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Case Highlights

Medicaid Provider Fraud Cases

Health & Wellness Medical Center

Four defendants were sentenced to serve a combined 114 months in federal prison, and were ordered to pay a combined total of more than $3.6 million in restitution to the Medicaid program.  Husband and wife pharmacists, Darrell Bryant and Gifty Kusi, owned and operated Health & Wellness Pharmacy in Dublin.  Subsequently, they opened their own Suboxone clinic, and hired Dr. Jornel Rivera as the facility's medical director and Dr. Bernard Oppong as the treating physician.  Together, the defendants perpetrated four unique schemes to defraud:  (1) They billed for compounded pain creams that were never provided to patients; (2) They billed for medically unnecessary pain creams that were never requested by patients or where the doctor who prescribed the pain cream had never met with the patient; (3) They billed for counseling services that were never provided (or billed individual counseling sessions when in fact the services were provided in a group setting); and (4) They billed for counseling services provided by unqualified individuals.
 
Darrell Bryant, RPh was convicted of health care fraud and conspiracy to commit health care fraud, and sentenced to serve 84 months in prison and three years of supervised release.  In addition, he was fined $35,000 and was ordered to pay $3.2 million in restitution, joint and several with his wife, Gifty Kusi.
 
Gifty Kusi, RPh was convicted of health care fraud and conspiracy to commit health care fraud, and sentenced to serve 12 months in prison, six months in a post-release facility, six months of home confinement, and three years of supervised release.  In addition, she was ordered to pay $3.2 million in restitution, joint and several with her husband, Darrell Bryant.
 
Dr. Jornel Rivera was convicted of health care false statements and was sentenced to serve six months in prison, six months of home confinement, and three years of supervised release.  In addition, he was fined $10,000 and was ordered to pay $260,551 in restitution.
 
Dr. Bernard Oppong was convicted of health care fraud, health care false statements, and conspiracy to distribute and dispense a controlled substance.  He was sentenced to serve 12 months in prison and two years of supervised release.  In addition, he was fined $20,000 and was ordered to pay $87,786 in restitution.

Braking Point Recovery Center

Six defendants were sentenced to serve a combined 108 months in federal prison and were ordered to pay a combined total of over $24 million in restitution to the Medicaid program.  Braking Point operated drug treatment facilities in Austintown and Whitehall.  Ryan Sheridan was the owner.  Jennifer Sheridan is Ryan Sheridan's ex-wife, and was the company's medical records and billing coordinator.  Kortney Gherardi was the company's program director at the Austintown officer.  Lisa Pertee was the Director of Operations at the Whitehall office.  Drs. Thomas Bailey and Arthur Smith were the company's medical directors.  The defendants billed Medicaid for (1) services that were either not performed or that were medically unnecessary; (2) services lacking adequate documentation to justify the claim; (3) services rendered by unqualified providers; and (4) services for which Braking Point was not properly credentialed.
 
Ryan Sheridan was convicted of health care conspiracy, health care fraud, conspiracy to distribute controlled substances, operating a drug premises and money laundering.  He was sentenced to serve 90 months in prison and three years of supervised release.  In addition, he was ordered to forfeit property and pay $24,479,939 in restitution, joint and several with his wife, Jennifer Sheridan, and Kourtney Gherardi.
 
Jennifer Sheridan was convicted of health care conspiracy and was sentenced to serve three years of supervised release.  In addition, she was ordered to pay $15,957,148, joint and several with her husband, Ryan Sheridan, and Kourtney Gherardi.
 
Kortney Gherardi was convicted of health care conspiracy and was sentenced to serve 18 months in prison and three years of supervised release.  In addition, she was ordered to pay $2,413,838, joint and several with Ryan and Jennifer Sheridan.
 
Lisa Pertee was convicted of use of a registration number issued to another to obtain controlled substances, and was sentenced to serve one year of probation and 60 days of community service.
 
Dr. Thomas Bailey was convicted of illegal dispensing of a controlled substance and was sentenced to serve two years of probation and six months of community service.  In addition, he was fined $5,000.
 
Dr. Arthur Smith was convicted of illegal dispensing of a controlled substance and was sentenced to serve two years of probation and six months of community service.  In addition, he was fined $5,000.

Dr. Nilesh Jobalia

Dr. Nilesh Jobalia was sentenced to serve 84 months in federal prison after pleading guilty to one count each of conspiracy to distribute controlled substances, health care fraud, and kickback violations.  In addition, he was ordered to pay restitution in the amount of $2,186,498.44 to Medicaid, Medicare, and the Ohio Bureau of Workers’ Compensation (“BWC”).  Jobalia owned and operated Cincinnati Centers for Pain Relief in Hamilton, and operated it as an illegal pain clinic.  He prescribed controlled substances to patients without ever actually seeing the patients, and billed insurers for medically unnecessary prescriptions.  In total, Jobalia wrote more than 67,000 prescriptions for Oxycodone, Fentanyl, and Morphine, resulting in the distribution of more than 7.2 million pills.  He also received more than $100,000 from a pharmaceutical company for purported speaking engagements about Fentanyl spray used for breakthrough cancer pain.  These speaking engagements were actually a sham, in which many attendees were not medical professionals permitted to prescribe the fentanyl spray.

Brenda Griffith

Brenda Griffith was sentenced TO serve 24 months in federal prison and three years of supervised release.  In addition, she was ordered to pay restitution to the Ohio Department of Medicaid in the amount of $205,430.56.  Griffith pled guilty in U.S. District Court for the Southern District of Ohio to one count each of conspiracy to unlawful distribution of controlled substances and health care fraud.  Griffith owned and operated Reasonable Choices, Inc., an outpatient drug treatment center (OBOT) in Springfield.  She illegally distributed prescriptions for controlled substances (namely Suboxone) outside the bounds of medical practice and for other than legitimate medical purposes.  In so doing, Griffith caused the submission of false claims to the Medicaid program, which paid for these prescriptions.  In addition, she submitted claims for services not rendered, and collected cash from patients for Medicaid-covered services.

Dr. Paul Yang‚Äč

Dr. Paul Yang was sentenced in U.S. District Court for the Southern District of Ohio after pleading guilty to a bill of information charging one count of conspiracy to commit health care fraud.  He was sentenced to serve two years of supervised release, and was given credit for one day of jail time already served.  In addition, he was ordered to pay restitution to Medicare in the amount of $61,850.33, and to Medicaid in the amount of $133,519.67.  Yang practiced at Lindenwald Medical Associates in Hamilton County, and there conspired with others to up-code claims for reimbursement of office visits submitted to government health care programs.  Yang and his co-conspirators would regularly see 40-60 patients per day, many of whom left the office with a prescription for controlled substances.  In addition, the defendants billed for medically unnecessary and often duplicative drug urine screens and other diagnostic tests, and received kickbacks from the lab that ran the tests.
 

Patient Abuse/Neglect and Misappropriation Cases

Lawrence Gamby, DDS

Dr. Lawrence Gamby pled guilty in Franklin County Common Pleas Court to one count of assault and was sentenced to serve three days in jail (suspended) and two months of probation.  In addition, and as a condition of his sentencing, Gamby submitted to a Dental Board review and subsequently entered into a consent agreement with the Board.  While providing mobile dental services to the residents of the Wesley Glen care facility in Columbus, Gamby encountered a female resident who refused to open her mouth to allow his examination.  The resident, who is 95 years old, is mall in stature, wheelchair bound, and suffers from dementia.  As Gamby attempted to open the resident’s mouth with a tongue depressor, she made a spitting sound, and blew a puff of air (no liquid) out of her mouth.  Gamby became enraged and smacked the resident in the face hard enough to force her head sideways and to move her wheelchair.

Tasha Dunfee, RN

Tasha Dunfee was sentenced to serve ten days in jail and three years of community control, pursuant to her guilty plea to one count of theft of drugs (F4), one count of illegal processing of drug documents (F4), and one count of forgery (F5).  While in the employ of the Altercare of Zanesville skilled nursing facility, Dunfee stole Oxycodone tablets intended for a facility resident, and falsified drug tracking records to conceal her theft.


Dewarn Bell

Dewarn Bell was convicted of forgery (F5) and gross patient neglect (M1), and was sentenced to serve six days in jail and three years of community control.  In addition, she was ordered to perform 100 hours of community service.  While employed as a State Tested Nurse Aide on the secure memory unit at the Glenwood Care and Rehabilitation Center in Canton, Bell failed to check on a particular dementia patient during an entire shift.  Unbeknownst to Bell, the patient had eloped from the facility prior to the start of her shift in the evening, and the patient was not discovered missing until the next morning.  The patient died from exposure.

Jolene Claybaugh

Jolene Claybaugh was convicted of patient neglect (M2) and was sentenced to serve 90 days in jail (suspended).  In addition, she was fine $250 and ordered to forfeit her State Tested Nurse Aide (“STNA”) certification.  While employed as an STNA at the Hospitality Center for Rehabilitation and Healing in Xenia, Claybaugh attempted to transfer a wheelchair-bound resident without the assistance of a mechanical lift, knowing that such a lift was required.  During the attempted transfer, the patient suffered a fracture of her right femur.

Roberta Bowers and Makiah Halsell

Roberta Bowers and Makiah Halsell each pled guilty to possessing criminal tools (F5) and were sentenced to serve three days in jail and three years of community control.  In addition, both defendants were ordered to attend a cognitive behavioral program and perform 20 hours of community service.  While employed as Resident Care Assistants at the Inn at Winchester care center in Franklin County, the defendants sprayed an elderly female resident in the face with hairspray, making a video of the attack as it unfolded, and posted the video to SnapChat.  Both defendants can be heard laughing loudly on the video, as they direct hairspray in the helpless resident’s eyes from a distance of 10-12 inches.  The resident was examined following the attack, and was diagnosed with possible "Chemical Pneumonitis" or inflammation of the lung caused by aspirating or inhaling irritants.

Denise Began

Denise Began was convicted of theft from a person in a protected class (F4) and misuse of credit cards (F4).  She was sentenced to serve three years of community control and was ordered to pay $2,641 in restitution to her victim.  Began took advantage of her friendship with an elderly resident the Life Care nursing facility in Elyria and without permission to do so, used the resident’s debit card to make personal purchases including food, gas, and the rental payment on a storage locker.  When confronted, Began admitted that she knew she was stealing from the resident.

Jacqueline Douglas

Jacqueline Douglas was convicted of theft from a person in a protected class (F3), and was sentenced to serve three years in prison (suspended) and five years of community control.  In addition, she was ordered to make full restitution to her victim, undergo a mental health evaluation and treatment, and submit to regular urinalysis testing.  Douglas misappropriated roughly $172,000 from her grandmother, who was a resident of the Friends Extended Care Center in Greene County.  Douglas served as her grandmothers Power of Attorney, and diverted funds from her grandmother’s bank account to cover her own personal expenses.  In one particular instance, after she pressed domestic violence charges against the father of her second child, Douglas withdrew $25,000 to bail him out of jail and to cover his legal expenses.

Shawna Isner

Shawna Isner was convicted in Lucas County of patient abuse, a felony of the fourth degree.  Isner was sentenced to serve six months of house arrest, 100 hours of community service, and two years of community control.  In addition, she agreed to not contest her placement on the Nurse Aide Registry, and agreed not to provide care to any patients.  Finally, she was ordered to pay $10,300 in funeral expenses for her victim.  While employed as a State Tested Nursing Assistant at the Arbors at Oregon nursing facility, Isner attempted to transfer a 98-year old female patient from her bed to a wheelchair without the use of a mechanical lift and without the assistance of another staff member, as required by the patient’s plan of care.  During the attempted transfer, the patient fell off the bed and landed on her face, fracturing her C1 and 2 vertebrae and her nose.  The patient also suffered lacerations to her face, and subsequently died from her injuries.

Thuy Murphy, LPN

Thuy Murphy was convicted of attempted theft of drugs (F5) and was sentenced to serve six months in jail (suspended) and five years of community control.  In addition, she was ordered to undergo drug evaluation and treatment, and submit to random drug urinalysis testing.  While employed as a Licensed Practical Nurse at the Pristine Senior Living & Post-Acute Care of Jamestown facility, Murphy diverted prescription opioids intended to treat facility residents for her own use, and falsified controlled drug records to conceal her thefts.
 

Workers’ Compensation Fraud Cases

Matthew Doerschuk

Matthew Doerschuk was convicted following a three-day trial in Franklin County Common Pleas Court of one count each of workers’ compensation fraud and grand theft, both felonies of the fourth degree.  He was sentenced to serve 18 months in jail (suspended) and three years of community control.  In addition, he was ordered to pay a $3,000 fine and restitution to the Ohio Bureau of Workers’ Compensation (“BWC”) in the amount of $10,730.21.  Doerschuk was injured while working as a corrections officer, and was awarded Temporary Total Disability benefits by the BWC.  While receiving these benefits, and in violation of his award, he continued to work, both in a hospital and as an Emergency Medical Technician (“EMT”).

Jeffrey Janson

Jeffrey Janson pled guilty to one count of Workers’ Compensation Fraud (F4), and was sentenced to serve six months in prison (suspended) and three years of community control.  In addition, he was ordered to pay restitution to the Ohio Bureau of Workers’ Compensation (“BWC”) in the amount of $141,578.83.  While receiving Temporary Total Disability benefits from the BWC, and in violation of his award, Janson continued to work as a salesman, a farm consultant, and a driver.