Norwalk woman charged in $9 million Medicare fraud case

NORWALK — A Norwalk woman was arrested Tuesday and charged with using forged medical orders to help carry out a $9 million laboratory testing scheme that defrauded Medicare, federal prosecutors announced.

Brenda Lee Lopez, 63, of Norwalk, was charged in a federal grand jury indictment with seven counts of health care fraud and five counts of aggravated identity theft, according to the U.S. Attorney’s Office for the Central District of California.

Lopez was expected to make her initial appearance and be arraigned Tuesday in U.S. District Court in Los Angeles.

Federal prosecutors said Lopez, who worked as a medical office manager, allegedly prepared false orders for urinary tract infection tests, respiratory pathogen panels and toxicology screens for Medicare beneficiaries. The orders allegedly included the names and forged signatures of four medical providers.

According to the indictment, the Medicare beneficiaries did not provide specimens for the tests. In some cases, prosecutors said, the beneficiaries were deceased at the time of testing.

Lopez allegedly provided the false orders to a laboratory, which then billed Medicare for the tests. At one point, prosecutors said, Lopez attempted to pay one of the providers after the provider learned that his name had been used without authorization to refer hundreds of tests to the laboratory.

Federal officials said the laboratory billed Medicare approximately $9,087,013 and was paid approximately $2,117,994 for testing referred by Lopez based on the allegedly false orders.

In exchange for the referrals, the laboratory allegedly paid Lopez and her family members approximately $335,000. Prosecutors said much of the money was spent at a casino and paid to others who assisted in the scheme.

If convicted, Lopez would face up to 10 years in federal prison for each health care fraud count. She would also face a mandatory two-year consecutive federal prison sentence for each aggravated identity theft count.

The case is being investigated by the FBI and the U.S. Department of Health and Human Services Office of Inspector General. Trial Attorney Matthew R. Belz of the U.S. Department of Justice’s Criminal Division, Fraud Section, is prosecuting the case.

Lopez was one of 10 defendants charged in the Central District of California as part of a national health care fraud takedown announced Tuesday by the Department of Justice. Federal authorities said the Southern California cases included alleged schemes involving Medicare, Medi-Cal, hospice care, laboratory testing, controlled substances and workers’ compensation claims.

In all, federal prosecutors in the Central District of California said the local cases involved defendants accused of defrauding government-funded health programs or abusing positions as doctors to illegally prescribe controlled substances.

The nationwide enforcement action resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged roles in health care fraud and opioid abuse schemes involving more than $6 billion in false claims, according to the Justice Department.

Federal officials said the takedown involved cases in 56 federal districts and participation from 50 state Medicaid Fraud Control Units. Authorities also announced the seizure of more than $182 million in cash, luxury vehicles and other assets.

The Justice Department said the national effort also included actions by the Centers for Medicare and Medicaid Services to suspend 1,079 providers and revoke billing privileges for 1,403 providers. Federal officials also announced civil monetary penalty settlements and other administrative actions tied to alleged fraud.

“Public health programs are intended to support the elderly, the ill, the needy, and other vulnerable members of our communities,” First Assistant United States Attorney Bill Essayli said in a statement. “It is not there to enrich fraudsters. Today’s announcement highlights our determination to hold anyone who defrauds our nation’s health care system criminally accountable. We will find you. We will arrest you. And we will seek long prison sentences.”

The Southern California cases announced Tuesday included a Whittier woman accused of participating in a scheme that submitted nearly $270 million in fraudulent claims to Medi-Cal for expensive prescription drugs, as well as defendants accused of conspiring to defraud Medicare through hospice companies.

In the Medi-Cal case, Christina Mareik, 61, also known as Christina Marie Sanchez Hernandez, of Whittier, was arrested June 17 on a federal criminal complaint charging her with health care fraud. Prosecutors allege Mareik played a key role in a scheme involving fraudulent prescriptions submitted to Medi-Cal for medications that were not medically necessary and, in many instances, were not provided to the purported recipients.

Federal prosecutors said the scheme resulted in nearly $270 million in claims submitted to Medi-Cal over an 11-month span, with Medi-Cal paying more than $178 million for 19 expensive, non-contracted drugs containing low-cost, generic ingredients.

In another Southern California case, Oren David Shachar, 59, of Van Nuys; Abraham Shin, 66, of Corona; and Jeannie Choi, 57, of Torrance, were charged in a 16-count indictment alleging they conspired to defraud Medicare of approximately $27 million through hospice care companies.

According to the indictment, Shachar submitted false claims for hospice services that were medically unnecessary or not provided because some beneficiaries were already deceased. Prosecutors also allege illegal kickbacks were paid to marketers to procure hospice beneficiaries and persuade them to remain enrolled in the hospices.

Other Southern California defendants announced Tuesday included Lynn Galbraith, 59, of Anaheim, who was charged in connection with alleged fraudulent Medicare claims for hospice services; three physicians accused of improperly prescribing controlled substances to one another; and Dr. Eugene Richard Dorsey, 83, of Orange, who was charged in connection with an alleged workers’ compensation fraud scheme.