New Haven Woman Arrested After Investigation into Theft from Medicaid Program

A New Haven woman has been arrested and charged with stealing from the Medicaid program.

Bethsabee Bernadel, age 53, of New Haven, was arrested on July 16, 2026 by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney and charged with one count of Health Insurance Fraud, in violation of Connecticut General Statutes § 53-442, and one count of Larceny in the First Degree by Defrauding a Public Community, in violation of Connecticut General Statutes § 53a-122(a)(3).

An investigation by the Medicaid Fraud Control Unit found that Bernadel, while employed as a Personal Care Assistant (PCA) for one recipient and a PCA Supervisor for a second recipient, submitted timesheets and was paid for services that were not provided. The PCA program is a Medicaid-funded program which provides recipients who have permanent, severe, and chronic disabilities, funds to hire PCAs to physically assist them with daily self-care activities that enable them to reside in their homes and remain in the community.

The investigation revealed that between March 1, 2021 and March 23, 2023, Bernadel created and submitted time sheets for hours during which she performed no supervisory duties. She also submitted timesheets for hours she did not work and for services she did not provide. The investigation concluded that Bernadel fraudulently billed Medicaid and received an amount of $7,700.12 in Medicaid payments she was not entitled to.

The money profited by her in the amount of $7,700.12 constitutes the crime of Larceny in the First Degree by Defrauding a Public Community. The submission of claims to the Department of Social Services provided by Bernadel contained false, incomplete, deceptive, or misleading information which constitutes Health Insurance Fraud.

Bernadel was released on a $10,000 non-surety bond and scheduled to appear on July 27, 2026 in Bridgeport Superior Court. The charges are merely accusations, and she is presumed innocent unless and until proven guilty.

Larceny in the First Degree by Defrauding a Public Community and Health Insurance Fraud, are classified as B felonies and are each punishable by up to 20 years in prison.

The case was investigated and will be prosecuted by the Medicaid Fraud Control Unit. The Unit is grateful for the assistance of the Connecticut Department of Social Services – Office of Quality Assurance, Connecticut Department of Developmental Services, and the Newington Police Department.

The Connecticut Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,612,588 for the fiscal year of October 1, 2025, through September 30, 2026. The remaining 25 percent, totaling $870,858 for the same fiscal year, is funded by the State of Connecticut.

Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Medicaid Fraud Control Unit at the Office of the Chief State’s Attorney at (860) 258-5986.

The South Carolina Law Enforcement Division (SLED) charged Cornelius Travis Jones, 46, with Presenting a False Claim for Insurance Payment – Value More Than $2,000 but Less Than $10,000 on Thursday, July 16, 2026. He was booked into the Florence County Detention Center.

SLED charged Jones later that day with Presenting a False Claim for Insurance Payment – Value More Than $2,000 but Less Than $10,000 and Presenting a False Claim for Insurance Payment – Value $2,000 or Less. He was then booked into the Darlington County Detention Center on those charges.

The South Carolina Department of Insurance requested the SLED investigation.

Details can be found in the attached warrants.

The case will be prosecuted by the South Carolina Department of Insurance.

New York Attorney General Letitia James today announced the arrests and criminal charges of Francia Aguila, 53, of Farmington, New York and Gifty Appiah, 59, of Staten Island, New York, for putting patients at an Astoria, Queens medical clinic at risk and stealing over $100,000 from Medicaid through false billing. An investigation by the Office of the Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) revealed that Aguila, the part owner of Steinway Hope Medical, fraudulently used Appiah’s identity and credentials as a licensed nurse practitioner to diagnose, treat, and prescribe medications to patients. While Aguila did not possess a license to practice medicine, she allegedly dressed in a white coat, referred to herself as “Doctor Fran,” and performed examinations on patients. Aguila used her fraudulent medical practice to bill $105,018.20 to Managed Care Organizations (MCOs) funded by New York’s Medicaid program from March 2021 through November 2024.

“Practicing medicine without a license risks the lives of New Yorkers and undermines the integrity of our health care system,” said Attorney General James. “New Yorkers in need of medical care sought treatment at Steinway Hope Medical, where they were taken advantage of by a fake doctor as part of an elaborate Medicaid fraud scheme. My office will continue to root out fraud in our state’s Medicaid program and protect New Yorkers by bringing unlicensed practitioners to justice.”

Appiah was allegedly paid $10,000 per month to act as the sole provider of medical services to patients at Steinway Hope Medical. However, Appiah rarely appeared at the clinic and instead allowed Aguila to medically examine patients who were seeking treatment. Aguila presented herself to patients as a doctor and used Appiah’s identity and credentials to prescribe medications. Aguila performed stethoscope exams, examined patients’ eyes with a penlight, and conducted other tests on unsuspecting patients. Through Steinway Hope Medical, Appiah and Aguila submitted fraudulent claims to Medicaid-funded MCOs that falsely stated Appiah performed the medical services.

Aguila and Steinway Hope Medical were each charged with one count of Unauthorized Practice of a Profession, one count of Falsifying Business Records in the First Degree, and one count of Unauthorized Use of a Professional Title. Appiah was also charged with one count of Offering a False Instrument for Filing in the First Degree and one count of Offering a False Instrument for Filing in the Second Degree. If convicted, Appiah and Aguila face a maximum sentence of one and a third to four years in state prison on the top count.

These charges are merely accusations, and the defendant is presumed innocent unless and until proven guilty in a court of law.

This investigation was handled by Detective Nefertiti Clarke under the supervision of Detective Supervisor Dominick DiGennaro, Detective Supervisor Ramon Almodovar, and Deputy Chief Ronald Lynch. The audit investigation was conducted by Principal Auditor Investigator Olga Sunitsky with the assistance of Auditor Investigator Victor Torres under the supervision of Regional Chief Auditor Jonathan Romano.

The criminal case is being prosecuted by Special Assistant Attorney General Michael Orvets under the supervision of New York City Regional Director Twan Bounds. Investigative support was provided by Legal Support Analyst Natalie Tamblyn under the supervision of Supervising Legal Assistant Alexandra Schmit.

MFCU is led by Deputy Attorney General Amy Held and Assistant Deputy Attorney General Thomas O’Hanlon. MFCU is part of the Division for Criminal Justice, which is led by Chief Deputy Attorney General José Maldonado and overseen by First Deputy Attorney General Jennifer Levy.

New York MFCU’s total funding for federal fiscal year (FY) 2026 is $70,793,651. Of that total, 75 percent, or $53,095,240, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $17,698,411 for FY 2026, is funded by New York State.

A Florida man was arrested after investigators say he submitted more than $159,000 in fraudulent health insurance claims and received reimbursements based on altered or counterfeit documents.

Florida Chief Financial Officer Blaise Ingoglia announced on Wednesday the arrest of Torey Jermaine Keith, who is accused of submitting 15 fraudulent health insurance claims totaling $159,557.

According to the Florida Department of Financial Services, the agency’s Criminal Investigations Division launched an investigation after Keith’s insurance company reported it was unable to verify the claims he had submitted.

Investigators determined that Keith allegedly filed claims that were counterfeit, fraudulent or altered in an effort to obtain insurance reimbursements. The insurance company ultimately paid out $159,557.50 before the alleged fraud was uncovered.

“This arrest serves as a warning for criminals who try to exploit the insurance system for their own financial gain. My investigators will continue to pursue fraudsters and bring them to justice,” Ingoglia said.

When criminals submit fraudulent claims, they aren’t just stealing, they are driving up the costs and insurance premiums for Floridians and their families across the state.”
Keith was arrested June 11, according to the Department of Financial Services. He faces charges of making false and fraudulent insurance claims, uttering a forged instrument and organized scheme to defraud.

The primary owner of St. Anthony’s Nursing and Rehabilitation Center, 767 30th St., Rock Island faces charges of health-care fraud, according to the U. S. Attorney’s Office, Southern District of Florida.

Rajiv (Raj) Shah has owned and operated the for-profit facility since April 2022, and has 91 percent ownership interest, according to documents at medicare.gov, which says the ownership type is an LLC (limited liability company). The charges were announced as part of the DOJ’s 2026 National Health Care Fraud Takedown, targeting hundreds of defendants nationwide.

Shah was indicted in June 2026.

People who were charged in the Southern District of Florida in connection with the health care fraud schemes include Rajiv Shah, 65, of Palm Beach County, Florida, who was charged by indictment with conspiracy to commit health care fraud and wire fraud, and health care fraud, in connection with an over-$64 million scheme to submit fraudulent claims to Medicare for medically unnecessary DME. (Durable Medical Equipment is medically, reusable devices such as wheelchairs, hospital beds, and CPAP machines used in homes.)

As alleged in the indictment, Shah, as the owner and operator of ACC-Q Data, LLC, a medical billing company, conspired with owners and operators of DME companies to submit fraudulent claims to Medicare. Medicare paid over $23 million based on those claims. Shah advised the DME companies how to avoid scrutiny from Medicare for the medically unnecessary DME and how to conceal the fraudulent nature of these claims. The case is being prosecuted by Trial Attorney Jody King of the Florida Strike Force.

United States Attorney Jason A. Reding Quiñones for the Southern District of Florida announced criminal charges against 12 defendants, including Shah, in connection with alleged schemes to defraud Medicare, Medicaid, the Federal Employees Health Benefit Program (FEHBP), and private insurers, court documents show. These charges were announced as part of the DOJ’s 2026 National Health Care Fraud Takedown, targeting hundreds of defendants nationwide.

National Health Care Fraud Takedown

The charges filed in federal court are part of the Department of Justice’s 2026 National Health Care Fraud Takedown, according to a news release. “The charges stem from schemes involving over $4 billion dollars in fraudulent claims for DME, skin substitutes and wound care products, laboratory testing, and community mental health services that were medically unnecessary, procured by kickbacks to marketers and beneficiaries, and not provided, some of which involved transnational criminal organization activity and significant patient harm and risk to public safety,” according to court records.

“Health care fraud isn’t just fraud, it’s stealing from every American taxpayer. This Department of Justice is no longer satisfied with chasing stolen money after it’s gone,” said U.S. Attorney Reding Quiñones. “We’re using data to detect suspicious claims earlier, prevent fraudulent payments whenever possible, seize the proceeds of fraud, and bring those responsible before the courts. If you choose to exploit our health care system for personal gain, expect to lose your money, your assets, and your freedom.”

“Health care fraud is more than a financial crime. Every dollar stolen through fraud is a dollar diverted from patient care, medical services, and programs that millions of Americans depend upon. The impact is felt not only in government-funded health care programs, but throughout the entire health care system,” said Special Agent in Charge Brett Skiles of FBI Miami. “The FBI and our partners work tirelessly to investigate health care fraud, but we cannot do it alone. If you believe you have information related to healthcare fraud or someone you know may have been a victim, file a complaint at the FBI’s Internet Crime Complaint Center at ic3.gov.”

“In the far-reaching enforcement action announced today, the HHS Inspector General’s Office and our law enforcement partners effectively shut down an expansive array of alleged high-dollar, corrosive health care fraud schemes and are bringing those we believe responsible to justice,” said Special Agent in Charge Isaac M. Bledsoe of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Simply put, fraudsters who exploit Medicare and Medicaid patients and jeopardize these safety net health care programs to enrich themselves will be held accountable for their crimes.”

“Medicaid is your tax dollars meant to help sick children, disabled adults, and struggling families get the doctor visits, therapy, and daily care they need. When someone cheats the system, they steal from the very people who need it most,” said Florida Attorney General James Uthmeier. “My office will keep working with our state and federal law enforcement partners to protect your taxpayer dollars so they work for the people who need it—not the cheaters.”

Court documents show the charges are part of a strategically coordinated, nationwide law enforcement action that resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged participation in health care fraud and opioid abuse schemes involving over $6.5 billion in false claims and significant patient harm, including death.

“This Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history,” according to a news release from U. S. Attorney’s Office, Southern District of Florida. In addition, unprecedented international cooperation over the two-week Takedown resulted in the apprehension and return to the United States of health-care fraudsters: One defendant in Kyrenia in connection with an over-$3.7 billion scheme; two defendants in Estonia in connection with a previously charged $10.6 billion scheme; and, in the Philippines, one of FBI’s Most Wanted Fraudsters in connection with a previously-charged $1.2 billion telemedicine fraud scheme.]

According to the attorney general’s office, the Takedown involves the cutting-edge use of data analytics to target the worst actors; the seizure of over $182 million in cash, luxury vehicles, jewelry, and other assets; and full-spectrum accountability for all criminal actors from doctor’s offices to corporate boardrooms. This coordinated enforcement action involves a whole-of-government approach, including:

Actions by the Centers for Medicare and Medicaid Services (CMS) to suspend 1,079 providers and revoke billing privileges for 1,403 providers.
48 Civil Monetary Payment settlements amounting to over $73 million, over 1,400 provider exclusions, and 25 actions by the HHS-OIG under the Civil Monetary Penalties Law seeking more than $10 billion in payments to the Medicare Trust Fund from payments that CMS caught and suspended before the funds were paid to the fraudulent providers.
Civil charges against 13 defendants for $14.8 million in health care fraud schemes, as well as civil settlements with 31 defendants totaling $23 million.
928 administrative cases by the Drug Enforcement Administration (DEA) seeking the revocation of authority to handle and/or prescribe controlled substances since October 1, 2025.
Medicare fraud

According to documents, $27,425,929 of health care fraud proceeds were seized pursuant to seizure warrants and civil forfeiture complaints from bank accounts belonging to 12 different clinics in South Florida: Always Medical Center Corp., Caso Quality East Corp., CRC Management, Envy South Florida Medical Center, H Services Corp., Hamilton State Inc., Medmed 137 Inc., Miami Special Care, Nakelly Medical Center Corp., Pronto Medical Center, Theron Medical Center LLC, and VCG Best Services. The seizure warrants and civil forfeiture complaints allege that the clinics were “bust outs” — billing Medicare for amniotic wound allografts and services that were never provided.

The seizure initiative is being led by Acting Assistant Chiefs Jil Simon and Keith Clouser, and Trial Attorney Owen Dunn, of the Florida Strike Force, Assistant Chief Jamie de Boer of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Sally Molloy, Elizabeth Young, Gabrielle Charest-Turken, Nadya Cheatham, Sandra Demirci, Daren Grove, Mitch Hyman, and Brian Zack of the Southern District of Florida.

The cases are being prosecuted by the Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, New England, Northeast, Texas, and West Coast Strike Forces; U.S. Attorneys’ Offices for the Middle District of Alabama, District of Arizona, Central District of California, Southern District of California, District of Colorado, District of Connecticut, District of Delaware, Middle District of Florida, Northern District of Florida, Southern District of Florida, Northern District of Georgia, District of Hawaii, District of Idaho, Northern District of Illinois, Northern District of Iowa, Southern District of Iowa, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of Massachusetts, Eastern District of Michigan, Southern District of Mississippi, District of Montana, District of Nebraska, District of New Hampshire, District of New Jersey, District of New Mexico, Eastern District of New York, Northern District of New York, Southern District of New York, Eastern District of North Carolina, Middle District of North Carolina, Western District of North Carolina, Northern District of Ohio, Northern District of Oklahoma, Western District of Oklahoma, District of Oregon, Eastern District of Pennsylvania, Middle District of Pennsylvania, Western District of Pennsylvania, District of Puerto Rico, District of Rhode Island, District of South Carolina, District of South Dakota, Middle District of Tennessee, Western District of Tennessee, Northern District of Texas, Southern District of Texas, Western District of Texas, District of Vermont, Eastern District of Virginia, Western District of Virginia, Northern District of West Virginia, Southern District of West Virginia, Eastern District of Wisconsin, and Western District of Wisconsin; and State Attorneys General’s Offices, through their MFCUs, in Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virgin Islands, Washington, Wisconsin, and West Virginia. In addition, the MFCUs for Alabama, North Carolina, South Dakota, Texas, and Virginia participated in the investigation of the federal cases announced.

Descriptions of each case involved in the enforcement action are available on the Department’s website here. The civil forfeiture complaints for the Southern District of Florida are available here.

Prosecutors in the Southern District of Florida’s Health Care Fraud Unit of the Economic Crimes and Cyber Frauds Section and the Department’s Health Care Fraud Unit of the Fraud Division comprise the Florida Strike Force and worked with these law enforcement agencies to investigate and prosecute the cases filed during the Takedown: the HHS-OIG; FBI; Department of Homeland Security, Homeland Security Investigations (HSI) and U.S. Citizenship and Immigration Services (USCIS); the Florida Medicaid Fraud Control Unit; Department of Labor Office of Inspector General; IRS; DEA; and Department of Veterans Affairs Office of Inspector General.

The Department of Justice has announced the creation of the National Fraud Enforcement Division (Fraud Division). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within federal benefit programs.

A multi-agency task force dismantled a massive, family-run criminal enterprise operating out of a West Palm Beach shopping plaza after a lengthy undercover investigation Thursday that allegedly laundered millions of dollars through the local construction industry.

The operation, based out of MLS Paralegal Services, used a network of fake “shell” companies to run a sophisticated workers’ compensation and money laundering scheme that handled more than $95.6 million in hidden cash, according to an arrest affidavit filed in Palm Beach County Circuit Court.

The Scam
Investigators with the Broward Sheriff’s Office Money Laundering Task Force and the Palm Beach County Sheriff’s Office named 36-year-old Marlen Suazo Gutierrez as the head of the operation. Detectives say the group specialized in a lucrative fraud scheme known as “certificate renting,” which exploits state insurance laws

In Florida, construction companies are legally required to carry workers’ compensation insurance to cover medical bills and lost wages if a worker is injured on the job. Because this insurance is expensive, in 2021, the suspects allegedly bought bare-minimum “ghost” policies, telling officials that they only employed a couple of office workers.

Once they had the official insurance certificate, the group “rented” it out to actual, uninsured subcontractors for a fee. This allowed those subcontractors to show a piece of paper and gain access to major commercial job sites illegally, while the masterminds pocketed the rental fees and hid the workforce from state regulators.

To orchestrate the fraud, the network registered at least seven interconnected shell companies, including DMF Construction Services and Ace Concrete & Pavers, under the names of various family members. Investigators discovered that every single one of these corporate entities used the exact same mailing address: a small, vacant West Palm Beach storage unit complex bearing signage for a shipping company.

Laundering Millions
To keep the scheme going, investigators say the enterprise had to run millions of dollars in payroll checks through an illegal, unregistered money service business to avoid the traditional banking system.

MLS Paralegal Services at 2601 S Military Trail in West Palm Beach, which investigators say was an illegitimate business, served as the physical headquarters and front for this entire operation. While it appeared to be a legitimate business on the outside, investigators state it functioned as an illegal, unregistered money service business and the central hub for the scheme. The office was crucial for two main reasons: it acted as the management base where family members coordinated the paperwork for fake shell companies, and it served as the primary cash hub for the multi-million dollar network.

During the undercover investigation, surveillance units watched the plaza as heavy backpacks and trash bags, suspected of being stuffed with illicit cash deliveries, were dropped off directly at the office.

According to court records, the tight-knit network relied on family members to systematically cash these payroll checks at various local storefronts to keep the money off the books:

Marlen Suazo Gutierrez, the alleged mastermind of the fraud, was booked for counts of organized scheme to defraud over $50,000, three counts of workers’ compensation fraud over $100,000, and three counts of operating an unauthorized money service business over $100,000.

Gustavo Lara Suazo, Marlen’s son, allegedly personally cashed over $1.1 million in payroll checks. He was listed on the payroll of multiple network companies simultaneously, at one point claiming to work 170 hours in a single 168-hour week.
Suazo was booked Thursday for counts of organized scheme to defraud over $50,000, three counts of workers’ compensation fraud over $100,000, and three counts of operating an unauthorized money service business over $100,000.

Alejandra Lagos Matute is accused of working directly with Gustavo to cash more than $1.3 million. Undercover teams also captured the pair cashing an additional $3.4 million for MDA Concrete Inc., a fake company registered in her name.
Matute was booked Thursday for counts of organized scheme to defraud over $50,000, three counts of workers’ compensation fraud over $100,000, and three counts of operating an unauthorized money service business over $100,000.

Blanca Cecilia Ramirez Farina, reportedly listed as the president of JNJ Construction Services Inc., allegedly manipulated payroll data to duck insurance premiums, resulting in a premium avoidance of nearly $168,000 for a single policy period.
Ramirez Farina was booked Thursday for counts of organized scheme to defraud over $50,000, three counts of workers’ compensation fraud over $100,000, and three counts of operating an unauthorized money service business over $100,000.

Erick Blandon was spotted by undercover units running the day-to-day operations at the West Palm Beach office alongside his father, Eduardo Blandon Martinez, who is Marlen’s husband and Gustavo’s stepfather.
Blandon was booked Thursday for counts of organized scheme to defraud over $50,000, three counts of workers’ compensation fraud over $100,000, and three counts of operating an unauthorized money service business over $100,000.

The Unraveling
The multi-million dollar operation began to fall apart after detectives placed court-authorized GPS tracking devices on the suspects’ vehicles.

The investigation reached a bizarre climax when Marlen, Gustavo, and Marlen’s husband, Eduardo Blandon Martinez, realized they were being watched, per investigators. Instead of fleeing, the trio used their own vehicles to physically block in an unmarked police unit and dialed 911 to report a suspicious vehicle, unknowingly bringing officers straight to the undercover detectives.

Ron Barlow said he always writes down all his doctor appointments on his calendar. When he gets his explanation of benefits, he said he lines up the dates of his visits with the charges billed to his insurance to make sure it’s correct.

But when we spoke with Barlow last November, he told 13 Investigates his Medicare account was being billed by Florida-based company Sunshine Senior Solutions for medical supplies he knew nothing about. 13 Investigates has since learned we were trying to reach the man the FBI now says was behind “one of the biggest Medicare scams in history.”

Ibrahim Khaldoon Hilmi, 58, was arrested in Turkey for “his alleged role in a $3.7 billion scheme to defraud Medicare,” the FBI announced on June 22, 2026.

Hilmi was charged with health care fraud and wire fraud conspiracy, money laundering conspiracy, and money laundering.

A federal indictment for Hilmi says he is listed as the sole authorized member of Sunshine Senior Solutions.

He is now facing federal charges for his role with Sunshine Senior Solutions and ABRH, another durable medical equipment company.

Federal prosecutors allege both companies were part of the same fraud scheme, describing them in the indictment as “shell companies that existed for the sole purpose of defrauding insurers and funneling insurance reimbursements to foreign actors overseas.”

Despite submitting $3.7 billion in claims to Medicare, Medicaid, and other insurers, the U.S. Attorney’s Office said only $5.7 million was paid out and deposited into Sunshine Senior Solutions and ABRH bank accounts.

Sunshine Senior Solutions had an office space in Delray Beach, Florida, and provided no legitimate business purpose and didn’t serve customers, according to the indictment.

After negative reviews started surfacing online alleging Sunshine Senior Solutions was committing health care fraud, federal authorities said Hilmi fled the country in May 2025.

13 Investigates could not reach Hilmi’s attorneys for comment.

Barlow was charged for “wound covers” and hundreds of catheters between September 2024 and February 2025, according to Medicare documents he received.

He said that when he saw those charges from Sunshine Senior Solutions on his account for equipment he didn’t need and never received, he reported them to Medicare as fraud.

“Somehow they tapped into some data source, got my information, and I’m guessing just went fishing. Let’s just bill this guy and see if it goes through,” Barlow said.

Medicare told 13 Investigates last year in a statement that they revoked Sunshine Senior Solutions’ ability to bill Medicare in June of last year.

“Medicare is funded from our tax dollars, so you’re paying for it,” Barlow said. “You and me, we’re all paying for it, and these guys are getting away with it.”

Barlow said it’s important for people to check their insurance statements to make sure they recognize the charges on their account, because that is how he discovered his concerns with Sunshine Senior Solutions.

A former New Haven firefighter and his wife are charged with allegedly staging an armed robbery last year in an attempt to collect more than $70,000 in insurance proceeds for expensive jewelry they claimed had been stolen at gunpoint a by Black man outside a West Haven convenience store.

Reginald Blakey, 46, and his wife, Eunice, 47, of Washingtonville, N.Y., will be in state Superior Court in Milford on Thursday where they each face charges of insurance fraud and conspiracy to commit first-degree larceny. They were both arrested May 21 by West Haven police following a monthslong investigation into the Dec. 16, 2025, incident.

They have not yet entered a plea. Each is released on $15,000 surety bond.

Reginald Blakey left the fire department approximately two years ago, according to the New Haven Fire Department.

United States Attorney Robert Frazer announces criminal charges against 6 defendants in connection with an alleged scheme to defraud Medicare and Medicaid involving a doctor and other medical professionals issuing medically unnecessary prescriptions to a pharmacist in exchange for cash kickbacks.

“The District of New Jersey remains committed to aggressively rooting out fraud, waste, and abuse committed by doctors, pharmacists, and medical professionals who betray their patients in pursuit of greed. Our Office will continue to ensure that those individuals who bilk our insurance systems to line their pockets with taxpayer dollars face swift justice.”

  • U.S. Attorney Robert Frazer

“Each of the defendants had a unique role in this alleged scheme, but the common thread is a complete disrespect for the Medicare and Medicaid programs that so many Americans rely on,” said Newark Special Agent in Charge Stefanie Roddy. “The defendants defrauded these programs through kickbacks that lined their pockets, while over $20 million taxpayer dollars were quietly disappearing. The FBI will continue to root out conspiracies to commit health care fraud and restore balance to a system that will not be shaken by these disrupters.”

The following individuals were charged by Information in the District of New Jersey on July 7, 2026 and appeared before Judge Karen M. Williams in federal district court in Camden in connection with the scheme:

Sherif Elmasri, 45, of Morganville, New Jersey, pled guilty to a two-count Information charging him with conspiring to commit health care fraud and to violate the Anti-Kickback Statute on June 16, 2025.
Boris Veysman, 48, of Freehold, New Jersey, pled guilty to a two-count Information charging him with conspiring to commit health care fraud and unlawfully distribute controlled substances on June 17, 2025.
Stephanie Cupo, 45, of South Plainfield, New Jersey, pled guilty to an Information charging her with conspiring to make false statements relating to health care matters and to use a Drug Enforcement Administration registration number issued to another person on January 7, 2026.
Nikki Steidle, 53, of Toms River, New Jersey, pled guilty to an Information charging her with conspiring to defraud the United States, solicit and receive kickbacks, offer and pay kickbacks, and unlawfully distribute controlled substances on June 30, 2026.
Janet Tadros, 59, of Union City, New Jersey, pled guilty to a two-count Information charging her with conspiring to commit health care fraud and to violate the Anti-Kickback statute on July 7, 2026.
Additionally, Ashlee Maixner, 39, of Lakehurst, New Jersey, was charged by indictment with conspiracy to defraud the United States, solicit and receive kickbacks, offer and pay kickbacks, unlawfully distribute controlled substances, and two counts of soliciting and receiving a kickback. Maixner was arraigned before Magistrate Judge André M. Espinosa in Newark on June 25, 2026, and pled not guilty.

According to documents filed in these cases and statements made in court:

From October 2022 to November 2025, Elmasri, a pharmacy owner, paid illegal kickbacks and bribes to several health care providers in exchange for them issuing prescriptions for high-reimbursement medications, which Elmasri selected, to Medicare and Medicaid beneficiaries. Elmasri personally profited from these prescriptions and the insurance claims it generated for his pharmacies.

One of the providers involved in the scheme was Dr. Boris Veysman, an emergency medicine doctor with offices in New Jersey. Elmasri paid Veysman to issue prescriptions recommended by Elmasri to Medicare beneficiaries Elmasri referred to Veysman from from approximately May 2023 to December 2024. Veysman, at times, did not examine the patients prior to issuing the prescriptions. Maixner and Steidle were advanced practice nurses who worked for Veysman and are also alleged to have received illegal kickbacks from Elmasri for issuing prescriptions. Cupo also worked for Veysman and submitted prior authorizations with false information to increase the likelihood that the prior authorizations she prepared would be approved by Medicare and other health care benefit programs.

Separately, Janet Tadros was the office manager of a neurology practice in Jersey City, New Jersey, who, from between December 2023 and November 2025, solicited and received cash kickbacks of approximately $3,000 per week in exchange for sending Elmasri’s pharmacies medically unnecessary prescriptions for patients who were not evaluated nor prescribed the medications and that were sent without the provider’s knowledge or authorization.

In total, the defendants are alleged to have caused a loss of approximately $20,684,264 to Medicare and Medicaid.

Veysman, Steidle, and Maixner are separately charged with allegedly conspiring to unlawfully distribute controlled substances to patients without assessing them.

The charges of conspiracy carry a statutory maximum of five years imprisonment as well as a maximum fine equal to twice the gross gain or twice the gross loss caused by the offense. The charges of conspiracy to commit health care fraud and violations of the Anti-Kickback statute each carry a statutory maximum of ten years imprisonment.

U.S. Attorney Frazer credited special agents of the Federal Bureau of Investigations, under the direction of Special Agent in Charge Stefanie Roddy, the Department of Health and Human Services, Office of the Inspector General, under the direction of Special Agent in Charge Naomi Gruchacz, and special agents, task force officers, and diversion investigators with the Drug Enforcement Administration (DEA) New Jersey Field Division, under the direction of Special Agent in Charge Towanda R. Thorne-James.

The Department of Justice has established the National Fraud Enforcement Division. The core mission of the National Fraud Enforcement Division is to zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars. The National Fraud Enforcement Division will fulfill that mission by coordinating with agencies responsible for administering benefit programs; partnering with federal, tribal, state, territorial, and local law enforcement on fraud-fighting efforts; developing systems and processes that ensure efficient identification of fraud against taxpayer dollars; and equipping prosecutors and law enforcement with state-of-the-art tools and resources needed to bring criminal actors to justice. The attorneys in the National Fraud Enforcement Division will work every day to protect the financial integrity of our government and the tax system that supports it.

The government is represented by Assistant U.S. Attorney Jake A. Nasar of the Healthcare Fraud Unit in Newark and Trial Attorneys Nicholas Peone, Paul J. Koob, and Kraig Ahalt of the Department of Justice’s Fraud Section. Valuable assistant in the investigation was provided by Assistant U.S. Attorney Jessica R. Ecker of the Northern District of Illinois.

The charges and allegations contained in the Indictment against Maixner are merely accusations, and the defendant is presumed innocent unless and until proven guilty.

Florida Chief Financial Officer Blaise Ingoglia on Thursday announced the arrest of a man in Miami-Dade County accused of carrying out an insurance fraud scheme that investigators say relied on the personal information of unsuspecting victims to obtain commission payments.

Luigino Jose Bosco, whom the Florida Department of Financial Services identified as an illegal immigrant, was arrested last week by the department’s Criminal Investigations Division. He has been charged with insurance fraud, application fraud, grand theft and organized scheme to defraud. If convicted, Bosco faces up to five years in prison.

According to the Department of Financial Services, the investigation began after an insurance company reported that fraudulent life insurance policy applications were being submitted using victims’ personal information.

Investigators said sworn statements from victims and evidence gathered during the investigation uncovered Bosco’s alleged scheme to file fraudulent policy applications in order to receive advance insurance commission payments totaling $5,043.23.

“Let this arrest serve as a warning. Whether you are here legally or illegally, Florida is not the place to run your fraud scheme. If you think you can steal someone’s identity, falsify applications, and profit off of unsuspecting Floridians, think again. Crime such as this drives up costs for hardworking families and undermines the trust that Floridians deserve to have in the marketplace. I applaud the work of our Criminal Investigations Division on this case and putting Bosco behind bars,” Ingoglia said in a statement.

In a video released with the announcement, Ingoglia said insurance fraud contributes to higher costs for consumers throughout Florida.

“A friendly reminder that insurance fraud drives up insurance rates and premiums in Florida. And if you’re an illegal immigrant who’s committing the fraud, well, it’s just a matter of time until we catch you and you are deported.”

He then pointed to Bosco as an example of the type of fraud his office is targeting.

“So let me introduce you to Luigino Jose Bosco, who allegedly stole personal information from unsuspecting victims to file fraudulent life insurance policy claims. Even though Jose was wanted by ICE, this criminal still decided it was a good idea to defraud Floridians.”

State officials said Bosco was wanted by U.S. Immigration and Customs Enforcement at the time of his arrest.

Ingoglia described the arrest as part of a larger statewide effort to combat fraud and financial crimes.

“This is yet another arrest in my ongoing crackdown on fraud and financial crime in our great state. Insurance scammers and illegal immigrants who commit crimes have no place in Florida. And if you think you’re going to get away with it, I have one thing to say: No way, Jose.”

He concluded the video with another warning aimed at those considering similar crimes.

“Florida is the land of opportunity, not an opportunity to take advantage of hardworking Floridians. We will find you and put you behind bars. So join me in saying, adios, Senor Bosco.”

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