Miami-Area Resident Pleads Guilty to Participating in $63 Million Medicare Fraud Scheme
U.S. Department of Justice June 27, 2012

Office of Public Affairs (202) 514-2007/TDD (202) 514-1888

WASHINGTON—A Miami-area resident pleaded guilty today in U.S. District Court in Miami for her role in a health care fraud scheme that resulted in the submission of more than $63 million in fraudulent claims to Medicare and Medicaid, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Sarah Da Silva Keller, 27, pleaded guilty before U.S. District Judge Marcia G. Cooke in Miami to one count of conspiracy to commit health care fraud. Keller admitted to participating in a fraud scheme that was orchestrated by the owner and operators of Health Care Solutions Network (HCSN), which operated purported partial hospitalization programs (PHPs), a form of intensive mental health treatment for severe mental illness.

According to an indictment unsealed on May 2, 2012, HCSN paid kickbacks to owners and operators of assisted living facilities in exchange for referring Medicare beneficiaries to HCSN for PHP treatment that was unnecessary and, in many instances, not provided. According to court documents, Keller admitted that she falsified records at the direction of others so that HCSN could bill Medicare for patients who did not receive the services from HCSN. Keller knew that the falsification of these records was part of a plan for HCSN to commit health care fraud.

At sentencing, scheduled for Oct. 17, 2012, Keller faces a maximum of 10 years in prison and a $250,000 fine for each count.

Nine other charged defendants, including the owner and operators of HCSN, await trial before U.S. District Judge Cecilia M. Altonaga. Defendants are presumed innocent until proven guilty at trial.

Today’s guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Xanthi C. Mangum, Acting Special Agent-in-Charge of the FBI’s Miami Field Office; and Special Agent-in-Charge Christopher B. Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.

The case is being prosecuted by Trial Attorneys Steven Kim, William Parente and Allan Medina of the Criminal Division’s Fraud Section. The case was investigated by the FBI, HHS-OIG and Medicaid Fraud Control Unit and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, 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.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

Stockton Man Sentenced to Almost Five Years in Prison for Identity Theft
U.S. Attorney’s Office May 31, 2012

Eastern District of California (916) 554-2700

SACRAMENTO, CA—Michael Garcia, 39, of Stockton, was sentenced today by United States District Judge Morrison C. England Jr. to 57 months in prison for fraud in connection with computers and in connection with an access device, United States Attorney Benjamin B. Wagner announced.

According to court documents, Garcia was employed as a technician by a contractor that provided information technology (IT) assistance to third parties. While employed there, Garcia accessed the computer servers of a law firm and an accountant firm without their knowledge or authorization and downloaded the personal information of more than 1,450 clients and employees. Garcia maintained this information on his computer and elsewhere.

According to court documents, Garcia and others used this personal and financial information to make counterfeited identification documents including driver’s licenses and military identification. They used the information to open bank accounts, draft bank checks, make cash withdrawals, obtain loans and lines of credit, and make unauthorized purchases. Additionally, Garcia accompanied others who wore stolen U.S. Customs and Border Protection uniforms to carry out certain fraudulent transactions, such as cashing checks, in the belief that the uniforms gave them more credibility. When arrested, Garcia possessed counterfeit California driver’s licenses, one of which bore his photo but with the name of a victim. The loss is more than $136,000.

Today in court, an employee of the accounting firm where Garcia unlawfully accessed the personal financial information told of the severe hardship suffered by the firm because of Garcia’s actions, as well as the personal toll she experienced because of Garcia’s breach of trust. Judge England commented that identity theft cases, particularly those where there has been an abuse of trust, negatively affect many lives.

This case was the product of an extensive investigation by the Federal Bureau of Investigation and the San Joaquin County Sheriff’s Department. Assistant United States Attorneys Todd Pickles and Robin Taylor prosecuted the case.