Attorney General Peter F. Kilmartin today announced that six individuals were arrested as part of a joint state and federal crackdown on Medicaid fraud. As announced this morning by Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., the national enforcement action included more than 412 charged defendants, including over 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving over $1.3 billion in false billings. In addition to Rhode Island, more than 30 state Medicaid Fraud Control Units participated in the investigations and arrests. In addition to criminal charges, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to 295 providers, including doctors, nurses and pharmacists.
On Wednesday morning, members of the Attorney General's Medicaid Fraud Control and Patient Abuse Unit, along with special agents from the federal Office of Health and Human Services, Office of Inspector General, executed warrants and arrested the following individuals, charged with medical assistance fraud and conspiracy.
Giovanne Gomez (age 29)
92 Eliza Street
Providence, RI
Two counts of medical assistance fraud
Five counts of conspiracy
Tomas Espinal (age 40)
92 Eliza Street
Providence, RI
Two counts of medical assistance fraud
One count of laundering monetary instruments
One count of conspiracy
Margarita Martinez (age 55)
116 Washington Avenue
Providence, RI
One count of medical assistance fraud
One count of conspiracy
Mariser Liranzo (age 37)
135 Whittier Avenue
Providence, RI
Two counts of medical assistance fraud
One count of conspiracy
Two additional defendants turned themselves in on Thursday morning:
Martine Silva (age 41)
825 Douglas Avenue
Providence, RI
Two counts of medical assistance fraud
Two counts of conspiracy
Anair Centeio (age 40)
54 Ferncliff Avenue, North Providence
Two counts of medical assistance fraud
One count of conspiracy
It is alleged that February 2016 through March 2017, Giovanne Gomez, who was employed as a coordinating manager at A Caring Experience, a state-Medicaid provider, and Martine Silva, who was also employed at A Caring Experience, conspired with the other defendants to steal the identities of former employees for the purposes of submitting falsified time sheets. It is further alleged that the fraudulent pay was diverted to several bank accounts linked to the defendants.
Upon noticing the fraudulent transactions, A Caring Experience reported the problem to the Medicaid Fraud Control Unit, which began the investigation. It is estimated the defendants fraudulently stole approximately $130,000 from the scheme.
"Medicaid fraud is not a victimless crime. Every dollar illegally diverted from the program means less money for programs and services for the patients who rely upon them," said Attorney General Peter F. Kilmartin, who announced the arrests as part of the nationwide crackdown announced by HHS and the U.S. Department of Justice Thursday morning. "We know that Medicaid fraud and abuse is more widespread than just what was uncovered through this investigation. I remain committed to working with our federal and state partners to develop more cases of suspected fraud."
Gomez, Espinal, Martinez, and Liranzo were arraigned on Wednesday in 6th Division District Court before Judge William C. Clifton. Bail was set at $10,000 personal recognizance. They are due back in court for a pre-arraignment conference on October 4, 2017.
Silva and Centeio were arraigned before Judge Clifton this morning. Bail was set at $4,000 personal recognizance for Silva and $3,000 personal recognizance for Centeio. Both are due back in court for a pre-arraignment conference on October 5, 2017.