Cory Werito, Health Care Fraud, New Mexico 2016

Cory Werito, a 33-year-old man from Farmington, New Mexico, has pleaded guilty to a health care fraud charge in federal court in Albuquerque. The guilty plea was announced by U.S. Attorney Damon P. Martinez and Special Agent in Charge Waldemar Rodriguez of Homeland Security Investigations (HSI) in El Paso.

Werito and his co-defendant, Rosita Toledo, 47, of Kirtland, New Mexico, were charged in a ten-count indictment that was filed on June 15, 2016. The indictment included nine health care fraud charges against Werito and Toledo, and an aggravated currency structuring charge against Werito.

According to the indictment, the health care fraud charges were based on the defendants’ roles in creating and operating a medical transportation company, CW Transport, a New Mexico company located in Farmington that provided non-emergency medical transportation to Arizona Medicaid recipients, funded by reimbursement payments from the Arizona Health Care Cost Containment System (AHCCCS), a healthcare benefit program.

The indictment alleged that over the course of two years between 2011 and 2013, CW Transport collected more than $1.9 million in Medicaid reimbursements from AHCCCS by submitting more than 18,000 claims for reimbursement, the vast majority of which were wholly or substantially false and fraudulent.

Count 10 of the indictment, the aggravated currency structuring charge, alleged that Werito conducted financial transactions involving the proceeds of the health care fraud in a manner that avoided the filing of Currency Transaction Reports (CTRs). CTRs are reports which must be filed by financial institutions on transactions involving more than $10,000 during any business day and are used by law enforcement authorities to uncover a broad range of illegal activities including money laundering.

Werito admitted, as the sole owner of CW Transport, he submitted approximately 18,765 claims for reimbursement to AHCCCS between July 2011 and July 2013. Because the claims were grouped in 140 invoices, Werito received 140 payments from AHCCCS in an amount totaling $1,959,405. Werito admitted submitting the claims for reimbursement as part of a scheme to defraud AHCCCS because he either never provided or provided in a substantially different manner many of the services for which he sought and received reimbursement.

At sentencing, Werito faces a maximum penalty of ten years in federal prison. Under the terms of his plea agreement, Werito also will be required to pay $1,218,165 in restitution. A sentencing hearing has yet to be scheduled.

Related Federal Cases