Medicaid Provider Fraud Cases
Geron Tate
Geron Tate, of Mansfield, Ohio, was convicted in Richland County Court of Common Pleas of one count of Aggravated Theft, a felony of the second degree, and Medicaid Fraud, a felony of the third degree. Mr. Tate was a licensed chemical dependency counselor who owned and operated G.L. Tate & Associates located in Mansfield, Ohio. Mr. Tate, billed for counseling services he and his business did not provide which included Mr. Tate traveling out of state and billing for more than 24 hours of counseling services in a day. Additionally, Mr. Tate fraudulently copied and pasted treatment and patient records and only changed the name and date to support his fraudulently billed counseling services. Mr. Tate was sentenced to serve 6 years in prison and pay restitution of $1,572,386 to the Ohio Department of Medicaid.
Paul Vernier
Paul Vernier, of West Portsmouth, Ohio, was convicted in the Lawrence County Court of Common Pleas of two counts of Medicaid Fraud, felonies of the fourth degree. Mr. Vernier owned and operated Community Counseling and Treatment Services, a drug treatment and Medication Assisted Treatment (MAT) services provider with offices in Scioto and Lawrence Counties. Mr. Vernier submitted claims for Medicaid reimbursement of group counseling services that either did not occur or did not comply with Medicaid’s client-to-counselor ratio requirements and directed staff to falsify treatment notes to facilitate the fraud. In addition, Vernier up-coded medical somatic claims for Medicaid reimbursement of suboxone administration services. Mr. Vernier was sentenced to serve a total of 18 months in prison, pay a $5,000 fine, forfeiture 3 real properties, and 3 business and checking accounts totaling $1,575,644.
Tina Vetter
Tina Vetter, of Powell, Ohio, was convicted in Franklin County Court of Common Pleas of one count of Medicaid Fraud, a felony of the third degree. Ms. Vetter was the owner of a charitable organization, the Murphy Thomas Foundation, which she used as an avenue to defraud the Ohio Medicaid program by billing for services she and her foundation did not provide. The Murphy Thomas Foundation provided Day-Habilitation services, Summer/Winter Camps, and educational services to Autistic children in Columbus, Ohio. Since the Murphy Thomas Foundation was not a Medicaid provider, Ms. Vetter established several subcontracting agreements to bill Medicaid for behavioral health, day camp, and Healthcheck services (a program designed to provide early and periodic screening, diagnosis, and treatment to babies, kids, and young adults younger than 21) for some of her recipients unbeknownst to the children's parents and caregivers. Ms. Vetter was sentenced to 3 years prison (suspended), 5 years community control, and ordered to pay restitution of $400,000 to the Ohio Medicaid program.
Stella Ayensu
Stella Ayensu, of Reynoldsburg, Ohio, was convicted in the U.S. District Court for the Southern District of Ohio of one count of Conspiracy to Commit Health Care Fraud. Ayensu was co-owner of Allets Career Center and Supreme Home Health Care, both located in Columbus, Ohio, who allegedly provided training for state tested nursing assistants and home health aides. Ayensu, in her capacity of owner of Allets Career Center, issued training certificates to aides without providing the required training. Ayensu, and her co-conspirators, then used the fraudulently certified aides to provide home health services to Ohio Medicaid recipients via Supreme Home Health Care and billed Ohio Medicaid for services rendered by the untrained and fraudulently certified providers. Ayensu was sentenced to 12 months and 1 day in prison, 3 years of post-release control, and ordered to pay restitution of $499,927 to the Ohio Medicaid program.
Dr. William Bauer
Dr. William Bauer, Bellevue, Ohio, of was convicted in the U.S. District Court for the Northern District of Ohio of 76 Counts of Distribution of Controlled Substances and 25 Counts of Health Care Fraud. Dr. Bauer, a former medical doctor located in Bellevue, Ohio, was found guilty by a federal jury of prescribing controlled substances to patients without medical necessity and outside the usual course of medical practice. Dr. Bauer prescribed high doses of opioids and other controlled substances to patients without regard to any improvement in pain level, function, or quality of life. Additionally, Dr. Bauer was found to prescribe dangerous drug combinations, failed to consider a patient’s state of addiction and ignored warning signs of abuse and diversion such as patient family members stealing medication, patients requesting frequent refills, and patients losing prescribed medications. Dr. Bauer also regularly administered epidural and trigger point injections without medical necessity and failed to meet standard medical procedural requirements. Dr. Bauer was sentenced to serve a total of 60 months in prison, 1 year of supervised release, to pay restitution totaling $464,098 to Medicare and the Ohio Medicaid program and pay $100,000 as Community Restitution to the Ohio Attorney General’s Crime Victims Services Section and the Ohio Department of Mental Health and Addiction Services.
Jasmine Hunt
Jasmine Hunt, of Akron, Ohio, was convicted in Franklin County Court of Common Pleas on one count of Medicaid Fraud, a felony of the fourth degree. Ms. Hunt was an independent home health aide who billed for the same service multiple times and billed for services in excess of 24 hours in a day. The investigation determined that Ms. Hunt did in fact provide services; however, Ms. Hunt inflated her billing to indicate she provided more services than what was actually provided. Additionally, investigators determined that Ms. Hunt traveled in and around Ohio on dates and times when her billing indicated she was rendering services. Ms. Hunt was sentenced to serve 14 months in prison (suspended), serve 4 years community control, and pay restitution of $125,000 to Ohio Medicaid.
Dr. Jimmy Henry
Dr. Jimmy Henry pled guilty in U.S. District Court for the Southern District of Ohio to one count of conspiracy to unlawfully distribute controlled substances and one count of violating the anti-kickback statute. Dr. Henry agreed to permanently surrender his medical license and his DEA registration and agreed to pay $264,240.52 in restitution to Medicare, Medicaid, and the Ohio Bureau of Workers’ Compensation. Of the total, $214,366.50 is apportioned to Ohio Medicaid. Dr. Henry owned and operated Midwest Spine and Pain, with offices in New Albany and Lewis Center, and he prescribed controlled substances, including highly addictive opioids, outside the usual course of practice and for other than legitimate medical purposes. In addition, Dr. Henry received kickbacks from Insys Therapeutics as part of a fraudulent “Speakers Program” marketing the company’s fentanyl-based sublingual spray, Subsys.
Kayode Adeyemi
Kayode Adeyemi was convicted of Medicaid fraud (F4) and was sentenced to serve 14 months in prison (suspended) and three years of community control. In addition, he was ordered to pay restitution in an amount to be determined during a scheduled December 8
th restitution hearing. Adeyemi, a Registered Nurse and independent home health provider, submitted claims for Medicaid reimbursement of services he did not provide to recipient Stacey Conner, including over $100,000 in services he allegedly rendered while he was outside the state / country. Connor was complicit in the crime, signing Adeyemi’s timesheets for services she knew he did not provide, in exchange for cash and/or assistance paying her bills. At one point, Adeyemi was paying Connor as much as $700 per month in kickbacks. In total, the defendants caused a loss to the Medicaid program of $359,545.17. Conner too has been convicted for her role in this scheme to defraud.
Patient Abuse/Neglect and Misappropriation Cases
Andrew Miller
Andrew Miller, of Loveland, Ohio, was convicted in Warren Count Court of Common Pleas to Attempted Patient Abuse, a felony of the fifth degree. During Mr. Miller’s employment at a long-term care facility, an 82-year-old fall-risk resident attempted to leave the dining hall with silverware. Mr. Miller confronted the resident and proceeded to shove the resident causing the resident to stumble and fall to the ground. Mr. Miller was sentenced to serve community control for 1 year, complete the “Thinking for a Change Program,” and ordered not to work with elderly during the time of his probation.
Gregory Cornell
Gregory Cornell, of Warren, Ohio, was convicted in Trumbull County Court of Common Pleas to Patient Abuse, a felony of the fourth degree. Mr. Cornell was a Licensed Practical Nurse (LPN) at a long-term care facility who was assisting a resident to bed when the resident, suffering from dementia, became combative. Mr. Cornell proceed to physically restrain the resident, place a pillow over the resident’s face, and verbally threaten the resident until another employee intervened. Mr. Cornell was sentenced to 5 years community control and his LPN license was revoked.
Cassandra Gillum
Cassandra Gillum, of Wellston, Ohio, was convicted in Jackson County Court of Common Pleas on one count of Theft from a Protected Class, a felony of the third degree, and one count of Theft, a felony of the fifth degree. Ms. Gillum was the Business Office Manager at Edgewood Manor of Wellston who had access to the resident fund management system. Ms. Gillum utilized schemes where she ‘replenished’ petty cash, created checks for expenditures, and signed other persons names to checks all of which utilized the residents’ personal funds. Ms. Gillum ultimately kept the money for her own personal gain. Ms. Gillum was sentenced to serve 48 months in prison (suspended), 5 years community control, and pay $21,634 in restitution.
Stanford Eason
Stanford Eason, of Cincinnati, Ohio, was convicted in Hamilton County Court of Common Pleas on one count of Grand Theft, a felony of the fourth degree. Mr. Eason befriended his victim, a resident of a long-term care facility, and misled the victim to purchase multiple vehicles for him and allow him to gain access to the victim’s debit card. Additionally, Mr. Eason was able to link his personal Lyft, Cash App, and gambling accounts directly to the victim’s bank account. After linking his accounts to the victim’s bank account, Mr. Eason routinely used the victim’s money for his own personal gain. This resulted in the victim not having money to pay for his own housing and was forced to move to another long-term care facility due to non-payment. Additionally, the victim applied for and was denied Medicaid due to multiple vehicles being registered in the victim’s name. It was determined that Mr. Eason misappropriated $31,085 in the victim’s funds for his own personal gain. At the time of sentencing, the court found Mr. Eason to be indigent and the victim had passed away so no restitution was ordered. However, the court ordered Mr. Eason to serve 3 years community control and 100 hours of community service.
Eric Copas
Eric Copas, of South Webster, Ohio, was convicted in Scioto County Court of Common Pleas on two counts of Theft of Drugs and two counts of Illegal Processing of Drug Documents, all felonies of the fourth degree. Mr. Copas was a licensed practical nurse (LPN) who worked at a local long-term care facility. During his employment, Mr. Copas diverted prescription opioids from facility residents for his own use and falsified facility-controlled drug records in an effort to conceal his thefts. Mr. Copas was sentenced to 5 years community control and a $300 fine.
Angela Gallegos
Angela Gallegos was indicted by a Hancock County grand jury for one count of theft from a person in a protected class, a felony of the third degree. Gallegos served as the Social Security representative payee for her 83-year old father, who is a resident of the St. Catherine’s Manor care facility in Findlay. As her father’s representative payee, Gallegos was charged with ensuring that her father’s social security benefits were used for his benefit, to include the cost of his care at St. Catherine’s Manor. But instead of paying the facility for her father’s care, she diverted $34,412.22 for her own personal use.
Workers’ Compensation Fraud Cases
Larry Brown
Larry Brown, of Flat Rock, North Carolina, was convicted in Franklin County Court of Common Pleas on one count of workers’ compensation fraud, a felony of the fifth degree. Following a workplace injury, Mr. Brown was awarded Permanent and Total Disability and Disabled Workers Relief Fund benefits by the Ohio Bureau of Workers’ Compensation (BWC). The restrictions of his award notwithstanding, Mr. Brown continued to work as a truck driver and arranged for his employer to direct his paychecks to his wife in an effort to avoid detection. In addition, Mr. Brown signed numerous BWC documents falsely representing he was not working. Mr. Brown was sentenced to serve 12 months in prison (suspended), 5 years community control, and pay restitution of $66,705 to the BWC.
David Gentrup
David Gentrup, of Hidden Valley, Indiana, was convicted in Franklin County Court of Common Pleas on one count of workers’ compensation fraud, a felony of the fifth degree and one count of Tampering with Records, a felony of the fourth degree. Mr. Gentrup applied for and received Living Maintenance Wage Loss (LMWL) benefits from the Ohio Bureau of Workers’ Compensation (BWC) due to a workplace injury. LMWL is paid to an injured worker who returns to work but due to his injury continues to have restrictions and earns less money than he did prior to his injury for which he is compensated by BWC. Mr. Gentrup had returned to work in an approved LMWL plan as a caregiver for elderly family members. However, an investigation by the BWC’s Special Investigations Department discovered that the family members who he was allegedly providing care to had passed away. Mr. Gentrup continued to falsify documents and provide those to BWC indicating he was providing care to these deceased individuals. Mr. Gentrup was sentenced to 5 years community control and pay restitution of $40,685 to the BWC.
Curtis Wilson
Curtis Wilson, of Columbus, Ohio, pled guilty to one count of Receiving Stolen Property, a felony in the fifth degree. On December 11, 2020, The Bureau of Workers’ Compensation issued a check in the amount of $18,369.33, via US Mail to a local business in Newark, Ohio. The BWC received an allegation that the owner of the local business did not receive nor cash the rebate check issued to his business. Bank records showed that BWC check was deposited via ATM into Mr. Wilson’s personal account on January 30, 2021. When confronted, Mr. Wilson stated that a homeless man offered Mr. Wilson $2,500 to cash the check for him. Mr. Wilson stated that he deposited the check and once the check cleared he gave the unknown man the money. During a second interview, Mr. Wilson again stated he deposited the check he received from an unknown man; however, he did not sign the check. He also stated he was happy he got what he got because he was behind on his mortgage. Mr. Wilson stated he was owning up to what he did and understood there would be consequences. Upon his plea of guilty, Mr. Wilson was ordered to pay restitution in the amount of $18,396.33 to the BWC.