In a landmark case, a Redondo Beach woman has been found guilty of leading a $24 million Medicare scam that involved fraudulent billing for unnecessary medical equipment and repairs. Tamara Yvonne Motley, also known as “Tamara Ogembe,” orchestrated a scheme that involved paying marketers for patient referrals, directing them to corrupt physicians who prescribed medically unnecessary durable medical equipment, such as power wheelchairs. Motley’s companies then submitted fraudulent bills to Medicare, leading to over $24 million in fraudulent claims. She has been found guilty of 20 counts of healthcare fraud, two counts of aggravated identity theft, and one count of conspiracy to commit money laundering. The case highlights the ongoing problem of healthcare fraud and the need for tighter oversight and regulations.
Overview of the Case
In a recent case that has garnered significant attention, a woman by the name of Tamara Yvonne Motley, also known as “Tamara Ogembe,” from Redondo Beach, has been found guilty of leading a $24 million Medicare scam. The charges against Motley involve submitting fraudulent claims for unnecessary medical equipment and repairs. The details of the charges and the resulting guilty verdicts shed light on the extent of the fraudulent activity and the impact it has had on the healthcare system.
Background of the Defendant
Tamara Yvonne Motley has been identified as the person behind the fraudulent scheme. She was the owner of two medical equipment and supplies companies – Action Medical Equipment and Supplies, based in Hawthorne, and Kaja Medical Equipment & Supply, located in Ventura. It was discovered that Motley had enrolled these companies with Medicare under the names of her out-of-state relatives, allowing her to execute the fraudulent activities without raising suspicion.
Motley’s scheme involved several key elements. Firstly, she would pay marketers to refer patients to her companies. These marketers would then direct the patients to corrupt physicians who would prescribe medically unnecessary durable medical equipment, such as power wheelchairs (PWCs). Motley’s companies would then submit fraudulent bills to Medicare for the equipment that was not needed or provided. This scheme enabled Motley to bill Medicare for services and products that were not legitimate.
Change in Reimbursement Rules
In January 2011, Medicare changed its reimbursement rules for power wheelchairs, making the upfront payments less lucrative for suppliers. This change prompted Motley’s company, Action Medical Equipment and Supplies, to switch its billing strategy. Instead of billing for the power wheelchairs themselves, they began billing for repairs and maintenance of the equipment. The scheme continued when Motley opened Kaja Medical Equipment & Supply after Action was shut down. Kaja primarily focused on billing Medicare for power wheelchair repairs, perpetuating the fraudulent activity.
Billing and Payments
Over the course of eight years, Action Medical Equipment and Supplies billed Medicare more than $18.2 million for durable medical equipment, including power wheelchairs, knee braces, and back braces. The repair or replacement of power wheelchairs accounted for a significant portion of the billings. Medicare paid Action nearly $10.3 million for these claims. Kaja Medical Equipment & Supply billed Medicare $6.3 million for power wheelchair repairs, with Medicare paying approximately $2.8 million for these claims. These numbers highlight the magnitude of the fraud and the financial impact on Medicare.
Sentencing and Potential Prison Time
Tamara Yvonne Motley is facing severe consequences for her actions. Following the reading of the guilty verdicts, she was remanded into custody. The sentencing hearing is scheduled for October 3rd, where Motley may receive up to 10 years in federal prison for each count of health care fraud, up to 20 years for the money laundering conspiracy count, and a mandatory two-year sentence for the aggravated identity theft counts. These potential prison sentences reflect the seriousness of the charges and aim to deter others from engaging in similar fraudulent activities.
Involvement of Other Defendants
The case also involved the participation of two other individuals who have been convicted. Cynthia Karina Marquez, who worked as an office manager at both Action Medical Equipment and Supplies and Kaja Medical Equipment & Supply, pleaded guilty to two counts of making false statements affecting a health care program. She received a time-served sentence, was placed on supervised release for three years, and was ordered to pay restitution. Juan Roberto Murillo, a repair technician at both companies, pleaded guilty to conspiracy to commit money laundering. He received three years’ probation and was ordered to pay restitution as well.
The investigation into this case was conducted by several agencies, including the US Department of Health and Human Services, Office of Inspector General, the Federal Bureau of Investigation, and the California Department of Justice. These agencies worked diligently to uncover the extent of the fraud and bring those responsible to justice. Their efforts were crucial in ensuring accountability and protecting the integrity of the Medicare system.
Prosecution of the Case
Assistant United States Attorneys Kristen A. Williams and David H. Chao from the Major Frauds Section are leading the prosecution of this case. Their expertise in handling complex fraud cases has been instrumental in presenting a strong case against Tamara Yvonne Motley and achieving the guilty verdicts. The prosecution’s dedication to upholding the law and seeking justice for the victims of this fraudulent scheme is commendable.
For further information or media inquiries regarding this case, interested parties can contact Thom Mrozek, the Director of Media Relations, at (213) 894-6947 or via email at email@example.com. Mr. Mrozek will be able to provide additional details and answer any questions related to the case.