Criminal Investigative Updates

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Category: CHAMPVA and Other Healthcare Fraud (VHA)
District: Minnesota
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Faiza Osman Ahmed, of Richfield, Minnesota, was charged with six counts of healthcare fraud in connection with an approximately $10 million scheme to defraud multiple healthcare programs. Allegedly, Ahmed submitted fraudulent claims to federal and state healthcare programs. She did so by billing for services that were not rendered; for services purportedly provided to recipients in their homes while they were traveling, while providers were working other jobs; and for recipients who never received the billed-for services. The VA OIG, the FBI, the HHS-OIG, Homeland Security Investigations, and the State of Minnesota Medicaid Fraud Control Unit and Bureau of Criminal Apprehension investigated this case.

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Category: Fraud Related to COVID-19
District: Massachusetts
Teaser Content

Denise Baez, a former VA medical technician from Brockton, Massachusetts, was sentenced to one year of probation for wire fraud. She submitted two Paycheck Protection Program loan applications, falsely claimed gross income from a sole proprietorship, and attached fraudulent tax documents. Baez received more than $41,000, used the funds for personal expenses, and was later granted loan forgiveness. The VA OIG and the Department of Labor, Employee Benefits Security Administration, investigated the case.

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Category: Theft of Government Funds and Fiduciary Fraud (VBA)
District: Florida, Middle
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Gail Starks, of Jacksonville, Florida, was charged with theft of government money or property and making false statements to a federal agency. According to the indictment, Starks stole Dependency and Indemnity Compensation benefits for approximately 35 years and lied about her marital status during the investigation. In addition to the criminal charge, the United States is seeking a forfeiture order for $397,120, the proceeds of the theft of government money. The VA OIG investigated this case.

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Category: Life Insurance Fraud and False Statements (VBA)
District: Maine
Teaser Content

Gregory P. Heimann Jr., of Forest City Township, Maine, pleaded guilty to making false statements to a federal official. He falsely claimed in May 2023 that he used a wheelchair and was unable to walk or stand since 2004. He was documented walking and standing without assistance numerous times. The VA OIG and the SSA OIG investigated this case with the Maine Warden Service.

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Publish Date
Category: CHAMPVA and Other Healthcare Fraud (VHA)
District: Massachusetts
Teaser Content

A Missouri surgeon and Kansas distributor have been sentenced for conspiring to pay and receive kickbacks aimed at inducing the use of spinal implants sold by SpineFrontier, Inc., as well as engaging in conduct aimed at obstructing the government’s federal investigation into the kickback scheme. Jason Montone, a surgeon in Lawson, Missouri, was sentenced to one year of supervised release and ordered to pay $379,000 in forfeiture. John Balzer, the distributor, was sentenced to one year of supervised release and ordered to pay forfeiture of $947,500. According to the charging documents, between late 2012 and October 2015, Balzer, Montone and their co-conspirators engaged in a scheme in which SpineFrontier and its CEO and CFO paid Montone a total of $379,000 pursuant to a sham consulting program. The VA OIG, the HHS OIG, the FBI, and the US Postal Inspection Service investigated this case.

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