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Jurick Croes, Raichell Felomina, Suvenca Martis Jailed for Murder of Riches Obi in Southwark

By
Shulammite Bello
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0

A man has been jailed for life for the murder and false imprisonment of Riches Obi in Southwark in 2020.

Jurick Croes, 38, of no fixed address, appeared at the Old Bailey Friday, where he was sentenced to 30 years’ imprisonment, less time served [877 days] for murder, and nine years for false imprisonment – to be served concurrently.

Raichell Felomina, 40, of no fixed address, was sentenced at the same hearing to seven years and six months for false imprisonment – to be eligible for release after five years and four months. He will be liable for deportation on release.

Suvenca Martis, 35, of Panmure Road, Lewisham, was sentenced to six years and six months for false imprisonment and five years for perverting the course of justice, totalling 11 years and six months minus three years and four months served on remand. She will be liable for deportation on release.

All three had been convicted following a trial at the Old Bailey on Tuesday, May 28.

Detective Chief Inspector Matt Webb from the Met’s Specialist Crime Command led the investigation and said, “We will never fully understand why Riches Obi was attacked and killed in his own home in such a brutal way, but it is thought that the three suspects were involved in some way in a money-making scam with the woman they targeted.

“We don’t know if he attempted to intervene, but we do know he was subjected to a sustained assault that ultimately ended his life. The identification and arrest of Martis was the result of complex enquiries and forensics. Her arrest led us to identify Felomina and Croesh who attempted to avoid capture by fleeing the country.

“This case clearly demonstrates that international borders do not stop UK Law Enforcement from reaching out to capture criminals. We utilsed every international cooperation tool available to us in order to bring them back to the UK to face the consequences of their actions.

“My thoughts today are with Riches’ family. They have waited many years to see justice done and it is my sincere wish that they may now find a way to move forward and cherish their memories of Riches without the spectre of this despicable crime hanging over them.”

An investigation was launched after officers were called to Riches home address in Harper Road, Southwark, on Tuesday, November 17, 2020, and found the door partially open. On entering the property, they found Riches lying on the floor with stab and slash wounds. Despite the efforts of paramedics who had rushed to the flat, Riches was pronounced dead at the scene.

When an officer called out to see if anyone else was in the house, they heard a woman reply, “I’m here”. Following her voice, officers went through the flat until they found her in a bedroom bound with cable ties. A scarf was tied around her neck, and it looked like it had been used as a gag.

On searching the property, officers found a bag of cable ties identical to the ones used to bind the woman. The ties contained a price tag to a nearby hardware store; when officers attended they viewed CCTV and identified Martis as the person who purchased them. Further CCTV analysis showed her driving away from the shop in a rented vehicle, which detectives later established she had hired for the days spanning the murder.

After she was arrested later that month, detectives seized Martis’ phone. Its contents were analysed and showed she had various communications and messages linking her to Felomina and Croes – this included ferry times showing them arriving from Holland before the murder, then fleeing on the same ferry on the night of 17 November. The phone also revealed Martis had been searching for heavy-duty duct tape the night before the murder and news of the murder in the aftermath of the attack.

Forensic analysis was to prove key in showing Felomina and Croes’s role in the incident. Two knives had been recovered from the flat, both of which had been used to attack Riches; forensics found DNA on both weapons matched Felomina and Croes. Other items found inside the address, including envelopes and the cable ties, revealed traces of DNA from both men. DNA from Croes was also found on a black baseball hat that had been discarded in the bedroom of the flat.

When the hire car Martis had used was seized and examined, Croes’s blood was found inside the vehicle.

Detectives traced Felomina to Holland, where he was arrested and extradited to the UK in November 2021.

Croes managed to flee to Colombia but was arrested in February 2022; his extradition took 18 months, but he was returned to the UK to face trial.

Murder of Deshaun Tuitt: Police Search for Killer in Islington

By
Shulammite Bello
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0

Detectives investigating the murder of Deshaun Tuitt in Islington have released an image of a man they want to speak with.

Fifteen-year-old Deshaun James Tuitt was fatally stabbed in Highbury Fields, N5, shortly before 9:00 p.m. on Thursday, August 4, 2022.

Detective Inspector Ben Dalloway said, “Our investigation into Deshaun’s death is ongoing and we want to hear from anyone who can name the man in the picture.

“I urge anyone who has information about the man pictured, or about Deshaun’s murder, to please do the right thing and get in touch either in person or anonymously.

“His family are desperate for answers and we are doing everything we can to get them the justice they need.

“If the man in the image is you, don’t wait for us to contact you, please get in touch without delay.”

How to Report Rape, Sexual Assault: Met Police

By
Shulammite Bello
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0

If you’ve been the victim of rape or sexual assault, there are many different ways you can report it to the police. We understand it can be difficult. You might not be completely sure what happened or how to talk about it.

Our trained officers and partner organisations are here to listen and work together to support you in any way we can. Importantly, your information could help us bring the offender to justice and make sure you and other people in a similar situation are kept safe.

Is someone in immediate danger? Is a crime taking place or has one just happened? If so, call 999 now and ask for the police. If you have a hearing or speech impairment, use our textphone service 18000 or text us on 999 if you’ve pre-registered with the emergencySMS service.

If you’d like to report online, rather than speaking to an officer by telephone in the first instance, you can securely and confidentially report rape or sexual assault to us online.

All reports made using this service are reviewed by our 24/7 contact centre within a few hours and someone will get back to you in a maximum of two days (although usually quicker).

If you’d like to talk to someone, our national non-emergency telephone number is staffed 24/7. Call us on 101 and report what happened or just get some advice.

If you’d like to speak to an officer in person, we can provide a safe and comfortable environment at any of our police stations.

The Havens are specialist centres in London for victims or rape and serious sexual assault. If you’re not ready to talk to the police just yet, a Haven can provide medical help and emotional support in confidence. They offer a 24/7 urgent advice number if you need to speak to someone for the first time and have been assaulted recently; they also offer appointments for non-urgent information and advice.

If someone you know has been raped or sexually assaulted, and doesn’t feel able to speak to the police yet, please report it yourself using any of the methods above. We’ll record the incident and help you to support the victim if needed.

Information provided anonymously via Crimestoppers is extremely valuable in helping us plan how we police each area.

You can contact them through their website or by calling 0800 555 111.

We understand that you may not be ready to talk to us about what has happened. The charities, groups and organisations on the support organisations page can offer support, advice and ways to report the incident without having to talk directly to the police.

Keanu Vella to Spend Years in Prison for Rape, False Imprisonment, Breaching Court-imposed Order

By
Shulammite Bello
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0

Keanu Vella, a registered sex offender, has been jailed for more than 12 years for rape, false imprisonment and breach of his court-ordered notification requirements.

Detective Constable Jessica Stephens of the Met’s East Area Public Protection Unit said, “Keanu Vella is a registered sex offender who is a clear danger to women. He has demonstrated that he is unable to comply with the court-ordered notifications that allow him his freedom, and it is right that he will now be in a place where he no longer poses a threat to women and girls.

“I hope that the sentence handed down encourages other victims of sex offences to come forward. It is so important that these offences are reported so we can support victims and start building cases against offenders to bring them before the courts.”

Vella, 30, of Maldon Walk, Woodford Green, appeared at Snaresbrook Crown Court on Thursday for sentencing for failing to comply with notification requirements. He was sentenced to 40 weeks’ imprisonment [to run concurrently]. Vela was also convicted of false imprisonment and was sentenced to four years’ imprisonment [to run concurrently]. Similarly, he was sentenced to 12 years and nine months’ imprisonment with an extended licence to 18 years and nine months.

He is also subject to an indefinite Registered Sex Offender notification requirement. Vella had changed his address to a property at Maldon Walk, Woodford, without notifying his offender management officer of his new address.

While at the new address, on May 10, 2023, Vella arranged for a woman offering escort services to visit him at home. However, when his agreed appointment time expired, he held the victim against her will and, holding her at knife point, he raped her.

Police were called by a passer-by when the victim was found in the street outside the address in a distressed state.

Vella was arrested at the scene.

On May 12, 2023, he was charged and remanded in custody to appear in court, where he pleaded guilty to failing to comply with notification requirements. He later appeared at Snaresbrook Crown Court on March 12, 2024, where he pleaded guilty to the other offences and was remanded ahead of sentencing.

PC Emma Porter, the victim’s Sexual Offence Liaison Officer, who supported the victim throughout the entire process, said, “We are grateful to the victim in this case. She has shown strength, courage and patience throughout the court process. Now that Vella is behind bars it is my sincere hope that she can put his abhorrent actions behind her and move forward with her life.”

Detectives Issue E-fit After Road Rage Assault in Finchley

By
Alex
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0

Detectives investigating a road rage attack in Finchley have released an e-fit of a man they want to identify.

The incident happened in Squires Lane, N3, on 10 October 2023, when the rider of a motorbike was involved in a dispute with a car driver and assaulted him.

The driver of the car, in his 60s, was taken to hospital for treatment before being discharged.

Meanwhile, detectives investigating a report of indecent exposure in Ealing on Friday released an e-fit image of the man they want to identify.

On June 17, an 18-year-old woman was walking on the footpath next to the River Brent near Ruislip Road when she noticed a man close to her who was naked from the waist down.

The victim, although shocked, was not harmed. The suspect fled along the canal in the direction of Gurnell Grove.

The suspect is described as being of Asian or Middle Eastern appearance, possibly aged 30s, with medium-length black hair and of average height.

 

INTERPOL, Mexico, Colombia Authorities Capture Criminal Kingpin, Dismantle Transnational Sex Trafficking Ring

By
Alex
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0

Authorities in the Americas, supported by INTERPOL, have successfully dismantled a criminal network involved in the trafficking of Colombian women to Mexico, arresting its leaders and safeguarding eight victims.

In a coordinated operation between the specialized prosecutor’s offices, investigative police and INTERPOL National Central Bureaus of Mexico and Colombia, authorities arrested the group’s main leader, a Cuban-Mexican citizen, in Medellín, Colombia, and his main associate in Yucatan, Mexico. Both suspects were wanted by Mexico and subject to INTERPOL Red Notices.

The criminal group first came to the attention of police in June 2022 when victims in Mexico managed to escape and report their ordeals to authorities. The young victims, usually from impoverished backgrounds in Cali, Medellín and Bogotá, were promised employment as waitresses or hostesses in Cancun and Merida.

Investigations uncovered that the victims would then receive ‘official’ letters of invitation to facilitate their access to Mexico. Upon arrival, the women were greeted by members of the criminal group, who took them to safe houses and confiscated their passports. They were then forced to sign contracts bonding them to unaffordable debts, which would be paid off by performing sex work in bars allegedly owned by the group’s leader.

In Mexico, authorities from the Attorney General’s Office carried out raids in homes and bars, which led to the rescue of the victims and the arrest of the woman suspected of running operations in Merida.

In Colombia, authorities found that the suspected ringleader had been leading an ostentatious lifestyle in a luxurious country house and travelling in high-end armored vehicles with a security detail. His wealth, estimated to be over 8 billion Colombian pesos (close to EUR 1 million), is believed to be the direct proceeds of the trafficking scheme.

Investigations are ongoing in both countries to identify and seize financial assets connected to the group, and to arrest any additional members which may still be at large.

The case is being supported by INTERPOL through Project Turquesa, a joint initiative with the United Nations Office on Drugs and Crime and funded by Global Affairs Canada.

Former Alaska City Treasurer, Jess Adams, Jailed 30 Months for Wire Fraud, Money Laundering, Tax Evasion

By
Shulammite Bello
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0

An Alaska man has been sentenced to 30 months in prison for embezzling more than $1 million from the City of Houston, Alaska, and from a Wasilla-based equipment company and then evading taxes on the embezzled profits.

According to court documents and statements made in court, from 2015 through 2018, Jess Adams was the treasurer for the City of Houston, where he was entrusted with bookkeeping responsibilities and had administrative access to the city’s accounting records and software.

Adams used this access to direct electronic transfers from the city’s bank account to a personal account in his name, which he maintained to hide the embezzled funds. Adams created fictitious entries in the city’s accounting records to disguise these payments as legitimate business expenses.

In October 2018, the City of Houston placed Adams on administrative leave, and he resigned from his position in November 2018. A year later, Adams was employed as a bookkeeper by an equipment company, where he exercised control over the company’s accounting records and software.

Using this access, Adams directed electronic transfers from the company’s bank account to other personal accounts that Adams opened in his name to hide the embezzled money. To conceal his activity, Adams used fictitious entries in the company’s accounting software to make it appear as though these funds were transferred for the payment of legitimate business expenses.

Adams then laundered the money he embezzled from the equipment company by making several wire transfers from his personal bank account to other accounts, each at a value greater than $10,000.

To further conceal his embezzlement and evade his taxes, Adams – a former seasonal tax return preparer for a national tax advisory company – filed false individual income tax returns for tax years 2016 through 2021. These returns did not disclose the additional income he embezzled.

In addition to his prison sentence, Adams was ordered to serve three years of supervised release and pay over $1.5 million in restitution to the United States, as well as additional restitution to the City of Houston and to the equipment company.

Rite Aid Corporation, Affiliates Agree to Settle False Claims Act, Controlled Substance Act Allegations Related to Opioid Dispensing

By
Samuel Nwite
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0

The Justice Department has announced that Rite Aid Corporation (Rite Aid) and 10 subsidiaries and affiliates have agreed to settle the government’s allegations under the False Claims Act (FCA) and Controlled Substances Act (CSA) asserted in United States ex rel. White et al. v. Rite Aid Corp., et al., No. 1:21-cv-1239 (N.D. Ohio).

Under the settlement, the government will be paid $7.5 million and have an allowed, unsubordinated, general unsecured claim of $401.8 million in Rite Aid’s bankruptcy case that is pending in the District of New Jersey. During the relevant time period, Rite Aid operated one of the country’s largest retail pharmacy chains with over 2,200 retail pharmacies in 17 states.

“Filling unnecessary prescriptions for powerful and addictive opioids, as the government alleged here, not only takes a toll on our communities, but also violates the law,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “As today’s settlement illustrates, the Justice Department is committed to holding pharmacies accountable for their role in the nation’s opioid crisis.”

“Pharmacies and pharmacists have an affirmative legal duty to ensure that the prescriptions they fill are legitimate,” said U.S. Attorney Rebecca C. Lutzko for the Northern District of Ohio. “When they disregard this responsibility and instead ignore red flags indicating that prescriptions for addictive painkillers are invalid, they violate the public’s trust and harm the community they are supposed to serve — all to make a buck. Our settlement with Rite Aid reinforces the Northern District of Ohio’s continued commitment to combatting the opioid crisis. My office and our law enforcement partners will continue to battle this epidemic by ensuring that corporate actors comply with their legal obligations, which help to restrict unwarranted public access to highly addictive medications, and thereby fight to keep vulnerable members of our communities from becoming addicted to opioids.”

The government’s complaint alleges that, from May 2014 through June 2019, Rite Aid knowingly dispensed at least hundreds of thousands of unlawful prescriptions for controlled substances that (1) lacked a legitimate medical purpose and were not issued in the usual course of professional practice and/or (2) were not valid prescriptions, were not for a medically accepted indication or were medically unnecessary.

These unlawful prescriptions included, for example, prescriptions for the dangerous, highly diverted combination of drugs known as “the trinity,” prescriptions for excessive quantities of opioids, such as highly addictive oxycodone and fentanyl, and prescriptions issued by prescribers who Rite Aid pharmacists had repeatedly identified internally as suspicious and as writing unlawful, unnecessary prescriptions.

The government further alleges that Rite Aid filled these prescriptions despite clear “red flags,” which highly indicated the prescriptions were unlawful and which pharmacists are trained to recognize. Rite Aid also allegedly ignored substantial evidence that its stores were dispensing unlawful prescriptions, including specific concerns raised by its pharmacists, and intentionally deleted internal notes about suspicious prescribers written by Rite Aid pharmacists, such as “writing excessive dose[s] for oxycodone,” and “DO NOT FILL CONTROLS.”

By knowingly dispensing unlawful prescriptions for controlled substances, the government alleges that Rite Aid violated the CSA and, where Rite Aid sought reimbursement from federal healthcare programs, also violated the FCA. 

Along with Rite Aid Corporation, the government’s complaint names as defendants the following Rite Aid subsidiaries: Rite Aid Hdqtrs Corp.; Rite Aid of Connecticut Inc.; Rite Aid of Delaware Inc.; Rite Aid of Maryland; Rite Aid of Michigan; Rite Aid of New Hampshire; Rite Aid of New Jersey; Rite Aid of Ohio; Rite Aid of Pennsylvania and Rite Aid of Virginia.

“Pharmacies and pharmacists have a critical responsibility to ensure controlled substances are dispensed lawfully and safely to the public. This includes highly addictive opioids as we continue to see the impact of the opioid crisis,” said Deputy Inspector General Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG is entering into a Corporate Integrity Agreement with Rite Aid, which includes a prescription drug claims review to have an Independent Review Organization determine whether prescription drugs are properly prescribed, dispensed, and billed.  HHS-OIG will continue to work with our law enforcement partners to hold providers accountable that put the public at risk.”

“America continues to live through the worst opioid epidemic we have ever seen. Rite Aid contributed to this crisis by ignoring obvious red flags and dispensing hundreds of thousands of unnecessary opioids,” said Administrator Anne Milgram of the Drug Enforcement Administration (DEA). “DEA will continue to do everything in our power to protect the health and safety of Americans and to end the opioid epidemic.”

The civil settlement includes the resolution of claims that certain Rite Aid pharmacies in Washington State violated the CSA by filling prescriptions written by prescribers who lacked proper controlled substance prescribing authority.

The settlement also resolves claims brought in 2019 under the qui tam, or whistleblower, provisions of the FCA by Andrew White, Mark Rosenberg and Ann Wegelin, who all previously worked for Rite Aid at various pharmacies. The FCA authorizes private parties to sue on behalf of the United States for false claims and share in any recovery, and permits the United States to take over the lawsuit, as it did here in part. The relators will receive 17% of the government’s FCA recovery in this matter.

In addition to the civil settlement, Rite Aid has entered into agreements with DEA and HHS-OIG to address its obligations going forward. Rite Aid and DEA entered a memorandum of agreement (MOA) designed to increase communication between the company, its retailers and DEA.

Employees will receive additional training to help them identify illegitimate prescriptions and minimize the risk of drug diversion. The MOA also requires Rite Aid to create and keep materials relevant to DEA investigations for at least five years.

Rite Aid further commits to implementing and managing an anonymous hotline for employees, patients and the public to report suspected illegal dispensing of highly diverted controlled substances and suspected violations of the CSA. Rite Aid has also entered into a corporate integrity agreement (CIA) with HHS-OIG. The CIA includes a prescription claims drug review to have an independent review organisation to determine whether prescription drugs are properly prescribed, dispensed and billed.

The settlement was approved on June 28 by the bankruptcy court as part of Rite Aid’s reorganisation plan, which is expected to become effective later this summer. The amount the government will recover on its unsecured claim under the settlement will depend on the ultimate amount of assets available to the bankruptcy estate for distribution to unsecured creditors.

Justice Department Fines Rite Aid Corporation, Elixir Insurance Company $101m for Falsely Reporting Rebates

By
Samuel Nwite
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0

The Justice Department has announced that Rite Aid Corporation and Rite Aid subsidiaries, Elixir Insurance Company, RX Options LLC and RX Solutions LLC, have agreed to resolve allegations that they violated the False Claims Act (FCA) by failing to report drug rebates to the Medicare Program accurately.

As part of the settlement, Elixir Insurance and Rite Aid will pay the United States $101 million, and RX Options and RX Solutions will grant the United States an allowed, unsubordinated, general unsecured claim for a total of $20 million in Rite Aid’s bankruptcy case pending in the District of New Jersey.

The settlement is based on the companies’ ability to pay and was approved on June 28 by the bankruptcy court as part of Rite Aid’s reorganisation plan, which is expected to become effective later this summer. In addition to operating one of the country’s largest retail pharmacy chains, Rite Aid offered Medicare drug plans and pharmacy benefits manager (PBM) services through Elixir Insurance, RX Options and RX Solutions.  

“Participants in Medicare’s drug program must accurately report price concessions, including drug manufacturer rebates, to ensure that the government receives the benefit of those concessions,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement reflects the Justice Department’s commitment to hold accountable entities that pursue their own financial interests at the expense of taxpayer programs.”

“Rite Aid and its Elixir subsidiaries lined their corporate pockets with millions of dollars of manufacturer rebates that should have been reported to Medicare,” said U.S. Attorney Rebecca C. Lutzko for the Northern District of Ohio. “Each of those dollars could have been used to benefit Americans with genuine health care needs. Our office will not tolerate deceptive health-insurance practices, and we will vigorously pursue those who violate the FCA.”

Under Medicare Part D, private entities known as Part D Plan Sponsors offer and administer insurance plans that provide prescription drug coverage to enrolled Medicare beneficiaries. Part D Sponsors must submit annual reports to the Centers for Medicare and Medicaid Services (CMS) with information about rebates and other remuneration the Plans received from drug manufacturers in connection with the Part D drugs provided to beneficiaries, which ensures that the government receives the benefit of any price concessions provided by drug manufacturers to purchasers of the drugs covered under the Part D plan.

CMS relies on the reports in the annual reconciliation process that determine payments due to the Plans or CMS at the end of the year.

The settlement resolves allegations that, between 2014 and 2020, the defendants improperly reported to CMS portions of rebates received from manufacturers as bona fide service fees, even though manufacturers did not negotiate with the defendants to pay such fees. The United States further alleged that Elixir Insurance knew the retained rebates did not meet the regulatory definition of bona fide services fees.

“Truthful and accurate documentation in the delivery of health care goods or services is crucial to the integrity of federal health care programs,” said Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Improper submission of manufacturer drug rebates and fees by Part D Plan Sponsors for pharmaceutical products in order to make more money will not be tolerated. Collaborating with our law enforcement partners, HHS-OIG is committed to preventing and investigating health care fraud in Medicare and other taxpayer-funded health care programs.”

The civil settlement includes the resolution of claims brought in 2021 under the qui tam, or whistleblower, provisions of the False Claims Act by Glenn Rzeszutko, who previously worked for RX Options. The FCA authorizes a private party to sue on behalf of the United States and share in any recovery. The qui tam case is captioned United States ex rel. Rzeszutko v. Rite Aid Corporation et al., No. 5:21-CV-574 (N.D. Ohio). The relator’s share of these proceeds has not yet been determined.

Strauss Ventures LLC, 12 Affiliated Skilled Nursing Facilities Fined $21.3m for Fraudulent Rehabilitation Therapy Services

By
Samuel Nwite
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0

Strauss Ventures LLC, doing business as The Grand Health Care System, and 12 affiliated skilled nursing facilities (collectively, the Grand) have agreed to resolve allegations that they violated the False Claims Act by knowingly billing federal health care programs for therapy services that were unreasonable, unnecessary, unskilled or that simply did not occur as billed.

“We expect nursing facilities to provide only reasonable and appropriate amounts of skilled rehabilitation therapy service to their residents and to bill government healthcare programs only for the services actually provided,” said Principal Deputy Assistant Attorney General Brian Boynton, head of the Justice Department’s Civil Division. “The department is committed to protecting both vulnerable nursing home patients and taxpayers against fraudulent conduct by unscrupulous actors.”

The settlement resolves allegations that, from as early as January 1, 2014, to September 30, 2019, the Grand knowingly submitted false claims for rehabilitation therapy for residents at 12 facilities Strauss Ventures owned and operated.

During this period, Medicare Part A (Medicare’s hospital insurance, which also pays for care in a skilled nursing facility in some circumstances) and TRICARE (the federal health care program for the Department of Defense) paid for such services at rates that varied based on the number of minutes of skilled rehabilitation therapy provided.

The Grand allegedly submitted bills where the reimbursement claimed was based on providing more therapy than was reasonable and necessary, or in some cases, where the therapists did not provide the amount of therapy reported.

As part of the settlement, the Grand admitted that certain now-former Grand management level employees implemented quotas that each of the 12 facilities was expected to reach, including quotas relating to beneficiaries’ lengths of stay and to the percentage of beneficiaries billed at the highest reimbursement level.

To meet these quotas, facilities often scheduled patients to receive therapy without consideration of what was reasonable and necessary based on the individual patients’ clinical condition. In addition, the Grand directed that no more than three patients be discharged from any facility per week and instructed that no Medicare Part A patients should be discharged from rehabilitation therapy unless it had been discussed with corporate officials.

The Grand admitted that this resulted in some Medicare beneficiaries “staying on therapy longer than was reasonable and medically necessary.”

The Grand acknowledged that there were various instances where supervisory officials, who did not personally evaluate or treat patients, set or adjusted the number of minutes of therapy that a Medicare patient would receive.

The Grand also acknowledged instances where supervisory personnel falsified the number of therapy minutes in the Grand’s electronic recordkeeping system or instructed subordinates to do so well after the therapy was allegedly rendered.

“Today’s settlement protects patients and taxpayers by ensuring that medical treatment is dictated by patient need and not by financial motive,” said U.S. Attorney Carla B. Freedman for the Northern District of New York. “Skilled nursing facilities provide important services to a vulnerable population, and we will continue to hold them accountable when they provide patients with unnecessary services and falsify records.”

The settlement also resolves federal allegations that the Grand submitted false claims to Medicaid for services rendered at its Pawling, New York, nursing home between Jan. 1, 2016, and June 30, 2021. These claims were allegedly false because the reimbursement rate was inflated by data that inaccurately reflected the degree of care needed by Medicaid patients there, including rehabilitation therapy services.

The Grand has also entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG) that requires an independent review organization to annually assess the medical necessity and appropriateness of therapy services billed to Medicare.

“Violations of the False Claims Act are absolutely unacceptable and will not be tolerated by the FBI and its partners,” said Executive Assistant Director Michael Nordwall of the FBI’s Criminal, Cyber, Response and Services Branch. “We will continue our work of protecting the American taxpayer by relentlessly pursuing businesses that do not comply with the rule of law. If you bill federal health care programs in an unnecessary manner, there will be consequences.”

“As a part of this settlement, the defendants acknowledged that they obtained funds from the Medicare program to which they were not entitled,” said Special Agent in Charge Naomi Gruchacz of HHS-OIG. “Individuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients.”

“Protecting the integrity of the healthcare system for our military members and their families is a top priority of the Defense Criminal Investigative Service (DCIS), the law enforcement arm of the Department of Defense Office of Inspector General,” said Acting Special Agent in Charge Brian J. Solecki of the DCIS Northeast Field Office. “DCIS will continue to work with its law enforcement partners and the Department of Justice to hold Department of Defense contractors accountable for their fraudulent activity and ensure America’s service members are not subject to unnecessary risk.”

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