Umar Adeyola, Health Care Fraud, New York 2018

BUFFALO, N.Y. – Umar Adeyola, 48, of Amherst, NY, has pleaded guilty to conspiracy to commit health care fraud, prosecutors announced.

According to U.S. Attorney James P. Kennedy, Jr., Adeyola founded, organized, and managed the HEART Foundation, a not-for-profit organization intended to assist area youths, and Heart Community Alliance (“HCA”), a related for-profit organization, intended to provide clinical services, such as counseling and psychotherapy, to youths.

Through his role with those organizations, Adeyola engaged in two major fraud schemes. The first scheme involved attempts by the defendant, on behalf of HCA, to defraud private insurance companies Blue Cross Blue Shield, Independent Health, and Univera. Adeyola arranged for the submission of false and fraudulent bills for office visits using the names and/or provider numbers of healthcare providers who had not actually rendered the services claimed.

Adeyola also falsified documents in response to an audit of HCA by Independent Health. During the course of the audit, the defendant made materially false statements to representatives of Independent Health, with respect to the deceased social worker who he claimed had rendered services at HCA.

The second scheme involved Adeyola’s theft of government funds in the form a federally funded grant received by the Heart Foundation. Specifically, in April 2013, the Heart Foundation was selected to be a recipient of a Department of Labor grant, administered by the Latino Coalition, an entity in California. Adeyola submitted in excess of 30 false and fraudulent reimbursement requests for grant funds, resulting in payment of approximately $135,000 to the Heart Foundation.

Assistant U.S. Attorney Maura K. O’Donnell, who is handling the case, stated that the defendant’s plea is the result of an investigation by the U.S. Department of Labor, Office of Inspector General, Office of Investigations – Labor Racketeering and Fraud, under the direction of Peter Nozka, Acting Special Agent-in-Charge of the New York Region; the Federal Bureau of Investigation, under the direction of Acting Special Agent-in-Charge Kevin P. Lyons; and the Department of Health and Human Services, Office of Inspector General, Office of Investigations under the direction of Special Agent in Charge Scott Lampert.

Related Federal Cases