the bounds of professional medical practice, and 11 counts of distribution of controlled substances outside the bounds of professional medical practice. In addition to these offenses, the superseding indictment filed on July 11, 2024, charged Dr. Emery with one count of conspiracy to unlawfully use a registration number. “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” “The illicit prescription and distribution of opioids pose a serious threat to public health and safety,” said U.S. Attorney King. “Part of our efforts to fight the opioid epidemic and protect our communities, is identifying those who distribute these substances to our friends, neighbors, and loved ones. Whether it involves physicians improperly prescribing controlled substances or street dealers selling drugs in our neighborhoods, we are committed to holding accountable those who profit by exploiting others’ struggles with substance abuse.” According to the charges, from no later than September 2018 through in or about 2022, Dr. Emery, then a physician licensed to practice medicine in North Carolina, allegedly conspired with other persons to intentionally and unlawfully prescribe, dispense, and distribute, and did unlawfully prescribe, dispense, and distribute, a mixture and substance containing a detectable amount of buprenorphine, a Schedule III controlled substance. It is also alleged that Dr. Emery engaged in the illegal distribution of buprenorphine on multiple occasions and while acting and intending to act outside the usual course of professional practice and not for a legitimate medical purpose. It is further alleged that Dr. Emery knowingly and intentionally conspired and agreed with others to use a registration number issued to another person in connection with the distribution or dispensing of a controlled substance. The Justice Department announced today criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets. The charges against Dr. Emery are allegations. The defendant is presumed innocent until proven guilty beyond a reasonable doubt in a court of law. In making today’s announcement, U.S. Attorney King thanked the DEA and IRS-CI for their investigation of the case. Assistant U.S. Attorneys Nick J. Miller and William Bozin of the U.S. Attorney’s Office in Charlotte are prosecuting the case.


title: Montclair Pharmacist Charged with Submitting Over $300 Million in Fraudulent Claims to Medi-Cal in Medication Reimbursement Scam

component: USAO - California, Central

body_text: LOS ANGELES – An Inland Empire pharmacist has been charged with using his Montclair pharmacy to submit more than $300 million in fraudulent Medi-Cal claims for prescription medications that were medically unnecessary, often not provided to patients, and were obtained through the payment of tens of millions of dollars in illegal kickbacks, the Justice Department announced today. Kyrollos Mekail, 36, of Moreno Valley, is charged with two counts of health care fraud. He is expected to be arraigned in the coming weeks in United States District Court. The charges filed in federal court are part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action . “This case alleges that a licensed pharmacist committed an enormous fraud against a public health program designed to help our state’s neediest residents,” said United States Attorney Martin Estrada. “Bringing to justice those who unlawfully take from the public is a priority for my office, especially where those offenders harm the most vulnerable in our community.” “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” “Healthcare fraud victimizes patients, endangers the health of vulnerable people, and plunders healthcare programs,” said FBI Director Christopher Wray. “This wide-ranging collaboration demonstrates the FBI’s commitment to rooting out predatory healthcare fraud, protecting patients, and ensuring critical healthcare funds go where they are needed most.” According to court documents, Mekail is a licensed California pharmacist who owns, operates, and is the pharmacist-in-charge of the Montclair-based Monte VP LLC, which does business as Monte Vista Pharmacy. Monte Vista Pharmacy is a provider under Medi-Cal, a California health care benefit program that provides reimbursement for medically necessary health care services for low-income individuals – including families with children, seniors, persons with disabilities, individuals in foster care, and pregnant women – and receives a significant amount of federal funding. In early 2022, Medi-Cal suspended its requirement that health care providers obtain prior authorization before providing certain health care services or medications as a condition of reimbursement. The suspension of the prior authorization requirements was part of an ongoing transition of Medi-Cal’s prescription drug program to a new payment system. From May 2022 to March 2023, Mekail and his co-schemers allegedly exploited Medi-Cal’s prior authorization suspension by billing Medi-Cal tens of millions of dollars per month for dispensing high-reimbursement, non-contracted, generic drugs through Monte Vista Pharmacy. Some prescription medications purportedly were to treat pain and also included Folite tablets, a vitamin available over the counter. Normally, these high-cost reimbursement medications would have required prior authorization under Medi-Cal’s old payment system. The information alleges the medication involved in this scheme was medically unnecessary, frequently was not dispensed to patients, and procured by kickbacks. In less than one year, Monte Vista Pharmacy billed Medi-Cal approximately $306,521,392 for the medications, of which Medi-Cal paid Monte Vista Pharmacy approximately $204,032,151, according to court documents. Mekail allegedly paid two co-schemers more than $36 million of the fraudulently obtained Medi-Cal proceeds as kickbacks for referring the prescriptions. He allegedly disguised these kickbacks as payments for “consulting services.” “Health care fraud affects every American,” said Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division. “It siphons off hard-earned tax dollars meant to provide care for the vulnerable and disabled. In doing so, it also raises the cost of care for all patients. Even worse, as the prosecutions we announce today underscore, health care fraud can harm patients and fuel addiction. The Criminal Division is committed to rooting out health care fraud, wherever it may be found, no matter who commits it. And we are using more tools than ever before to uncover misconduct and hold wrongdoers to account, whether they are executives in corner offices or doctors who violate their oaths.” “This work is important to the Department of Health and Human Services (HHS) and the millions of Americans we serve. HHS vigorously pursues anyone who commits fraud against our health care programs. But it takes all of us, working together, to be successful,” said HHS Deputy Secretary Andrea Palm. “Those who steal from these programs are stealing from the American families who rely on them and putting patients at risk. We won’t stop until all those who try to defraud the federal government are caught and held accountable.” “We will not tolerate fraud that preys on patients who need and deserve high quality health care,” said the HHS-OIG Inspector General Christi A. Grimm. “The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today’s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.” An information is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. If convicted of all charges, Mekail would face a statutory maximum sentence of 10 years in federal prison for each count of health care fraud. The United States Department of Health and Human Services Office of Inspector General (HHS-OIG), the FBI, and the California Department of Justice are investigating this matter. Assistant United States Attorney Roger A. Hsieh of the Major Frauds Section and Assistant Chief Niall M. O’Donnell and Trial Attorney Siobhan M. Namazi of the U.S. Department of Justice, Criminal Division, Fraud Section are prosecuting this case. Assistant United States Attorney James E. Dochterman of the Asset Forfeiture and Recovery Section is handling asset forfeiture matters in this case.


title: Kalamazoo Doctor Charged for Role in Telehealth Fraud Scheme

component: USAO - Michigan, Western

body_text: Case part of Department of Justice’s 2024 National Health Care Fraud Enforcement Action GRAND RAPIDS, MICHIGAN — U.S. Attorney for the Western District of Michigan Mark Totten today announced that Theresa A. Kordish, D.O. has admitted in a plea agreement to costing Medicare over $794,000, by using a telehealth application to improperly approve orders for medical braces and genetic testing. The charges filed in this case are part of the U.S. Justice Department’s 2024 National Health Care Fraud Enforcement Action . Dr. Kordish signed and certified that each order was medically indicated and necessary for a particular Medicare beneficiary. In reality, Dr. Kordish clicked to approve orders in a matter of seconds, without conducting any meaningful review. On June 18, 2024, Kordish was charged by Felony Information with making a false statement in a matter involving the Medicare program. Kordish will be arraigned on the charge and a plea hearing will be held in July 2024. “Medicare is a lifeline to millions of Americans, and its viability depends on the good faith and honesty of doctors to ensure that funds are spent appropriately,” said U.S. Attorney Mark Totten . “When doctors violate their sacred trust, they damage the integrity of our entire healthcare system. My office has zero tolerance for medical fraud.” “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland . “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” According to Dr. Kordish’s admissions in her plea agreement, she worked with a purported telehealth company called Real Time Physicians LLC, to approve orders for medical braces and genetic testing. Real Time did not operate a legitimate telehealth company, but instead created and maintained an internet-based exchange that produced fraudulent medical records, which were used to cause Medicare to pay fraudulent claims. Despite certifying that she had conducted the required medical review for each order she signed, Dr. Kordish approved most orders in less than 60 seconds, and still others in as little as 20 seconds—approximately the minimum time necessary to click through and apply an electronic signature. In June 2022, a federal court sentenced Real Time’s owner, Marc Sporn, to 14 years in prison for his role in the scheme. “When practitioners submit false claims to our federally funded insurance programs, whether it be for prescription drugs or durable medical equipment, it severely undermines the integrity placed in our healthcare providers and contributes to millions of dollars in losses that could go to patients in need,” said Cheyvoryea Gibson, Special Agent in Charge of the FBI in Michigan. “With the support of our law enforcement partners, the FBI will continue to hold responsible all who try to defraud the government.” “We will not tolerate fraud that preys on patients who need and deserve high quality health care,” said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG) . “The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today’s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.” The charges announced today by U.S. Attorney Mark Totten are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets. The Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals’ Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit’s Data Analytics Team. Descriptions of each case involved in today’s enforcement action are available on the Department’s website here . This case is being investigated by the Department of Health and Human Services Office of Inspector General (HHS-OIG) and Federal Bureau of Investigation. It is being prosecuted by Assistant United States Attorney Patrick Castle. A complaint, felony information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. ###


title: National Enforcement Action Results in 193 Individuals Charged, Including 2 in West Virginia, for Over $2.75 Billion in False Claims and Controlled Substance Abuse Schemes

component: USAO - West Virginia, Southern

body_text: CHARLESTON, W.Va. – United States Attorney Will Thompson announced criminal charges today against a Logan County physician and a Kentucky registered nurse in connection with separate alleged controlled substance abuse schemes. The charges filed in federal court are part of the Justice Department’s 2024 National Health Care Fraud Enforcement Action. “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” “The indictments handed up in the Southern District of West Virginia allege that the defendants betrayed their duties as health care providers for personal gain,” Thompson said. “The nationwide enforcement action announced today shows the commitment of the U.S. Department of Justice and this office to safeguard patients and the health care system from abuse and fraud.” The charges announced today by Thompson are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and controlled substance abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets. The Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals’ Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit’s Data Analytics Team. Descriptions of each case involved in today’s enforcement action are available on the Department’s website . The Southern District of West Virginia, in particular, worked with the Department’s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Drug Enforcement Administration (DEA) and the Food and Drug Administration-Office of Criminal Investigations (FDA-OCI). The following individuals have been charged in the Southern District of West Virginia: Brian McDevitt, D.O., 60, of Chapmanville, was charged by indictment with three counts of unlawful distribution of a controlled substance in connection with prescribing clonazepam outside the scope of professional practice and not for a legitimate medical purpose. As alleged in the indictment, McDevitt, a sole practitioner operating the Chapmanville Medical Clinic, knowingly issued clonazepam prescriptions on three separate dates that were outside the scope of professional practice and not for a legitimate medical purpose. The case is being prosecuted by Assistant United States Attorneys Owen Reynolds and Francesca Rollo. Jacqueline Brewster, 54, of Belfry, Kentucky, was charged by indictment with one count of obtaining controlled substances by fraud, one count of tampering with consumer products, and one count of wrongfully obtaining individually identifiable health information under false pretenses and with intent to use for personal gain in connection with the theft of, and tampering with, vials of hydromorphone at a hospital in Raleigh County, West Virginia. As alleged in the indictment, Brewster, a travel nurse, used her credentials to access hydromorphone for her own personal use. Brewster tampered with the hydromorphone vials by diluting the remaining liquid in the bottles to make it appear as though they were full. As part of this scheme, Brewster accessed patient files for patients not assigned to her. The case is being prosecuted by Assistant United States Attorney Owen Reynolds. A complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. A copy of this press release is located on the website of the U.S. Attorney’s Office for the Southern District of West Virginia. Related court documents and information can be found on PACER by searching for Case Nos. 2:24-cr-96 McDevitt) and 5:24-cr-104 (Brewster). ###


title: Virginia Company and Owner Sentenced for Criminally Filling Wetlands

component: Energy and Natural Resources Division

body_text: Boyd Farm LLC and its owner Frazier T. Boyd III were sentenced yesterday for criminally filling wetlands in Goochland and Louisa Counties, Virginia. Boyd Farm was sentenced to pay a fine of $300,000 and serve a year of probation for a felony violation of the Clean Water Act. Boyd was sentenced to 30 days home confinement and a year of probation. At various times between 2017 and 2019, Boyd and his company had workers use excavators and other earthmoving equipment to pull vegetation, grub stumps and grade land at three sites in Virginia’s Piedmont region. The work left behind piles of dirt, slash and stumps. Operators hired by Boyd Farm then placed debris from those piles into wetlands and streams at the properties. The Clean Water Act requires permits for such discharges into covered wetlands and other waters of the United States. Unpermitted discharges like these can destroy habitat and degrade the pollution cleaning function of wetlands. The United States does issue permits to fill wetlands under some conditions. Boyd Farm and Boyd knew of the requirement for these permits but did not seek or obtain them for any of their properties. In 2015, the Environmental Protection Agency (EPA) had issued Boyd Farm an Administrative Order requiring compliance with the Clean Water Act and requiring restoration of impacted wetlands and streams at another property in Goochland County where unpermitted discharges had occurred. Assistant Attorney General Todd Kim of the Justice Department’s Environment and Natural Resources Division and U.S. Attorney Jessica D. Aber for the Eastern District of Virginia made the announcement. EPA’s Criminal Investigation Division investigated the case, with assistance from the Virginia Department of Environmental Quality. Trial Attorney Elise Kent Bernanke of the Environment and Natural Resources Division and Assistant U.S. Attorney Michael Moore for the Eastern District of Virginia prosecuted the case.


title: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims

component: USAO - Michigan, Eastern

body_text: DETROIT - Today, United States Attorney Dawn N. Ison announced criminal charges against six defendants in connection with alleged schemes to defraud Medicare. The charges filed in federal court in Detroit are part of the Justice Department’s 2024 National Health Care Fraud Enforcement Action. “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” “Medicare is an essential safety net for seniors and individuals with disabilities. The Department of Justice and my office are committed to investigating and prosecuting those who steal taxpayer funds intended to protect vulnerable members of our community,” said United States Attorney Dawn N. Ison. “We will not tolerate fraud that preys on patients who need and deserve high quality health care,” said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). “The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today’s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.” The charges announced today by U.S. Attorney Ison are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 147 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.5 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the government, in connection with the enforcement action, seized over $150 million in cash, luxury vehicles, gold, and other assets. The Eastern District of Michigan, in particular, worked with the Department’s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation. The following individuals have been charged in the Eastern District of Michigan: • Ibrahim Sammour, 63, and Bashier Sammour, 28, of Wayne County, Michigan, were charged by indictment with conspiracy to pay illegal kickbacks, Ibrahim Sammour was additionally charged with conspiracy to commit health care fraud and health care fraud, and Bashier Sammour was additionally charged with making false statements relating to health care matters, all in connection with an alleged scheme to fraudulently obtain over $2 million from Medicare. According to charging documents, the Sammours operated Individualized Home Health Care, P.C., through which they submitted false and fraudulent claims to Medicare for home health care services that were medically unnecessary, not provided as represented, or not rendered. Five others were also charged by information—two registered nurses, two group home owners, and a licensed practical nurse—for their involvement in the charged conspiracies. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Jeff Crapko of the Midwest Strike Force. • Yvette Hardy, 60, of Wayne County, Michigan, was charged by information with health care fraud in connection with an alleged scheme to fraudulently obtain over $3.4 million in Medicare funds. According to the information, Hardy, who owned and operated Pebble Brook Care Agency LLC, caused the submission of false and fraudulent claims to Medicare for psychotherapy services that were not provided as represented or not rendered at all. The case is being prosecuted by Trial Attorney Shankar Ramamurthy of the Midwest Strike Force. • Ruby Scott, 53, of Oakland County, Michigan, was charged by indictment with a conspiracy to defraud the United States and to pay illegal health care kickbacks, as well as with paying illegal health care kickbacks, in connection with an alleged scheme to fraudulently obtain over $2.2 million in Medicare funds. According to the indictment, Scott, who owned and operated Delta Home Health Care LLC, caused the submission of claims to Medicare for home health care services obtained through the payment of illegal kickbacks to patient recruiters in violation of the Anti-Kickback Statute. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Kelly Warner of the Midwest Strike Force. • Dr. Vijil Rahulan, 52, of Hyderabad, India, was charged by indictment with conspiracy to commit heath care fraud and health care fraud, in connection with an alleged scheme to fraudulently obtain over $82 million in Medicare funds. As alleged in the indictment, Rahulan caused the submission of false and fraudulent claims for DME and genetic testing that were medically unnecessary or otherwise ineligible for reimbursement through Medicare because they were not the product of a doctor-patient relationship and examination. The indictment further alleges that the defendant’s fraudulent conduct resulted in over $28.7 million being paid by Medicare. The case is being prosecuted by Trial Attorneys Kelly Warner and Andres Almendarez of the Midwest Strike Force. • Amro Sharafeldin, 40, of Michigan, was charged by criminal complaint with a scheme to violate the Anti-Kickback Statute and illegally purchase Medicare beneficiary information, in connection with Sharafeldin’s operation of Prestige Specialty Pharmacy (“Prestige”) in Sterling Heights, Michigan. As alleged in the complaint, Sharafeldin, through Prestige, agreed to pay kickbacks and bribes to illegally acquire Medicare beneficiary information, which he and others then used in February and March 2023 to bill Medicare more than $1 million for OTC COVID-19 tests, regardless of whether the Medicare beneficiary requested the test kits. The case is being prosecuted by Assistant U.S. Attorney Andrew Lievense of the U.S. Attorney’s office for the Eastern District of Michigan. A complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. Descriptions of each case involved in today’s enforcement action are available on the Department’s website here .


title: Windsor Man Pleads Guilty in Case Involving Thousands of Fake Calls to the Veteran’s Affairs Crisis Line

component: USAO - North Carolina, Eastern

body_text: RALEIGH, N.C. – A Windsor man pleaded guilty today to making false statements to the United States Department of Veteran’s Affairs (VA) Crisis Line after making more than 12,000 calls to the hotline as a non-veteran, often providing fake names and addresses, and, in some cases, causing emergency services to be dispatched. “This defendant made more than 12,000 fake cries for help to a hotline intended to provide assistance to the brave men and women who served in our military,” said U.S. Attorney Michael Easley. “This tied up hotline operators who could have been helping true veterans – not to mention the resources wasted when emergency services was dispatched.” According to court documents and other information presented in court, Ricky Ray Ryan, Jr., 31, a non-veteran, contacted the VA Crisis Line over 12,000 times between 2016 and 2023. The VA Crisis Line is operated by the VA for veterans experiencing difficult life events or challenges after leaving the military.VA Crisis Line employees are trained to remain online with callers until their services are no longer needed or emergency services are dispatched. During each of his calls to the VA Crisis Line, Ryan, who used a software program to mask his identity, reported to be experiencing suicidal ideations, and then provided fake names, false addresses, and dates of birth. On many occasions, emergency services were dispatched in response to Ryan’s claims, but the addresses Ryan provided were either fake or not his actual address. Ryan pleaded guilty to one count of making a false statement and faces a penalty of up to five years in prison when sentenced. Michael Easley, U.S. Attorney for the Eastern District of North Carolina made the announcement after U.S. District Judge James C. Dever III accepted the plea. The United States Department of Veteran’s Affairs, Office of Investigation, is investigating the case and Special Assistant U.S. Attorney Lisa K. Labresh is prosecuting the case. Related court documents and information can be found on the website of the U.S. District Court for the Eastern District of North Carolina or on PACER by searching for Case No. 2:24-cr-1-D-RN. ###


title: U.S. Attorney Breon Peace Announces 11 Arrests in National Health Care Fraud Enforcement Action

component: USAO - New York, Eastern

body_text: Today, United States Attorney Breon Peace announced criminal charges against nine defendants in connection with alleged schemes to defraud Medicare and Medicaid. Merrick B. Garland, United States Attorney General; Breon Peace, United States Attorney for the Eastern District of New York; Nicole M. Argentieri, Principal Deputy Assistant Attorney General and head of the Justice Department’s Criminal Division; James Smith, Assistant Director-in-Charge, Federal Bureau of Investigation; Ivan J. Arvelo, Special Agent-in-Charge, Homeland Security Investigations, New York (HSI); Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG); Thomas M. Fattorusso, Special Agent-in-Charge, Internal Revenue Service Criminal Investigation, New York, (IRS-CI); and Raymond A. Tierney, Suffolk County District Attorney, announced the arrests and charges. “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” stated Attorney General Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” “These defendants have been charged with treating the Medicare and Medicaid programs like cash registers they could use to ring up withdrawals from the public treasury straight into their pockets,” stated United States Attorney Peace. “The enforcement actions announced today demonstrate my Office’s resolve to prosecute those who exploit our health care benefits programs for personal gain.” Mr. Peace expressed his appreciation to the U.S. Drug Enforcement Administration, the New York City Police Department and the New York City Human Resources Administration, for their work on the cases. “Health care fraud affects every American,” stated Principal Deputy Assistant Attorney General Argentieri. “It siphons off hard-earned tax dollars meant to provide care for the vulnerable and disabled. In doing so, it also raises the cost of care for all patients. Even worse, as the prosecutions we announce today underscore, health care fraud can harm patients and fuel addiction. The Criminal Division is committed to rooting out health care fraud, wherever it may be found, no matter who commits it. And we are using more tools than ever before to uncover misconduct and hold wrongdoers to account, whether they are executives in corner offices or doctors who violate their oaths.” “These nine defendants allegedly submitted bills for services not provided collecting millions in reimbursements from Medicare and Medicaid programs. This is yet another unfortunate example of individuals abusing government services intended to help patients in need. These actions are representative of the FBI’s nationwide efforts to bring justice to criminals who attempt to manipulate healthcare programs for personal benefits,” stated FBI Assistant Director-in-Charge Smith. “As alleged, the defendants abused their positions and power to exploit vulnerabilities in the Medicare and Medicaid systems to the tune of $7.1 million in illicit funds. Through the American Medical Utilization Management Corporation (AMC), these purported medical providers are accused of flouting vital narcotics regulations and healthcare practices despite the incalculable risks to the public,” said HSI New York Special Agent in Charge Ivan J. Arvelo. “HSI New York, through the New York OCEDTF Strike Force and in coordination with our law enforcement partners, is committed to disrupting the illegal distribution of prescription drugs by utilizing its broad statutory authorities to bring to an end the plague of overprescribed pharmaceuticals.” “We will not tolerate fraud that preys on patients who need and deserve high quality health care,” stated HHS-OIG Inspector General Grimm. “The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today’s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.” “Health care providers are rightly expected to treat their patients with honesty and integrity, often in the most vulnerable times,” stated IRS-CI Special Agent-in-Charge Fattorusso. “The defendants in this case are accused of or have been convicted of betraying this sacred trust strictly for their own greed and financial gain. Today’s actions should serve to restore integrity in the system and put those who engage in these fraudulent acts on notice that law enforcement will not turn a blind eye.” “My Office remains committed to stand and work with our federal partners in combatting crime and keeping our citizens safe," stated Suffolk County District Attorney Tierney. “Those who seek to illegally profit off the backs of hardworking U.S. taxpayers will be found out and brought to justice. The defrauding of our citizens will not be tolerated.” U.S. v. Feng Jiang On June 26, 2024, Feng Jiang was charged by indictment with conspiracy to commit health care fraud, conspiracy to defraud the United States and pay health care kickbacks, conspiracy to commit money laundering and money laundering in connection with an alleged $24 million scheme involving multiple New York pharmacies. As alleged in the indictment, Jiang and his co-conspirators paid kickbacks in the form of supermarket gift certificates and cash to Medicare beneficiaries and Medicaid recipients who filled medically unnecessary prescriptions at Elmcare Pharmacy Inc. and NY Elm Pharmacy Inc. The indictment further alleges that Jiang and others wrote checks to various “trading companies” to obtain cash that was distributed as profits amongst the pharmacies’ owners and used to pay illegal kickbacks and bribes. The case is being prosecuted by Trial Attorney Patrick J. Campbell of the Criminal Division, Fraud Section, Health Care Fraud Unit, Northeast Strike Force, which is based out of the Office’s Business and Securities Fraud Section. U.S. v. Joseph Tony Brown-Arkah and Evens Jean On June 26, 2024, Joseph Tony Brown-Arkah and Evens Jean were charged by indictment in connection with an alleged $7.1 million health care fraud scheme and narcotics distribution. Brown-Arkah and Jean were charged with conspiracy to commit health care fraud, health care fraud, conspiracy to distribute narcotics and narcotics distribution, and Jean was also charged with false statements. As alleged in the indictment, Brown-Arkah, the owner of American Medical Utilization Management Corporation (AMC), a medical clinic in Brooklyn, along with Jean, a nurse practitioner, and others, engaged in an alleged scheme to bill Medicare and Medicaid fraudulently for services not provided or not provided as billed, and to prescribe narcotics pursuant to prescriptions that were not issued for a legitimate medical purpose by a provider acting in the usual course of professional practice. In particular, AMC was a purported provider of medicated addiction treatment and had a significant number of patients being treated with buprenorphine (Suboxone), a Schedule III narcotic. Many of these patients received prescriptions written by Jean, who lived in Florida and did not see or speak with the patients; instead, Jean issued the narcotics prescriptions based on information provided by individuals not entitled to prescribe buprenorphine, some of whom were not licensed medical professionals. As alleged in the indictment, Jean also made multiple false statements to law enforcement regarding his prescriptions of buprenorphine. The case is being prosecuted by Trial Attorneys Miriam Glaser Dauermann of the Department’s National Rapid Response Strike Force and Margaret Mortimer of the Criminal Division, Fraud Section, Health Care Fraud Unit, Northeast Strike Force, which is based out of the Office’s Business and Securities Fraud Section. For patients who are prescribed a controlled substance medication and have lost access to their healthcare provider, contact either of these virtual treatment providers for evaluation, prescription for medication to help manage opioid withdrawal (buprenorphine, as applicable), and referral to outpatient care: Virtual Express Care (NYC Health and Hospitals) (631) 397-2273; 24 hour/day, 7 days/week www.expresscare.nyc or MATTERS Medication for Addiction Treatment (765) M-A-T-T-E-R-S [(765) 628-8377] www.mattersnetwork.org Referrals to harm reduction services and drug treatment programs: Call the OASAS (Office of Addiction Services and Supports) 24/7 HOPEline 1-877-8-H-O-P-E-N-Y or text HOPENY (467369) U.S. v. Albert Muratov Albert Muratov pleaded guilty on June 11, 2024 to health care fraud in connection with a scheme to defraud Medicare by billing for undispensed cancer medication. Muratov, who operated Ave M Pharmacy in Brooklyn, New York, along with Artom Rafaelov and others, handled the pharmacy’s finances and payments and, together with others, caused the submission of approximately 253 claims to Medicare for Targretin Gel 1%. Targretin is a prescription drug used to treat skin conditions caused by Cutaneous T-Cell Lymphoma, a rare skin cancer. The average wholesale price for a 60-gram tube of Targretin Gel 1% was over $34,000. From 2017 to 2021, the defendant and his co-conspirators, including Rafaelov, billed Medicare for Targretin that was medically unnecessary, not ordered by a professional, or that they did not dispense; as a result, Medicare paid Ave M Pharmacy more than $4 million. The government’s case is being handled by the Office’s Business and Securities Fraud Section. Assistant U.S. Attorney John Vagelatos is in charge of the prosecution. U.S. v. Artom Rafaelov Artom Rafaelov pleaded guilty on September 28, 2022 to a criminal information charging him with health care fraud. Rafaelov owned and operated Ave M pharmacy in Brooklyn. Between approximately February 2017 and September 2021, Rafaelov and co-conspirator Albert Muratov defrauded Medicare by causing Ave M to submit fraudulent claims for Targretin Gel 1% (described above) that were neither purchased nor stocked by Ave M; and not medically necessary or not prescribed by the doctors that Ave M claimed had prescribed the medication. In March 2024, Rafaelov was sentenced by United States District Judge William F. Kuntz II to 37 months’ imprisonment and ordered to pay $4.2 million in restitution to Medicare. The government’s case is being handled by the Office’s Business and Securities Fraud Section. Assistant U.S. Attorney John Vagelatos is in charge of the prosecution. U.S. v. Ahmed et al. On June 11, 2024, Noman Ahmed, Adnan Arshad, Rehman Diwan, Jessica Hendrickson, Jose Marte, Mohammed Saleem, Faisal Shamsi and Waqas Shamsi were arrested on a eight-count indictment charging them with conspiracy to commit health care fraud, health care fraud, conspiracy to defraud the United States and pay health care kickbacks, paying health care kickbacks, and money laundering. The defendants owned, operated and were employees of several transportation companies. From approximately December 2020 to the present, the defendants paid illegal health care kickbacks to Medicaid beneficiaries so that those beneficiaries would order medical transportation services specifically from the defendants, which generally included transportation to addiction treatment centers for the beneficiaries’ purportedly necessary methadone treatment. The defendants generally did not provide the medical transportation services ordered by the Medicaid beneficiaries. In total, the defendants and their transportation companies – 668 MTK Taxi LLC, All-Star Taxi LLC, Apollo Transportation, Sunrise Taxi LLC, and Transportation Solution NY Corp. d/b/a A1 Transport – fraudulently billed Medicaid millions of dollars for these services throughout the course of the scheme. At least two claims were submitted to Medicaid for individuals who were deceased, and some claims were submitted for individuals who were hospitalized or incarcerated. The government’s case is being prosecuted by Assistant U.S. Attorney Adam Toporovsky of the Criminal Section of the Office’s Long Island Division, and Special Assistant U.S. Attorney Jennifer Milito. * * * The charges in the indictments are allegations and the defendants are presumed innocent unless and until proven guilty. The enforcement actions announced today by U.S. Attorney Peace are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings to government programs. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Department of Justice, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold and other assets. The Defendants : FENG JIANG (also known as “Jeff”) Age: 42 Oakland Gardens, Queens E.D.N.Y. Docket No. 24-CR-264 _______________________________ JOSEPH TONY BROWN-ARKAH Age: 76 Brooklyn, New York EVENS JEAN Age: 58 Cape Coral, Florida E.D.N.Y. Docket No. 24-CR-263 ______________________________ ALBERT MURATOV Age: 46 Forest Hills, Queens E.D.N.Y. Docket No. 24-CR-164 (WFK) ______________________________ ARTOM RAFAELOV Age: 41 Fresh Meadows, Queens E.D.N.Y. Docket No. 22-CR-368 (WFK) ______________________________ NOMAN AHMED Age: 37 Port Jefferson Station, New York ADNAN ARSHAD (also known as “Eddie”) Age: 45 Mount Sinai, New York REHMAN DIWAN Age: 24 Hicksville, New York JESSICA HENDRICKSON Age: 36 Patchogue, New York JOSE MARTE Age: 33 Bronx, New York MOHAMMED SALEEM Age: 38 Dix Hills, New York FAISAL SHAMSI (also known as “Jimmy”) Age: 49 Massapequa, New York WAQAS SHAMSI (also known as “Ricky”) Age: 44 Massapequa, New York E.D.N.Y. Docket No. 24-CR-231 (JMA)


title: Illinois Man Sentenced to 15 Months’ Imprisonment for Fraud Involving Luxury Vehicles

component: USAO - Wisconsin, Eastern

body_text: Gregory J. Haanstad, United States Attorney for the Eastern District of Wisconsin, announced that on June 26, 2024, Tomasz Bazarewicz (age: 39) was sentenced to fifteen months’ imprisonment for conspiring to commit money laundering. Bazarewicz’s term of imprisonment will be followed by three years of supervised release. Along with his coconspirators, Bazarewicz also will be responsible for paying $3,500,000 in restitution to his victims. Publicly filed documents in the case reflect that Bazarewicz and his coconspirators engaged in a sophisticated scheme to defraud vehicle brokers and dealerships involving the foreign sale of luxury automobiles. Over the course of the conspiracy, Bazarewicz both lied to the conspirators’ customers, calming their fears about missing automobiles, and laundered the conspiracy’s proceeds during luxury gambling trips. All told, Bazarewicz was responsible for laundering over three million dollars of ill-gotten funds. “At the time he learned of the ongoing conspiracy, Mr. Bazarewicz was professionally successful and doing well financially,” said U.S. Attorney Haanstad. “Despite this, rather than avoiding the criminal conduct or doing the right thing by reporting it, he joined in and helped further it for his own financial gain. I commend the hard work of the investigating agents and all who worked to hold the conspirators accountable in this matter.” “Our commitment to justice is unwavering, and the outcome of this case exemplifies our dedication to dismantling criminal enterprises that exploit the financial system,” said Ramsey Covington, acting Special Agent in Charge, IRS Criminal Investigation, Chicago Field Office. “The collaborative efforts of IRS Criminal Investigation and the U.S. Attorney’s Office has been instrumental in achieving this result, ensuring Bazarewicz and his co-conspirators are held accountable for their criminal activities.” At the sentencing hearing, United States District Judge Lynn Adelman noted that confinement was appropriate in Bazarewicz’s case to deter other would-be fraudsters from engaging in similar conduct. Judge Adelman also noted that while Bazarewicz was not the conspiracy’s ringleader, he took an active role in advancing these crimes, establishing his own subsidiary company to be used in the scheme and encouraging other members of the conspiracy, via text message, to “run it up.” This matter was investigated by the Criminal Investigation division of the Internal Revenue Service. It was prosecuted by Assistant United States Attorneys Laura Kwaterski and Kevin Knight. # # # For Additional Information Contact: Public Information Officer Kenneth.Gales@usdoj.gov 414-297-1700 Follow us on Twitter


title: Former Regions Bank Manager Pleads Guilty to Embezzlement and Bank Fraud Scheme

component: USAO - Louisiana, Middle

body_text: United States Attorney Ronald C. Gathe, Jr. announced that Eric Jason Schouest, age 53, of Plaquemine, Louisiana, pled guilty before U.S. District Judge John W. deGravelles to embezzlement and bank fraud. Schouest’s embezzlement and bank fraud convictions are each punishable by a maximum penalty of 30 years in prison, a fine of $1 million, and a period of supervised release. According to admissions made during his plea, Schouest was employed at Regions Bank from 2010 to 2021 as a branch manager overseeing business transactions and practices at the Regions Bank Plank Road branch. In his capacity as branch manager, he had the authority to access customer accounts, instruct others to open and close accounts, issue cashier’s checks, and transfer funds in and out of bank customers’ accounts. Beginning in or about 2020, and continuing through in or about April 2021, Schouest exploited his position of trust at Regions Bank to embezzle funds from customer accounts and deposit the money into his personal bank accounts. He also sent false and fraudulent emails and forged documents to other Regions Bank employees to conceal his scheme. Some of the traceable fraudulent funds were used to make loan payments on personal items such as a house and a car. Through his scheme, Schouest misappropriated more than $250,000 from Regions customer bank accounts. This matter is being investigated by the Social Security Administration Office of the Inspector General, the United States Treasury Inspector General for Tax Administration, and the U.S. Secret Service. The case is being prosecuted by Deputy Criminal Chief Edward H. Warner and Litigation Counsel Jennifer M. Kleinpeter.


title: Eastern District of Wisconsin Participates in National Health Care Fraud Law Enforcement Action

body_text: Today, United States Attorney Gregory J. Haanstad announced that a grand jury had indicted Lori Banyard Butts (age 47; of Wales, Wisconsin) in connection with an alleged scheme to defraud Wisconsin Medicaid and the Centers for Medicare and Medicaid Services. The indictment charges Butts with eight counts of healthcare fraud, in violation of Title 18, United States Code, Section 1347, and eight counts of wire fraud, in violation of Title 18, United States Code, Section 1343. The indictment alleges that through her company, Butts billed for the staffing of adult family homes that was not provided. The indictment alleges that her company received approximately $1.4 million to which it was not entitled, and that Butts then converted a substantial portion of this money to her personal use. U.S. Attorney Haanstad explained that the indictment in this case was part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action, which was a strategically coordinated, two-week initiative that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. More on the nationwide effort, including statements from the Attorney General and the leadership of other participating federal agencies and departments can be found here https://www.justice.gov/opa/pr/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over-275-0 . If convicted, Butts would face up to ten years’ imprisonment on each of the health care fraud counts and up to 20 years’ imprisonment on the wire fraud counts. Each count of conviction also could result in a fine of up to $250,000. The case was investigated by FBI-Milwaukee, with assistance from the Criminal Investigation division of the Internal Revenue Service. The matter is being prosecuted by Assistant United States Attorneys Carter Stewart and Zachary Corey. An indictment is merely an allegation. All defendants are presumed innocent. ### For further information contact: Public Information Officer Kenneth.Gales@usdoj.gov (414) 297-1700 Follow us on Twitter


title: N.C. Man Sentenced to Over 13 Years in Federal Prison for Drug Trafficking

component: USAO - South Carolina

body_text: COLUMBIA, S.C. — Rico Green, 48, of Waxhaw, N.C. was sentenced to more than 13 years in federal prison after pleading guilty to a drug trafficking offense. Evidence presented to the court showed that on Jan. 5, 2022, Green sold fentanyl to members of the Lancaster County Drug Task Force during an undercover operation. The undercover buy was part of a larger investigation which revealed Green’s drug trafficking activity in Lancaster County, S.C. and Union County, N.C. In March 2022, Green was found with a large quantity of fentanyl after he attempted to run from Lancaster County deputies during a traffic stop. The court also heard evidence that months after his March 2022 arrest and subsequent bond, Green attempted to sell a firearm to another undercover officer during a drug deal in Waxhaw, N.C. Green pleaded guilty to drug trafficking on March 27, 2024. Green has two prior convictions for distribution of cocaine, two prior convictions for distribution of crack cocaine, and two prior convictions for trafficking cocaine. United States District Judge Mary Geiger Lewis sentenced Green to 160 months imprisonment, to be followed by a six-year term of court-ordered supervision. There is no parole in the federal system. This case was investigated by the Drug Enforcement Administration, the Bureau of Alcohol, Tobacco, Firearms, and Explosives, the South Carolina Law Enforcement Division, the Lancaster County Sheriff’s Office, the Lancaster Police Department, and the Union County, N.C. Sheriff’s Office. Assistant U.S. Attorney Lamar J. Fyall is prosecuting the case. ###


title: U.S. Attorney Announces Participation in Coordinated National Health Care Fraud Enforcement Action

component: USAO - Kentucky, Western

body_text: Louisville, KY – Today, U.S. Attorney Michael A. Bennett announced criminal charges against six defendants in connection with schemes to defraud health care benefit programs and misuse of controlled substances in the Western District of Kentucky. The charges filed in federal court are part of the Justice Department’s 2024 National Health Care Fraud Enforcement Action. The charges stem from three unlawful billing schemes, one opioid theft scheme, and a doctor who allowed his staff to issue Schedule II controlled substance prescriptions in his absence. “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.” The charges announced today by U.S. Attorney Bennett are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets. The Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals’ Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit’s Data Analytics Team. Descriptions of each case involved in today’s enforcement action are available on the Department’s website here . The Western District of Kentucky, in particular, worked with the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Department of Health and Human Services Office of Inspector General (HHS-OIG); the Federal Bureau of Investigation (FBI); the Drug Enforcement Administration (DEA); the United States Postal Inspection Service (USPIS); the Internal Revenue Service, Criminal Investigation (IRS-CI); the Defense Criminal Investigative Services; the U.S. Department of Labor (DOL); the U.S. Food and Drug Administration (FDA); the Kentucky State Police (KSP); the Kentucky Cabinet for Health and Family Services Office of Inspector General; the Kentucky Office of the Attorney General, Office of Medicaid Fraud and Abuse Control; and the Louisville Metro Police Department (LMPD). The following individuals have been charged in the Western District of Kentucky: Shafi Abbas , 57, of Pendleton, Kentucky, was charged by information with conspiracy to commit health care fraud and money laundering in connection with an alleged scheme to fraudulently obtain over $2.6 million in Medicare funds. According to the information, Abbas, through Aidmen Medical Equipment LLC and Justright Medical Equipment LLC, fraudulently billed Medicare for durable medical equipment, which was medically unnecessary, unwanted by patients, and not prescribed by the patients’ medical providers. Based on those false and fraudulent claims, Medicare paid approximately $1.3 million. In addition, Abbas allegedly transferred offshore the proceeds of health care fraud in a value greater than $10,000. The case is being prosecuted by Assistant U.S. Attorney Joseph Ansari of the U.S. Attorney’s Office for the Western District of Kentucky. Carissa Uptegraff , 44, of Glasgow, Kentucky, was charged by indictment with theft of medical products. According to the indictment, Uptegraff , a pharmacy employee, stole a pre-retail medical product, oxycodone, which had a value over $5,000. The alleged thefts took place at two different pharmacies prior to the controlled substances being made available for retail purchase by a consumer. The case is being prosecuted by Assistant U.S. Attorney Joseph Ansari of the U.S. Attorney’s Office for the Western District of Kentucky. Dr. Lawrence Peters , 62, of Louisville, Kentucky, was charged by information with conspiracy to illegally use a Drug Enforcement Administration (“DEA”) registration number issued to another. According to the information, Dr. Lawrence Peters allegedly conspired with others in his medical practice to issue pre-signed and unsigned prescriptions for Schedule II controlled substances and further directed his staff to fill the prescriptions at his physician’s owned pharmacy. The case is being prosecuted by Assistant U.S. Attorneys Joseph Ansari and Chris Tieke of the U.S. Attorney’s Office for the Western District of Kentucky. Tammy Daniels a/k/a Tammy Richardson , 55, of Louisville, Kentucky, was charged by indictment with wire fraud and health care fraud in connection with an alleged scheme to fraudulently obtain over $750,000 from her employer, a medical practice, and over $422,000 in Medicare funds. According to the indictment, Daniels was employed as the accounts manager for a medical practice when she used the medical practice’s credit cards to purchase personal items, transferred money from the practice’s bank account to pay the credit card invoices, transferred money from the practice’s bank account to pay for other personal credit card purchases, and used her access and position to bill for false and fraudulent medical procedures to pay credit card invoices in order to hide the unlawful use of the credit cards, all without her employer’s knowledge and authorization. As a result of the fraudulent scheme, health care benefit programs, including Medicare, paid over $79,000. The case is being prosecuted by Assistant U.S. Attorney Joseph Ansari of the U.S. Attorney’s Office for the Western District of Kentucky. Michael Boaz , 45, and Christopher Augustus , 40, of Clinton, Kentucky were charged by indictment with conspiracy to commit health care fraud, health care fraud, and aggravated identity theft in connection with an alleged scheme to fraudulently obtain over $1,000,000 from health care benefit programs. According to the indictment, Boaz and Augustus falsely and fraudulently billed various health care benefit programs for medications dispensed from the Clinton and Bardwell Pharmacies by using material misrepresentations, material omissions, and deception in order to obtain authorization for the medications from physicians and nurse practitioners. In addition, the indictment alleges that Boaz and Augustus knowingly possessed, transferred, or used the means of identification two individuals, a nurse practitioner, and a physician, including the individuals’ names and unique National Provider Identifier numbers, without lawful authority, in relation to the health care fraud. The case is being prosecuted by Assistant U.S. Attorney Raymond McGee of the U.S. Attorney’s Office for the Western District of Kentucky. A complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. ###


title: OptumRx Agrees to Pay $20M to Resolve Allegations that It Filled Certain Opioid Prescriptions in Violation of the Controlled Substances Act

component: Civil Division

body_text: OptumRx Inc., a prescription drug benefit provider, has agreed to pay $20 million to resolve allegations that it improperly filled certain opioid prescriptions in violation of the Controlled Substances Act. The settlement resolves an investigation initiated by the Drug Enforcement Administration (DEA) into whether, between April 2013 and April 2015, OptumRx improperly filled certain opioid prescriptions in combination with other drugs such as benzodiazepines and muscle relaxants, commonly referred to as “trinity” prescriptions. The United States alleged that these combination prescriptions, which OptumRx filled primarily from a mail order pharmacy location in Carlsbad, California, raised “red flags” indicating that the prescriptions may not have been intended for legitimate medical use and could lead to abuse or diversion of highly addictive and powerful opioids. The United States also contended that these trinity prescriptions carry significant risk of harm and that these red flags must be resolved prior to filling a controlled substance prescription. During the course of its investigation, the government alleged that OptumRx received numerous trinity prescriptions that raised red flags but filled those prescriptions without always resolving the red flags. OptumRx reports that the company has instituted enhanced protocols in handing opioid prescriptions since 2017 to reduce the number, dose and duration of opioid prescriptions it dispenses. OptumRx also reports that it instituted more robust concurrent drug utilization review procedures to assist in identifying and not filling prescriptions for dangerous opioid combinations and excess dosing. During the course of the government’s investigation, OptumRx also closed its mail order pharmacy operations in Carlsbad, California. “Pharmacies providing opioids and other controlled substances have a duty under the Controlled Substances Act to ensure that they fill prescriptions only for legitimate medical purposes,” said Principal Deputy Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department will continue to work with its law enforcement partners to ensure that pharmacies do not contribute to the opioid addiction crisis.” “Pharmacies are the last line of defense protecting the public from potentially dangerous and addictive medications,” said U.S. Attorney Tara McGrath for Southern District of California. “Combating the opioid crisis on all fronts includes holding pharmacies accountable if they shirk any part of the responsibilities required in filling prescriptions for potentially harmful drugs.” “DEA registrants have an obligation to protect the public, not help fuel the opioid epidemic,” said Assistant Administrator Thomas W. Prevoznik of the DEA Diversion Control Division. “The trinity style prescription combination helped fuel the start of the opioid addiction crisis and raises a red flag, which this registrant should have recognized and reacted to rather than putting profits before patients’ safety.” DEA’s Office of Diversion Control, San Diego Division Office conducted the investigation. Assistant U.S. Attorneys Joseph Price, Dylan Aste, Betsy Boutelle and Colin McDonald for the Southern District of California and Trial Attorneys Scott B. Dahlquist and Brandon Robers and Assistant Directors Rachael Doud and Gabriel H. Scannapieco of the Civil Division's Consumer Protection Branch represented the United States. This is the second substantial resolution of an opioid related investigation announced by the Justice Department in recent months. Late last year, the department announced a $12 million resolution and consent decree involving Droguería Betances LLC, one of Puerto Rico’s largest drug distributors . In that case, the United States alleged that Betances failed to report to the DEA hundreds of “suspicious orders” for opioids and other controlled substances distributed to Betances’ pharmacy customers. The claims resolved by the settlement agreement announced today are allegations only. And there has been no determination of liability.