United States Attorney Breon Peace has announced criminal charges against two defendants last week. The defendants have been charged in connection with alleged Medicare and Medicaid fraudulent billing schemes. The charges filed in federal court in Brooklyn are part of the Department of Justice’s 2023 National Health Care Fraud Enforcement Action.
Carlo Elomina Garcia, a licensed occupational therapist and the owner of Carlo E. Garcia Occupational Therapy in Queens, was arrested and arraigned on June 26, and released on a $25,000 bond pending trial. Jian Ai Chen, a medical assistant and the owner of two pharmacies in Brooklyn, was arrested and arraigned on June 14, before Chief United States Magistrate Judge Lois Bloom and released on a $500,000 bond pending trial.
"As alleged, the defendants abused the trust placed in them by Medicare and Medicaid by falsely billing these essential programs for their own enrichment," said Peace. "This enforcement action demonstrates our continued commitment to vigorously prosecute healthcare providers who steal from taxpayer-funded programs intended to help those in need.”
These arrests and charges are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud. These charges included over $2.5 billion in alleged fraud.
As alleged in the criminal complaint, from May 2017 through June 2021, Garcia, through his company, billed Medicare and Medicaid for over $3.9 million in occupational therapy services and was paid over $1.6 million. Many of those services were not eligible for reimbursement, were not provided as billed or were not provided at all, including repeatedly billing for over 24 hours of one-on-one occupational therapy services in a single day.
Chen is charged with conspiracy to defraud in connection with a scheme to pay over $5 million in kickbacks to Medicare and Medicaid beneficiaries in exchange for bringing their prescriptions to AC Pharmacy Corp. and A Star Pharmacy Inc., which she owned. Chen agreed with others to submit false and fraudulent claims to Medicare and Medicaid plans for dispensing prescription medications that were induced by the payment of kickbacks and not actually dispensed. Chen’s pharmacies received approximately $101 million as a result of the scheme.
“These enforcement actions, including against one of the largest health care fraud schemes ever prosecuted by the Justice Department, represent our intensified efforts to combat fraud and prosecute the individuals who profit from it,” stated Attorney General Merrick Garland. “The Justice Department will find and bring to justice criminals who seek to defraud Americans and steal from taxpayer-funded programs.”
