May 25, 10

NEWS / California Patient Recruiter Sentenced to 12 Months in Prison for Medicare Fraud in Power Wheelchair

A Fresno, Calif.-area patient recruiter was sentenced today to one year and one day in prison for her participation in a nearly $1 million power wheelchair fraud scheme, announced the Departments of Justice and Health and Human Services (HHS).

Maria Nela Moreno, 57, was also sentenced by U.S. District Judge John F. Walter of the Central District of California to three years of supervised release and was ordered to pay $110,000 in restitution.

On Feb. 26, 2010, a Los Angeles jury found Moreno guilty of one count of conspiracy to commit health care fraud and six counts of health care fraud. The evidence introduced at trial showed that Moreno solicited Medicare beneficiaries for expensive, high-end power wheelchairs and other medical equipment they did not need by meeting with groups of seniors and going door-to-door at low-income, senior living communities in Sanger and Parlier, Calif., near Fresno. Several Medicare beneficiaries testified that Moreno wore a badge with her picture on it that appeared to resemble a hospital identification badge and told them she was from Medicare or another government agency.

According to the beneficiaries who testified at trial, Moreno convinced them to provide their identification cards and Medicare insurance numbers by telling the beneficiaries that they should take a power wheelchair because Medicare would soon run out of money, and the beneficiaries would not be able to get a chair in the future if they needed one. Moreno copied the beneficiaries’ identification cards and Medicare insurance numbers with a portable scanner she carried with her. The evidence at trial showed that Moreno recruited Medicare beneficiaries for power wheelchairs they did not need at a cost to Medicare of $6,000 per power wheelchair.

Witnesses testified that at the Elderberry Apartments in Sanger, one of the locations where Moreno and her co-conspirators illegally recruited beneficiaries to receive power wheelchairs, many residents left the wheelchairs unused. The former manager of the Elderberry Apartments testified that few, if any, of the residents actually needed the power wheelchairs.

Witnesses testified at trial that they received beneficiary information from Moreno and provided the information to a fraudulent medical clinic in Los Angeles, which used the information to create bogus prescriptions for power wheelchairs. Witnesses testified that they purchased the fraudulent prescriptions and medical documents from the clinic, and then sold them for more than $1,000 per prescription to durable medical equipment (DME) supply companies in and around Los Angeles. Moreno was paid a kickback for each power wheelchair that the DME companies were able to fraudulently bill to Medicare using the beneficiary information Moreno obtained.

Cooper Medical Supply of Canoga Park, Calif., was one of the DME supply companies that billed Medicare using the beneficiary information obtained by Moreno. Evidence presented at trial established that between January 2006 and September 2009, Cooper Medical Supply submitted approximately $946,590 in false and fraudulent claims to Medicare, almost all of which were for power wheelchairs. Evidence at trial also established that additional DME companies across southern California purchased prescriptions that were for the beneficiaries recruited by Moreno. On May 10, 2010, Cooper Medical Supply’s owner, Ajibola Sadiqr, was sentenced to 55 months in prison for his role in this fraud scheme. The owners of other DME supply companies who used the beneficiary information of Moreno’s recruits to submit false claims to Medicare have also been sentenced to prison.

Today’s sentencing was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney André Birotte Jr. for the Central District of California; Tony Sidley, Assistant Chief of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse; Glenn R. Ferry, Special Agent-in-Charge for the Los Angeles Region of the Office of Inspector General for HHS (HHS-OIG); and Steven Martinez, Assistant Director in Charge of the FBI’s Los Angeles Field Office

The case was prosecuted by Trial Attorney Jonathan Baum and Senior Trial Attorney Jerrob Duffy of the Criminal Division’s Fraud Section, and was investigated by the California Department of Justice and HHS-OIG. The case 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 Central District of California.

Since their inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than 560 individuals who collectively have falsely billed the Medicare program for more than $1.2 billion. In addition, HHS’s 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.

http://www.justice.gov/opa/pr/2010/May/10-crm-607.html

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