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Health Care Fraud in New Mexico: Duo Charged with Swindling Medicaid
ALBUQUERQUE, N.M. – A federal indictment has unveiled the alleged scheme of Cory Werito, 32, of Farmington, and Rosita Toledo, 46, of Kirtland, in a health care fraud case that has left the community stunned.
According to the indictment, Werito and Toledo, owners of CW Transport, a medical transportation company in Farmington, orchestrated a complex web of deceit that resulted in the collection of over $1.9 million in Medicaid reimbursements from an Arizona-based Medicaid agency between 2011 and 2013. The vast majority of the submitted claims were either entirely or substantially false and fraudulent.
The indictment alleges that Werito and Toledo used CW Transport to provide non-emergency medical transportation to Arizona Medicaid recipients. However, instead of providing legitimate services, they submitted false claims for reimbursement, amounting to over 18,000 claims in total.
The indictment also includes an aggravated currency structuring charge against Werito, which alleges that he conducted financial transactions involving the proceeds of the health care fraud in a manner that avoided the filing of Currency Transaction Reports (CTRs). Werito allegedly conducted at least 200 cash withdrawals, each for several thousands of dollars but less than $10,000 and totaling at least $800,000, to avoid the filing of CTRs.
The indictment includes forfeiture provisions seeking an order requiring Werito and Toledo to forfeit to the United States at least $1,959,405, the proceeds allegedly derived from the health care fraud.
If convicted, Werito and Toledo face up to ten years of imprisonment on each of the ten counts of the indictment. Charges in indictments are merely accusations, and defendants are presumed innocent unless found guilty in a court of law.
The Albuquerque office of Homeland Security Investigations (HSI) investigated the case, assisted by the FBI, U.S. Marshals Service, San Juan County Sheriff’s Office, the Arizona Health Care Cost Containment System, and the New Mexico Office of the Attorney General. Assistant U.S. Attorney Jeremy Peña is prosecuting the case.
Mandatory Facts:
Defendant/respondent: Cory Werito and Rosita Toledo
Criminal charges: Ten-count indictment including nine health care fraud charges and one aggravated currency structuring charge
City and state: Farmington, New Mexico
Exact date: June 28, 2016
Sentence or outcome: Currently in custody pending arraignment and detention hearings, scheduled for June 30, 2016
Dollar amounts: $1.9 million in Medicaid reimbursements, at least $800,000 in cash withdrawals, and $1,959,405 in alleged proceeds of health care fraud
Key Facts
- State: New Mexico
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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