Our Work at the Attorney General's Office

About AG > Service Divisions > Health Care Fraud > Case Highlights

Case Highlights

Medicaid Provider Fraud Cases

Dr. Frank Lazzerini

Dr. Frank Lazzerini was sentenced to serve 113 years in prison (with 22 years mandatory), and was ordered to pay $71,757.49 in restitution to the Ohio Department of Medicaid and four of its managed care plans.  In addition, the Court ordered Lazzerini to immediately and permanently surrender his license to practice medicine, and ordered him to pay $65,516.98 to the Ohio Attorney General’s Office and $101,767.90 to the Ohio State Board of Pharmacy for the costs of the investigation and prosecution.  A Stark County jury found Lazzerini guilty of 187 felonies, including Medicaid fraud, engaging in a pattern of corrupt activity, telecommunications fraud, grand theft, tampering with public records, illegal processing of drug documents, trafficking in drugs, aggravated trafficking in drugs, and involuntary manslaughter.
 
Lazzerini operated Premier Family Practice near Canton, and his convictions relate to his prescribing behavior.  Lazzerini’s scheme targeted pain patients, particularly those covered by Medicaid, and he provided them with dangerous prescriptions for controlled substances for the purpose of developing dependency, and causing the patients to return to his office every two to four weeks.  This allowed Lazzerini to bill Medicaid for medical office visits each time a patient returned for a prescription, and Lazzerini up-coded his office visits to the two highest levels of complexity, dramatically increasing his Medicaid reimbursement.

Reckitt Benckiser Group

Drug distributor Reckitt Benckiser Group agreed to pay $700 million in a multistate agreement to settle allegations that the company’s improper marketing of Suboxone caused false claims to be submitted to government health care programs between 2010 and 2014.  The investigation revealed that Reckitt knowingly promoted Suboxone to doctors who prescribed the drug to patients for uses that were unsafe, ineffective and medically unnecessary.  The company also made fictitious claims that Suboxone Sublingual Film, another form of the drug, was less prone to abuse and accidental pediatric exposure than similar products.  The company made another misleading statement in a 2012 petition to the Food and Drug Administration, falsely claiming it had stopped manufacturing and selling Suboxone Sublingual Tablets due to safety concerns about the tablet formulation of the drug.  Investigators found that Reckitt also fraudulently attempted to delay the entry of generic competition for various forms of Suboxone to control drug pricing.  Ohio will receive $39.4 million under the deal.

Clinton Green

Clinton Green, who was previously found guilty of one count of health care fraud and one count of tax fraud, was sentenced in U.S. District Court for the Southern District of Ohio to serve 42 months in prison and three years of supervised release.  In addition, he was ordered to pay restitution totaling $3,385,457.41, joint and several with his mother and co-defendant, Jeralyn Dougherty.  Dougherty’s sentencing was continued to a date yet to be determined.  Green and Dougherty owned and operated Tritan EMS, a medical transportation company in Columbus, and submitted claims for Medicaid and Medicare reimbursement of ambulance transportation services for patients who did not require an ambulance and who were actually transported in a wheelchair van rather than an ambulance.  The defendants also submitted personal income tax returns that misrepresented the income they received from Tritan EMS.

Cindy Dahdah

Cindy Dahdah was sentenced in U.S. District Court in Columbus to serve five years in prison and three years of supervised release, pursuant to her October 2018 guilty plea to conspiracy to commit health care fraud, health care fraud, and health care false statements.  In addition, she was ordered to pay restitution of $2,670,950.25.  Cindy Dahdah and her late husband, Salim Dahdah, M.D., owned and operated Ohio Institute of Cardiac Care (“OICC”) in Springfield.  OICC focused on treating patients who suffered from cardiac related illnesses, including coronary artery disease.  Most of the practice’s patients were elderly and economically disadvantaged.  The couple created protocols for patients requiring certain tests and procedures that were medically unnecessary, based purely off a patient’s diagnosis.  For example, a patient with diabetes was required to have an annual nuclear stress test regardless of the patient’s need or symptoms.  As such, multiple experts agreed the couple caused claims for medically unnecessary tests and procedures – including nuclear stress tests and invasive cardiac procedures.  In fact, Cindy Dahdah directed employees to go back into a patient’s chart to 2004, in order to determine if there were other diagnosis codes that they could use to schedule additional tests.  Employees were chastised if they failed to comply with the protocol, and they were threatened with losing their jobs. From 2007 through 2015, the co-defendants caused more than 2,000 fraudulent claims to be submitted to Medicare, Ohio Medicaid, and, Anthem Blue Cross and Blue Shield.

Alta Home Health Care‚Äč

Alta Home Health Care paid $1,575,834 (which represents a double damages settlement) to the federal government and the Ohio Department of Medicaid to resolve allegations that the company failed to properly certify home health aides, forged or altered signatures on plans of care, and submitted claims for Medicare and Medicaid reimbursement of services it did not provide.

Communicare

A civil settlement with Communicare, the owner of multiple nursing facilities throughout Ohio, concluded with the final payment in a settlement totaling $1,500,255.41.  The settlement resolves allegations that facilities owned by Communicare submitted and were paid for untimely claims.  Nursing facilities, like all Medicaid providers, have one year from the date of service to submit a claim for reimbursement to the Ohio Department of Medicaid (“ODM”).  If a Medicaid claim is submitted and denied by ODM, the Medicaid provider has up to an additional year to correct the submission error and resubmit the claim.
 
In August of 2011, ODM launched a new claims payment system called the Medicaid Information Technology System (“MITS”), which contained timely submission edits.  However, due to problems with the implementation of MITS, ODM turned off the timely submission edits from August 2, 2011, through September 30, 2012.  During this time frame, twenty-five Communicare nursing facilities submitted claims for daily and ancillary services that were more than two years from the date of service, which is outside the timely submission requirement.  Because the timely submission edit was turned off, these claims were paid.  Significantly, no other nursing facilities in the entire state submitted late claims during the time that the timely edits were turned off.  All of the claims were initially timely submitted and denied.  Most of the claims were regularly resubmitted and some claims had not been submitted for over 5 years.  Each claim’s history had to be reviewed by tracing all the remittance advices for every submission and identifying the denial codes for each submission.  There were thousands of claims that had to be reviewed.  Some of the late claims submitted during the time that the edits were off were legitimate, but many were not.

Arnita Leff

Arnita Leff was convicted of one count of conspiracy to commit health care fraud in U.S. District Court, and was sentenced to serve six months of home incarceration and five years of probation.  In addition, she was ordered to pay restitution in the amount of $661,010.19, $157,000 of which she tendered at sentencing.  Leff, a Licensed Social Worker and an owner of Partners to Empowerment Wellness Center, conspired with the company’s biller, Angela Meeks (who was indicted but passed away prior to sentencing), to submit claims for reimbursement of:  (1) psychotherapy services and psychological diagnostic evaluations that were never provided; (2) individual counseling services, when in fact such services were rendered in a group setting; and (3) non-covered services, such as yoga and other “holistic” services.  In addition, Certain of the services provided by the company require supervision by a Licensed Independent Social Worker (“LISW”) to be eligible for reimbursement by Medicaid, and the defendants used the National Provider Identifier of an LISW on claims for reimbursement to make it appear as though the underlying services had been so supervised, when in fact they were not.

Dr. Robert Rosenstein

Dr. Robert Rosenstein was convicted of one count of healthcare fraud in U.S. District Court, and was sentenced to serve 33 months in prison, with three years of supervision upon release.  In addition, he was ordered to pay $405,306.26 in restitution to Medicare and $48,309.21 in restitution to the Ohio Department of Medicaid, $75,000 of which he paid prior to sentencing.  Rosenstein was excluded from Medicare and Medicaid due to a prior program-related conviction, but continued to see patients anyway, and billed the services under another podiatrist’s name.

Felicia Betts

Felicia Betts was sentenced to serve seventeen months in prison for her conviction of Medicaid fraud (F4).  Betts, a Licensed Practical Nurse and independent home health provider, submitted claims for Medicaid reimbursement of services she did not provide.  Betts worked the overnight shift for a juvenile Medicaid recipient for less than two months, when the recipient’s parents discontinued the overnight services.  A month later, Betts billed as though she had provided weekend services for this same patient, and got paid.  The next month she billed for several weekends, and got paid for those as well.  For the next eight months, Betts billed as though she was providing this recipient with twelve hours of service each day, despite the fact that she actually provided none of these hours.  In total, the loss to the Medicaid program is more than $214,000.

Janay Corbitt

Janay Corbitt was convicted of theft, a felony of the fourth degree, and was sentenced to serve 17 months in prison (suspended) and five years of community control.  In addition, she was ordered to pay $204,412.02 in restitution.  Corbitt ran a business called Family First Adult Recovery Center, which provided drug and alcohol counseling services.  Special Agents interviewed 31 recipients who supposedly received services from Family First.  Only two of those recipients received anything that could even be considered counseling, and even those two did not receive anywhere near the amount of services for which the agency billed.  The remaining recipients never received any counseling at all, and many argued that they never even needed it.  Instead, Family First promised to provide needed items (food, supplies, help with shelter, etc.) in exchange for the recipients’ Medicaid numbers.  Family First then used this information to bill Medicaid for services they did not provide.

Georgia Mitchell

Georgia Mitchell was convicted of Medicaid fraud, a felony of the fourth degree, and was sentenced to serve 17 months in prison (suspended) and five years of community control.  In addition, she was ordered to pay restitution in the amount of $118,420.22.  Mitchell was a home health aide who was authorized to provide services to her adult son at his residence in three separate four-hour shifts, seven days per week, for a total of 84 hours per week.  Mitchell billed as though she provided these services every single day for years, and was identified by the Ohio Department of Medicaid as an outlier for use of the overtime modifier code.  Physical surveillance revealed that Mitchell was not even leaving her house during the hours she was allegedly providing services, so the Unit secured a search warrant to place a GPS tracker on Mitchell’s car.  During the 40 days the tracker was active, Mitchell only went to her son’s residence on one occasion.  The Unit then obtained an additional search warrant for Mitchell’s cell phone records.  The cell site location information so obtained revealed that Mitchell had been at her son’s residence only 30 times during the preceding two year period, while she billed as though she had made approximately 2,000 visits to her son’s home during that time.

Jeffrey Kleinman, DDS

Jeffrey Kleinman was convicted of Medicaid fraud, a felony of the fourth degree, and was sentenced to serve one year of community control.  In addition, he was fined $500 and ordered to pay restitution of $99,546.59 to the Ohio Department of Medicaid.  Kleinman, the owner of Dixie Dental & Denture Center in Dayton, submitted claims for Medicaid reimbursement of oral examinations he did not conduct, denture repairs that were not performed, and dentures that were never delivered.  During the execution of a search warrant, Agents found these dentures stored in the basement of the facility.

Angela Vilk

Angela Vilk was convicted of Medicaid fraud, a felony of the fourth degree, and was sentenced to serve twelve months in prison and five years of community control.  After a contested restitution hearing, the court ordered her to pay $41,283.71 in restitution to the Department of Medicaid, the full amount requested by the State.  Vilk, a Licensed Practical Nurse, was employed as a Minimum Data Set (or “MDS”) Coordinator at East Galbraith nursing facility in Cincinnati.  The MDS is a resident assessment instrument used in care planning.  Under Ohio Medicaid, the MDS is also used to establish average resident acuity, which drives the direct care component of the facility’s Medicaid per diem reimbursement rate.  Assessments of each facility resident are performed periodically, but not less than every 90 days, and each assessment is submitted to the Centers for Medicare and Medicaid Services (“CMS”) electronically.  The Medicaid Fraud Control Unit’s investigation revealed that during a two year period, Vilk knowingly falsified information in certain MDSs with the intent of inflating the facility’s Medicaid reimbursement.  In all, thirteen such false MDSs were identified, causing the loss to Medicaid.

Patient Abuse/Neglect and Misappropriation Cases

Sharda Thorpe

Sharda Thorpe was convicted in Avon Lake Municipal Court of attempted gross patient neglect, a second-degree misdemeanor.  Thorpe was sentenced to perform 100 hours of community service and was ordered to pay court costs of $192.00.  While employed as a State Tested Nurse Aide at the Avon Healthcare Center, Inc. dba The Woods on French Creek Nursing & Rehabilitation Center, Thorpe attempted to transfer an elderly female resident from her bed to a wheelchair.  The patient suffered from severe cognitive impairment and per her doctor’s orders, required a two-person transfer.  As Thorpe moved the patient from her bed, she dropped the patient.  As she fell, the patient caught her right leg on of the edge of the chair, causing a deep laceration (almost to her bone).  The resulting wound measured nearly eight inches long by three and one-half inches wide, and required surgical intervention.

Anthony O'Neal

Anthony O’Neal pled guilty to one count of attempted patient abuse (F5) and was sentenced to serve 90 days in jail and 30 hours of community service.  While employed as a Care Partner at The Gables of Kentridge in Portage County, an assisted living facility, O’Neal committed a physical act of abuse against an elderly female resident.  O’Neal aggressively pressed his hand against the patient’s left shoulder, knowing that it would cause her to open her mouth as she screamed out in pain, thereby allowing him to more easily insert her dentures.  O’Neal later asserted that he did it “to see if she would scream,” so he could, contrary to his lack of authority, assess her pain level.

Amanda Watkins

Amanda Watkins was convicted in Sylvania Municipal Court of patient neglect, a misdemeanor of the second degree.  The Court issued a 90 day sentence, suspended 68 days, gave her credit for two days of jail time, and ordered her to serve the remaining 20 days in an alcohol and drug treatment facility.  In addition, the Court prohibited her from working in a healthcare facility.  Watkins, a former housekeeper with Kingston Care Center of Sylvania, attempted to transport a female resident outside the facility in a wheelchair.  Watkins was not only untrained in proper transport techniques, but was under the influence of alcohol at the time.  Watkins left the resident sitting in the wheelchair, unlocked and on a sidewalk incline, and returned to the facility to get “a cup of water.”  In her absence, the wheelchair rolled down the incline and off a curb, propelling the resident out of the wheelchair and causing the resident to strike her head and body against the pavement.  The resident sustained abrasions to her face, knee, and hip, as well as transverse fractures of the proximal tibia and fibular neck of her right leg.

Hollis Bailey

Hollis Bailey was convicted of theft, a felony of the fifth degree, and was ordered to pay restitution to the Ohio Department of Medicaid in the amount of $14,425.26.  Bailey owned New Day Village, Inc., which operated several adult care facilities in Zanesville and Cambridge.  Bailey’s facilities accepted Medicaid funds under the residential state supplement (“RSS”) program to pay for lodging and services rendered to eligible residents.  Pursuant to RSS rules, once a recipient is no longer living in an appropriate home/facility, the recipient stops being eligible for RSS.  The investigation revealed that Bailey knowingly continued to cash RSS payment checks after recipients were no longer living at her facilities.  Bailey stole over $14,000 in RSS funds that had been earmarked for a total of seven former New Day residents.  For example, in the case of one resident, Bailey continued to accept checks for seven months after the resident had moved out of New Day, despite her admission that she was aware he no longer lived there.  Another resident died in December 2016, but Bailey continued to receive RSS payments earmarked for this resident for ten more months.  When interviewed, Bailey admitted that what she had done was wrong.

Kim Scaffe

Kim Scaffe was sentenced to serve nine months in prison and up to three years of post-release control.  Following a three-day jury trial in Fulton County Common Pleas Court, Scaffe was found guilty of two counts of theft of drugs, felonies of the fourth degree.  While employed as a Licensed Practical Nurse at the Swanton Health Care nursing facility, Scaffe stole a medication card containing 29 Percocet pills (combination of oxycodone and acetaminophen) prescribed to one facility resident, and a card of 30 Percocet pills prescribed to another resident.

Deborah Parkins

Deborah Parkins was convicted of theft, a felony of the fifth degree, and was sentenced to serve four years of community control and ordered to pay full restitution to her victims.  While employed as the Business Office Manager at the Minerva Park Healthcare and Rehabilitation Center in Franklin County, Parkins forged resident signatures to make unauthorized withdrawals from the residents’ trust accounts.  In total, she stole $7,543 from 30 different facility residents.  Agents identified 255 individual instances of theft, with 312 forged signatures.

Cynthia Laird

Licensed Practical Nurse Cynthia Laird was convicted of two counts of tampering with evidence, felonies of the third degree, and six counts of theft of drugs, felonies of the fourth degree.  Laird was sentenced to serve a three-year term of community control during which she must continue her intensive outpatient treatment, perform 50 hours of community service, and attend at least one mental health counseling session per week.  Additionally, she is prohibited from working as a nurse or in any related field, and she must submit to random drug and alcohol testing.  Should she violate the terms of her community control, the court may impose a prison term of six years.

Workers’ Compensation Fraud Cases

Gregory Fitzer

Gregory Fitzer was convicted of workers’ compensation fraud (F4), and was sentenced to serve twelve months in prison (suspended) and four years of probation.  In addition, he was ordered to pay $211,536 in restitution and $23,187 in investigative costs to the Ohio Bureau of Workers’ Compensation (“BWC”).  Fitzer worked as a process server and investigator for several Zanesville law firms, and also worked as a truck driver and laborer for the retail company “Woodbury Outfitters” while receiving BWC benefits as a totally disabled person.

James Hesler

James Hesler was convicted of two counts of workers’ compensation fraud and was sentenced to serve 18 months in prison (suspended) and five years of community control.  In addition, he was ordered to pay restitution to the Ohio Bureau of Workers’ Compensation (“BWC”) in the amount of $88,194.53.  Hesler owned and operated a roofing business which had employees and payroll.  However, in order to avoid paying premiums to the BWC, Hesler reported that he had no employees.

Michael Myers

Michael Myers was convicted of workers’ compensation fraud, a felony of the fifth degree, and was sentenced to serve six months in jail (suspended) and one year of community control.  In addition, he was ordered to pay restitution to the Ohio Bureau of Workers’ Compensation (“BWC”) in the amount of $45,337.99.  Myers worked as a salesman for Restoration 1 while receiving BWC benefits as a totally disabled person, and directed his employer to cut his paychecks in his wife’s name in furtherance of the scheme.

Ronald Dorfeld

Ronald Dorfeld was convicted of workers’ compensation fraud and sentenced to serve nine months in prison (suspended) and five years of community control. In addition, he was ordered to pay restitution to the Ohio Bureau of Workers’ Compensation (“BWC”) in the amount of $78,957.  Dorfeld owned and operated a marketing business while collecting BWC benefits as a totally disabled person.