{"id":53459,"date":"2023-06-27T18:08:40","date_gmt":"2023-06-28T01:08:40","guid":{"rendered":"https:\/\/cjnotebook.com\/?p=53459"},"modified":"2023-06-27T18:08:40","modified_gmt":"2023-06-28T01:08:40","slug":"calif-woman-guilty-of-24-million-medicare-scam-for-unnecessary-equipment","status":"publish","type":"post","link":"https:\/\/cjnotebook.com\/?p=53459","title":{"rendered":"Calif. Woman Guilty of $24 Million Medicare Scam for Unnecessary Equipment"},"content":{"rendered":"

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0LOS ANGELES<\/strong><\/span><\/p>\n

\"\"A South Bay woman was found guilty Tuesday of nearly two dozen felonies for fraudulently billing Medicare more than $24 million, according to federal officials.<\/span><\/p>\n

She did this by submitting fraudulent claims for medically unnecessary durable medical equipment \u2013 mostly power wheelchairs (PWC) \u2013 and PWC repairs, many of which were never performed.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tamara Yvonne Motley, 54, a.k.a. \u201cTamara Ogembe,\u201d of Redondo Beach, was found guilty by a federal jury of 20 counts of health care fraud, two counts of aggravated identity theft, and one count of conspiracy to commit money laundering.<\/span><\/p>\n

\u00a0Motley was taken into custody.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 According to evidence presented at her five\u00ad<\/b>-day trial, from July 2006 to August 2014, Motley was the de facto owner of the Hawthorne-based Action Medical Equipment and Supplies. <\/span><\/p>\n

\"chrome<\/a>From January 2013 to November 2016, Motley was the de facto owner of the Ventura-based Kaja Medical Equipment & Supply. Both companies were enrolled with Medicare in the names of Motley\u2019s out-of-state relatives.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Motley orchestrated a scheme in which she paid marketers for patient referrals and then directed them to take patients to corrupt physicians, who prescribed medically unnecessary durable medical equipment, such as PWCs, that Motley\u2019s companies used to submit fraudulent bills to Medicare.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 In January 2011, when Medicare changed the reimbursement rules for PWCs to make the upfront payments less lucrative to suppliers, <\/span><\/p>\n

Action switched to billing Medicare for PWC repairs and continued that scheme at Kaja once Action was shut down. <\/span><\/p>\n

These repairs were not medically necessary because the patients did not need the PWCs to be with, were not needed to make the PWCs serviceable in any event, and often simply were not performed. <\/span><\/p>\n

These repairs were expensive \u2013 often billed for $3000-$4000 \u2013 and accounted for nearly half of Action\u2019s billings and almost all of Kaja\u2019s.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Over eight years, Action billed Medicare more than $18.2 million for DME \u2013 most for PWCs, but also for PWC accessories, knee braces and back braces \u2013 and the repair or replacement of PWCs. <\/span><\/p>\n

Medicare paid Action nearly $10.3 million.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Between July 2013 and November 2016, Kaja billed Medicare $6.3 million, primarily for PWC repairs. Medicare paid Kaja approximately $2.8 million for those claims.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Judge Blumenfeld scheduled an October 3 sentencing hearing, at which time Motley will face up to 10 years in federal prison for each health care fraud count, up to 20 years in federal prison for the money laundering conspiracy count, and a mandatory sentence of two years in federal prison consecutive to the other sentences for the aggravated identity theft counts.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Two other defendants have been convicted in this case:<\/span><\/p>\n