Four Defendants Plead Guilty in Connection with HMA Direct Insurance Fraud Scheme
BOSTON—Four men pleaded guilty yesterday in connection with their participation in a fraudulent scheme perpetrated through a Massachusetts health insurance company known as HMA Direct.
William O’Brien, of West Barnstable, Mark Celentano, of Ipswich, Francis Gaetani, of Sutton, and Ronald Anger, of Sutton, pleaded guilty before U.S. Senior District Judge Mark L. Wolf. Sentencing is scheduled for Jan. 14, 2015.
O’Brien pleaded guilty to conspiracy, wire fraud, health care fraud, and obtaining customer information from a financial institution by false representation. Celentano pleaded guilty to conspiracy, health care fraud, and obstruction of justice. Gaetani and Anger each pleaded guilty to wire fraud.
HMA Direct offered self-funded insurance plans to small businesses in New England. At the heart of HMA Direct’s business was “carving out” from its clients’ self-funded plans those employees who had significant health risks, and then, through false statements, arranging for those employees to be insured through traditional health insurance providers.
O’Brien and Celentano participated in the carve-out scheme and subsequent lies to the health insurance providers. O’Brien also arranged for Gaetani and Anger, who were investors in HMA Direct, to pretend that they were satisfied customers of the company and to provide fake references to prospective clients. In addition, when contacted by federal investigators, Celentano obstructed justice by lying about the role he had played in the HMA Direct carve-out scheme.
For O’Brien, Gaetani, and Anger, the maximum sentence under the relevant statutes is 20 years in prison, three years of supervised release, and a $250,000 fine. For Celentano, the maximum sentence under the statute is 10 years in prison, three years of supervised release and a $250,000 fine.
Two other defendants in this scheme, Michael Cassandro, of Middleton, RI, and Shelley Lenkutis, of Waltham, previously pleaded guilty to related charges. They are scheduled to be sentenced on Dec. 10, 2014.
United States Attorney Carmen M. Ortiz; Susan Hensley, Director of the U.S. Department of Labor, Employee Benefits Security Administration, Boston Regional Office; Cheryl Garcia, Special Agent in Charge for the U.S. Department of Labor, Office of Inspector General, Office of Labor Racketeering and Fraud Investigations, New York Regional Office; Vincent B. Lisi, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division; and William P. Offord, Inspector in Charge of the U.S. Postal Inspection Service, made the announcement. The case is being prosecuted by Assistant United States Attorneys Kristina Barclay, Gregg Shapiro, and Alexander Berlin.