Five Sentenced in South Florida to Prison Terms for Their Roles in Tricare and Medicare Fraud Scheme

U.S. District Judge Cecilia M. Altonaga has sentenced five defendants, including a doctor, to federal prison terms for their roles in a scheme that defrauded Tricare and Medicare out of more than $9.6 million.


U.S. District Judge Cecilia M. Altonaga has sentenced five defendants, including a doctor, to federal prison terms for their roles in a scheme that defrauded Tricare and Medicare out of more than $9.6 million. The defendants tricked beneficiaries into having the federal health care programs pay for medically unnecessary compounded prescription medicines and cancer genetic tests. Their sentences are as follows:

  • Dr. Mangala Ramamurthy, 64, of Texas was sentenced to 34 months for her role in the scheme: prescribing compounded pain creams and referring Genetic Cancer tests that were medically unnecessary. Dr.  Ramamurthy earlier pled guilty to conspiracy to defraud the U.S. and conspiracy to receive healthcare kickbacks.
     
  • John Scholtes, 56 of Boca Raton, Florida, was sentenced to 97 months for his role in the scheme. Scholtes earlier pled guilty to conspiracy to commit healthcare fraud, conspiracy to defraud the U.S., and conspiracy to receive healthcare kickbacks.
     
  • Anthony Mauzy, 43, of California, was sentenced to 49 months for his role in the scheme. Mauzy earlier pled guilty to conspiracy to commit healthcare fraud.
     
  • Thomas Sahs, 41, of California, was sentenced to 45 months for his role in the scheme. Sahs earlier pled guilty to conspiracy to commit healthcare fraud.
     
  • Rajesh Mahbubani, 46, of Texas, was sentenced to 49 months for his role in the scheme. Mahbubani earlier pled guilty to conspiracy to commit healthcare fraud.

On January 31, 2020, a sixth co-conspirator, Senthil Kumar Ramamurthy, 38, of Texas, was sentenced to 121 months in federal prison for his role in the scheme. S.K. Ramamurthy earlier pled guilty to conspiracy to commit healthcare fraud, conspiracy to defraud the US, and conspiracy to receive healthcare kickbacks. S.K. Ramamurthy is the son of Dr. Ramamurthy. 

Ariana Fajardo Orshan, U.S. Attorney for the Southern District of Florida, Cynthia Bruce, Special Agent in Charge, Defense Criminal Investigative Service (DCIS), Southeast Field Office, and SAC Omar Pérez Aybar, Special Agent in Charge for Health and Human Services, Office of Inspector General (HHS-OIG) made the announcement. 

Tricare is the health care program for the U.S. military that pays the health care costs of active and retired military personnel and their families, including the costs of medically necessary prescription medications. Medicare is a federally-funded program that provides free or below-cost health care benefits to certain individuals, primarily the blind, elderly, and disabled.

According to court records, the co-conspirators targeted Tricare for about 10 months, starting in 2014. After making their way onto U.S. military bases, co-conspirators convinced Tricare beneficiaries to sign-up for compounded prescription medications that the beneficiaries did not need. To encourage sign-up, co-conspirators falsely told the beneficiaries that the pharmacies would custom-design their medications or that the medications were free. In fact, the medications were not custom-designed and the patients had co-payments. Compounding pharmacies paid the co-conspirators millions of dollars in kickbacks in exchange for sending the pharmacies expensive prescription orders. 

In mid-2015, Tricare scaled back its reimbursements for compounded medications. The defendants turned to Medicare. They paid doctors to refer Medicare beneficiaries to a lab in Georgia for cancer genetic screening testing, even though the doctors had never examined the beneficiaries. As with the compounded medications, the cancer genetic screening tests were not medically necessary.

The owner of the Georgia lab, Minal Patel, 40, was indicted in the Southern District of Florida in September 2019. An indictment is an accusation and a defendant is innocent until proven guilty. 

To date, fraudulent compounding pharmacy schemes have caused estimated losses to Tricare in excess of $2 billion. Fraudulent genetic testing lab schemes have caused estimated losses to Medicare of approximately $2.1 billion.   

U.S. Attorney Fajardo-Orshan commended the investigative efforts of DCIS and HHS-OIG.  Assistant United States Attorneys Kevin J. Larsen, Anna Maria Martinez, and John C. Shipley prosecuted the case. Assistant United States Attorney Daren Grove is handling the asset forfeiture matters. 

Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov.

Justice.gov (February, 2020) Five Defendants Sentenced in South Florida to Prison Terms for Their Roles in Tricare and Medicare Fraud Scheme

Help a veteran in need by donating here.

Chicago Woman Found Guilty for Role in $7 Million Scheme to Defraud Medicare

A federal jury found a Chicago woman guilty on Friday for her role in a scheme to defraud Medicare of approximately $7 million between 2011 and 2017.


A federal jury found a Chicago woman guilty on Friday for her role in a scheme to defraud Medicare of approximately $7 million between 2011 and 2017.

After a four-day trial, Angelita Newton, 42, was found guilty of one count of conspiracy to commit health care fraud and wire fraud.   Sentencing has been scheduled for Oct. 13, 2020 before U.S. District Judge Virginia Kendall of the Northern District of Illinois, who presided over the trial. 

According to evidence presented at trial, from approximately 2011 to 2017, Newton worked at Care Specialists, a home health company based in Chicago, Illinois, and owned by Ferdinand Echavia, 46, and Ma Luisa Echavia, 44, both of Chicago.  Newton was the Echavias’ employee and personal assistant.  In that role, Newton conspired with the Echavias and others to submit claims to Medicare for unnecessary home health services for unqualified patients or for visits that did not happen as billed, the evidence showed. 

Newton created and completed visit notes and other documents purporting to reflect nursing services purportedly rendered by Ferdinand Echavia with the knowledge that he was not actually providing the services.  Newton was aware that Ferdinand Echavia was making cash payments to patients, which Newton knew to be illegal, the evidence showed.

The evidence at trial showed that between 2011 and 2017, Medicare paid Care Specialists approximately $7 million for home health care services. 

Three other defendants have been charged in connection with the fraud at Care Specialists.  Ferdinand Echavia pleaded guilty to conspiracy to commit health care fraud and wire fraud on Jan. 28, 2020, and is awaiting sentencing.  Ma Luisa Echavia pleaded guilty to conspiracy to commit health care fraud and wire fraud on Jan. 29, 2020, and is awaiting sentencing.  A former nurse at Care Specialists, Reginald Onate, 31, of Aurora, Illinois, pleaded guilty to one count of conspiracy to commit health care fraud, and is awaiting sentencing. 

Soffe Men’s 3 Pack-USA Poly Cotton Military Tee

This case was investigated by the FBI and HHS-OIG.  Trial Attorneys Leslie S. Garthwaite and Patrick Mott of the Criminal Division’s Fraud Section are prosecuting the case.  Former Trial Attorney Jessica Collins of the Fraud Section previously handled the prosecution.   

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney John R. Lausch Jr. of the Northern District of Illinois, Special Agent in Charge Emmerson Buie Jr. of the FBI’s Chicago Field Office and Special Agent in Charge Lamont Pugh III of the United States Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Division Office made the announcement.

The Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Justice.gov (February, 2020) Chicago Woman Found Guilty for Role in $7 Million Scheme to Defraud Medicare

Help a veteran in need by donating here.