Tag: Fraud

 BROWNSVILLE, Texas – Maria Luisa Yzaguirre and Jeremiah Yzaguirre, both of Harlingen, Texas, have been charged with conspiracy to commit health care fraud, aggravated identity theft and money laundering. The charges allege that between 2019 and 2023, the Yzaguires submitted more than $14 million in claims to Medicare for power wheelchairs, power scooters, parts and repairs for 37 individuals. In multiple instances, they allegedly billed Medicare more than $600,000 for parts and repairs...

 TRENTON, N.J. – Patrick Fitchner of Orlando, Fla., pleaded guilty Aug. 22 to one count of conspiracy to commit health care fraud in Trenton federal court. Fitchner and his conspirators solicited and received kickbacks and bribes in exchange for providing DME companies with completed doctors’ orders for medically unnecessary DME, such as orthotic braces, using telemedicine companies to obtain the prescriptions. The DME orders were subsequently fraudulently billed to Medicare and...

BOSTON – David Santana, owner of Conclave Media and Nationwide Health Advocates, will plead guilty to one count of conspiracy to commit health care fraud in connection with a $44 million telemedicine fraud scheme involving medically unnecessary durable medical equipment, including orthotics such as back and knee braces, and genetic tests. According to the charging documents, between January 2018 and August 2021, Santana, through his companies Conclave and Nationwide, entered into business...

LOS ANGELES – Tamara Yvonne Motley, 54, a.k.a. “Tamara Ogembe,” of Redondo Beach, Calif., was found guilty of nearly two dozen felonies for billing Medicare more than $24 million by submitting fraudulent claims for medically unnecessary durable medical equipment – mostly power wheelchairs and repairs, many of which were never performed. She was found guilty by a federal jury of 20 counts of health care fraud, two counts of aggravated identity theft, and one count of conspiracy...

MIRAMAR, Fla. – A federal jury has convicted Steven King, 45, of Miramar, Fla., for conspiracy to commit health care fraud and wire fraud for dispensing unnecessary lidocaine and diabetes testing supplies and billing Medicare more than $50 million. King was the chief compliance officer of AIC Holdings, which held pharmacies in various states including All American Medical Pharmacy in Warren, Mich. King and his co-conspirators took several steps to conceal their scheme, including enrolling their...

NEW YORK – Alexandra Stchaslivteseva, 52, of New York has been arrested for allegedly offering and paying illegal health care kickbacks and money laundering, resulting in Medicare paying more than $17.3 million in false claims. She allegedly offered and paid kickbacks and bribes to several purported telemedicine companies and marketing companies in exchange for completed doctor orders of medically unnecessary orthotic braces and continuous glucose monitors for Medicare beneficiaries. Stchastlivtseva...

TAMPA and RALEIGH, N.C. – Ruth Bianca Fernandez has been sentenced to three years in prison for her role in a conspiracy to commit health care fraud and for making a false statement in a matter involving a federal health care benefit program. Government officials say Fernandez, who worked directly under Patsy Truglia, who has already been sentenced, and other conspirators generated medically unnecessary physician orders via their telemarketing operation for certain orthotic devices—knee...

BOSTON – Blue Cross Blue Shield of Massachusetts is warning members to be vigilant, as scams offering free DME and pharmacy products are on the rise. Medicare beneficiaries and patients who've had a recent injury or surgery are often targeted by scammers, it says. In many cases, the perpetrators solicit physicians to sign off on unnecessary orders or prescriptions, such as back braces or pain cream, which are then improperly billed to a patient's health insurer. "While these types of...

CAPE GIRARDEAU, Mo. – U.S. District Judge Stephen N. Limbaugh sentenced a businessman from Jackson, Mo., to 30 months in prison for health care fraud and ordered him to repay $7.5 million. Jamie McCoy, 42, pleaded guilty on Nov. 23, 2020, to three felony counts: committing health care fraud, making false statements related to health care matters, and offering and paying illegal kickbacks for referrals. He admitted owning or operating companies that supplied orthotic braces and other DME: AE...

MIAMI – A south Florida federal grand jury has charged Mirosis Gonzalez and her daughter Berioska Sosa with paying kickbacks in exchange for referrals of Medicare beneficiaries to their pharmacy, then using the referrals to steal millions from Medicare. Gonzalez and Sosa owned and operated Aviva Care Pharmacy (which did business under the name American Care Pharmacy) in Sunrise, Fla. From August 2016 through May 2020, the defendants allegedly paid kickbacks and bribes to marketing and telemedicine...