Six Charged in $1 Million Health Insurance Fraud Scheme
Falsely Billed For Bogus Medical Treatments While Purportedly Abroad
Six individuals, five from Massachusetts and one from New York, have been charged with orchestrating a health insurance fraud scheme that sought over $1 million in reimbursements for falsified medical expenses purportedly incurred during international travel.
The accused include Brendon Ashe, 40, of Dorchester; Aqiyla Atherton, 36, of Roxbury; Darline Cobbler, 40, of Randolph; Henry Ezeonyido, 36, of Brockton; Ariel Lambert, 34, of Brooklyn, NY; and Chinenye Nwodim, 36, of Brockton. Each faces one count of health care fraud, as detailed in a recently unsealed complaint. All six defendants were released under specific conditions after initial appearances in federal court in Boston.
The complaint alleges that the defendants submitted claims to four different health insurance companies for expensive medical treatments they claimed to have received and paid for out-of-pocket while traveling abroad. These treatments allegedly related to traumatic injuries such as stabbings, hit-and-run accidents, and gunshot wounds, necessitating hospitalization overseas. However, it is asserted that the defendants were actually in the United States during the periods they claimed to be receiving medical care abroad. Moreover, some defendants are said to have obtained unrelated medical services in the U.S. concurrently with their supposed hospitalizations overseas.
The defendants allegedly supported their fraudulent claims with fabricated documentation, including fake bank records, falsified medical records, and bogus police reports. In several instances, the details of these claims and their supporting documents were reportedly nearly identical, covering dates of service, countries of alleged injury, and the nature and circumstances of these injuries.
Acting United States Attorney Joshua S. Levy emphasized the severity of the alleged crimes, stating, “These defendants allegedly fabricated over $1 million in insurance claims for injuries that never happened, in a brazen abuse of our healthcare system. This kind of deceit is not only illegal but also victimizes every law-abiding person by diverting resources from those truly in need and driving up costs for everyone.”
Jodi Cohen, Special Agent in Charge of the FBI Boston Division, remarked, “Yesterday, the FBI charged six people whose guiding compass appears to have been greed. We believe they feigned injuries they never suffered and submitted bogus claims for medical treatment rendered in overseas hospitals they never set foot in.”
Inspector in Charge of the United States Postal Inspection Service, Boston Division, Ketty Larco-Ward, added, “These individuals allegedly lied and said they sustained injuries or illness and had to pay substantial healthcare costs while abroad for their medical needs. We allege that they then fraudulently requested their health insurance carriers to reimburse them for these fictitious costs, including by using the U.S. Mail.”
Anthony M. DiPaolo, Executive Director of the Massachusetts Insurance Fraud Bureau, stated, “Insurance Fraud Bureau of Massachusetts is committed to combating this illegal activity through vigilant investigation and collaboration with our partners. Insurance fraud harms everyone and undermines trust in the insurance system.”
The charge of health care fraud carries potential penalties of up to 10 years in prison, up to three years of supervised release, and a fine of up to $250,000, or twice the gross gain or loss from the offense. Sentences are determined by a federal district court judge based on the U.S. Sentencing Guidelines and relevant statutes.
