Sober Homes Co-Owner Sentenced to Ten Years in Prison
MIAMI, FL – Three former co-owners and clinical directors of
a group of purported substance abuse treatment centers and sober homes were
sentenced to prison today for their roles in a conspiracy to commit health care
fraud and wire fraud that resulted in an actual loss of more than $3.8 million,
and through which the conspirators sought to obtain more than $21 million.
U.S. Attorney Ariana Fajardo Orshan for the Southern
District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami
Field Office, and Special Agent in Charge Omar Pérez Aybar of the U.S.
Department of Health and Human Services Office of the Inspector General
(HHS-OIG) made the announcement.
Ali Ahmed, 38, Hector Efrain Alvarez, 49, and Mauren Morel,
45, all of Broward and Palm Beach Counties, previously pled guilty to one count
of conspiracy to commit health care fraud and wire fraud (Case No.
19cr60200). U.S. District Judge Federico
A. Moreno of the Southern District of Florida sentenced Ahmed to 120 months in
prison, Alvarez to 32 months in prison and Morel to 32 months in prison. In addition, the defendants were ordered to
forfeit certain property and pay forfeiture money judgments, as well as to pay
restitution. Specifically, Ahmed owes
$4,204,336 in restitution; Alvarez owes $3,884,035; and Maurel owes $320,301 in
restitution.
In recent years, South Florida has become the locus for drug
and alcohol addicts seeking assistance in an effort to become and remain
sober. Substance abuse treatment centers
that assist such persons undergoing detoxification from an intoxicating or addictive
substance are regulated under state and federal law. These substance abuse treatment centers, or
detox centers, offer a continuum of care including, from most intensive to
least intensive, as follows: inpatient detox, Partial Hospitalization Programs
(PHP’s), Intensive Outpatient Programs (IOP’s), and Outpatient Programs
(OP’s). Persons undergoing treatment on
an out-patient basis, whether in PHP, IOP, or OP, typically elect to live in a
“recovery residence,” also known as a “sober home” or “halfway house,” with
other persons who are also in treatment and committed to a drug and
alcohol-free lifestyle.
Jacob’s Well, Inc. (Jacob’s Well) was a Florida corporation,
located at 7950 SW 30th Street, Suite 202, Davie, Florida. Jacob’s Well was a substance abuse treatment
center licensed with the Florida Department of Children and Families that
purportedly provided private insurance beneficiaries with substance abuse
treatments and services.
Medi MD, LLC. (Medi MD) was a Florida corporation, located
at 7950 SW 30th Street, Suite 200, Davie, Florida. Medi MD was a substance abuse treatment
center licensed with the Florida Department of Children and Families that
purportedly provided private insurance beneficiaries with substance abuse
treatments and services.
Arnica Health was a Florida corporation, located at 7950 SW
30th Street, Suite 202, Davie, Florida.
Arnica Health was a purported medical treatment center co-located with
the purported substance abuse treatment centers. Together with Medi MD and Jacob’s Well,
Arnica Health operated as a part of Serenity Living and was affiliated with
sober homes known as Serenity Ranch.
Ali Ahmed was Treasurer of Jacob’s Well, Director of
Operations for Medi MD, and co-owner of Jacob’s Well, Medi MD, and Arnica
Health.
Sebastian Ahmed was the CEO and co-owner of Jacob’s Well,
Medi MD, and Arnica Health.
Hector Efrain Alvarez was Clinical Director of Medi MD.
Mauren Morel was Clinical Director and co-owner of Jacob’s
Well.
Medi MD, Jacob’s Well, and Arnica Health together operated
as Serenity Ranch/Serenity Living.
According to court documents, from June 2016 through April
2019, Ali Ahmed, Sebastian Ahmed, and Mauren Morel, submitted and caused others
to submit, via interstate wire communications, approximately $1,693,276 in
claims which falsely and fraudulently represented that various health care
benefits, primarily substance abuse PHP, IOP, and OP services, were medically
necessary, prescribed by a doctor, and provided by Jacob’s Well to insurance
beneficiaries of Aetna, BCBS, Cigna and UHC.
As a result of such false and fraudulent claims, Aetna, BCBS, Cigna, and
UHC made payments to the corporate bank accounts of Jacob’s Well in the
approximate amount of $320,301.
Furthermore, during the same approximate time period, Ali
Ahmed, Sebastian Ahmed, and Hector Efrain Alvarez submitted and caused others
to submit, via interstate wire communications, approximately $21,899,439 in
claims which falsely and fraudulently represented that various health care
benefits, primarily substance abuse PHP, IOP, and OP services, were medically
necessary, prescribed by a doctor, and provided by Medi MD to insurance
beneficiaries of Aetna, BCBS, Cigna, Humana and UHC. As a result of such false and fraudulent
claims, Aetna, BCBS, Cigna, Humana and UHC made payments to the corporate bank
accounts of Medi MD in the approximate amount of $3,884,035.
Ali Ahmed, Sebastian Ahmed, Hector Efrain Alvarez, and
Mauren Morel used the proceeds of the health care fraud for their personal use
and benefit, the use and benefit of others and to further the fraud scheme.
As set forth in Court documents, the scheme involved not
only financial exploitation but also sexual exploitation of vulnerable,
drug-addicted patients, whom were attracted and induced to attend Serenity
Ranch facilities with free flights, free housing, vapes, clothing, spa days,
benzodiazepine medications, and even drugs.
Indeed, the evidence showed that patients were permitted to keep using
drugs, and even provided drugs – including heroin and cocaine – by conspirators
such as Ali Ahmed. Ali Ahmed also
engaged in sexual relationships with patients and, as a result of the
destabilizing environment at the facilities, many patients did not get the
treatment that they so desperately needed.
Co-defendant Sebastian Ahmed, the former CEO of Jacob’s
Well, Medi MD, and Arnica, who was charged in the same indictment, has pleaded
not guilty and is set for trial on February 18, 2020, before Senior U.S. District
Judge James I. Cohn. He is presumed
innocent of the charges.
The FBI and HHS-OIG investigated the case, with assistance
from the Davie Police Department, Broward County Sheriff's Office and U.S. Drug
Enforcement Administration (DEA).
Assistant U.S. Attorneys Christopher J. Clark and Lisa H. Miller are
prosecuting the case, and Assistant U.S. Attorneys Nicole Grosnoff and Peter A.
Laserna are handling the asset forfeiture issues related to this matter.
Related court documents and information may be found on the
website of the District Court for the Southern District of Florida at
www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov.
No comments:
Post a Comment