Mesbel Mohamoud, Health Care Fraud, California 2021

LOS ANGELES - In a shocking turn of events, Mesbel Mohamoud, 47, of Inglewood, has pleaded guilty to a health care fraud charge for improperly billing Medi-Cal for substance abuse counseling services. Mohamoud, who owns and operates The New You Center Inc. (TNYC), a South Los Angeles drug and alcohol abuse treatment program, has admitted to submitting false and fraudulent bills for counseling sessions that were not conducted at all, were not conducted at authorized locations, or did not comply with Drug Medi-Cal regulations.

According to Mohamoud's plea agreement, from January 2009 to December 2015, TNYC submitted false and fraudulent bills for counseling sessions that were not conducted at all, were not conducted at authorized locations, or did not comply with Drug Medi-Cal regulations regarding the length of sessions or the number of clients. Mohamoud also allegedly caused TNYC to bill for clients who did not have a substance abuse problem, to falsify documents related to services supposedly provided to clients, and to forge client signatures on documents such as sign-in sheets.

For example, in September 2013, TNYC submitted a fraudulent claim for Medi-Cal reimbursement in the amount of $62.15 for a three-hour counseling session for a client on August 17, 2013 – the same day when the client was hospitalized and did not receive any counseling from TNYC.

Mohamoud and her mother-in-law, Erlinda Abella, 66, also of Inglewood, co-founded TNYC in 2005. Abella was the company's program director and also pleaded guilty to a health care fraud charge. The two women admitted that TNYC submitted approximately $527,313 in false and fraudulent claims for group and individual substance abuse counseling services and was paid $260,101 on those claims.

Mohamoud and Abella each face a statutory maximum sentence of 10 years in federal prison. Judge Philip S. Gutierrez has scheduled a February 8, 2021 sentencing hearing for Mohamoud and a January 25, 2021 sentencing hearing for Abella.

The FBI, the California Bureau of Medi-Cal Fraud and Elder Abuse, and the U.S. Department of Health and Human Services, Office of Inspector General investigated this matter. Assistant United States Attorney Cathy J. Ostiller of the Major Frauds Section is prosecuting this case.

Mohamoud's guilty plea is a significant blow to the healthcare industry, which has been plagued by cases of health care fraud. The case highlights the need for increased vigilance and oversight to prevent such schemes from taking place in the future.

Mesbel Mohamoud is currently out on bail and is expected to appear in court on February 8, 2021, for sentencing. The investigation is ongoing, and it is unclear at this time whether any other individuals or entities will be charged in connection with this case.

Source: https://www.justice.gov/usao-cdca/pr/inglewood-women-plead-guilty-running-half-million-dollar-scheme-improperly-billed-medi