San Francisco and Los Banos Doctor Sentenced to Two Years in Prison in $3.2 Million Medicare Fraud Scheme
SAN FRANCISCO—Edna Calaustro was sentenced to 24 months in prison and Mele Saavedra was sentenced to three years’ probation yesterday for conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks involving the Medicare program, and health care fraud, announced United States Attorney Melinda Haag, FBI Special Agent in Charge David J. Johnson, and Special Agent in Charge for the Los Angeles Regional Office of Inspector General of the Department of Health and Human Services Glenn R. Ferry.
The evidence at trial showed that beginning in approximately December 2006 and continuing through July 2011, Patrick Sogbein, the owner of Debs Medical Distributors, a Van Nuys durable medical equipment company, and his wife, Adebola Adefunke Adebimpe, the owner of Dignity Medical Supply, a Santa Clarita durable medical equipment company, submitted over 400 false and fraudulent claims to Medicare using fraudulent prescriptions and medical records prepared by Calaustro. The evidence also showed that Sogbein and Adebimpe worked with Calaustro, then a San Francisco-based physician, and street level recruiters, including Eduardo Abad and Saavedra.
Abad and Saavedra recruited beneficiaries at locations in the Tenderloin and South of Market neighborhoods in San Francisco, including a fast food restaurant at the Powell Street cable car turnaround and a Tenderloin neighborhood senior center. After identifying beneficiaries, Calaustro, with Abad or Saavedra, went to the beneficiaries’ homes with a portable copy machine, copied their Medicare cards, and conducted sham examinations to obtain background information for the required Medicare paperwork. Calaustro gave the fraudulent paperwork and bogus prescriptions to Sogbein and Adebimpe. Sogbein and Adebimpe, in turn, created additional fraudulent paperwork in the names of their respective companies and submitted the claims to Medicare. Sogbein paid Calaustro a $100 kickback for each power wheelchair prescription. Sogbein paid Abad and Saavedra a $100 and $50 kickback, respectively, for each beneficiary they identified. From December 2006 through July 2011, Sogbein and Adebimpe were paid more than $1.6 million for over 400 fraudulent power wheelchair claims submitted to Medicare using the fraudulent prescriptions written by Calaustro. In mid-2011, Calaustro began working as a physician in Los Banos.
Calaustro, 71, of Daly City and Los Banos, and Saavedra, 49, of San Francisco, respectively, along with co-defendants Sogbein, Adebimpe, and Abad, were indicted by a federal grand jury on Jan. 26, 2012, for conspiracy to commit health care fraud, in violation of 18 U.S.C. § 1349, and health care fraud, in violation of 18 U.S.C. § 1343. Calaustro and Saavedra were arrested on Feb. 9, 2012, in Los Banos and San Francisco, respectively. After their initial appearances, Calaustro and Saavedra were released on bail. On Sept. 19, 2013, a grand jury returned a superseding indictment, charging Sogbein, Adebimpe, Calaustro, Abad, and Saavedra with conspiracy to commit health care fraud, in violation of 18 U.S.C. § 1349, and health care fraud, in violation of 18 U.S.C. § 1343. The indictment also charged Sogbein, Calaustro, Abad, and Saavedra with conspiracy to pay and received kickbacks involving the Medicare program, in violation of 18 U.S.C. § 371.
On Sept. 30, 2013 and Oct. 21, 2013, respectively, Calaustro and Saavedra pleaded guilty to conspiracy to commit health care fraud, conspiracy to receive kickbacks involving the Medicare program, and health care fraud. Calaustro and Saavedra both testified in November 2013 at the trial of co-defendants Sogbein, Adebimpe, and Abad.
The sentences for Calaustro and Saavedra were handed down yesterday by the Honorable Jeffrey S. White, United States District Court Judge. Judge White also sentenced Calaustro to a 3 year period of supervised release following her 24 month prison term and ordered forfeiture of $1,577,426 and restitution of the same amount to Medicare. Calaustro remains out of custody and is scheduled to begin serving her sentence on Nov. 17, 2014. Judge White sentenced Saavedra to perform 500 hours of community service during her 3 year term of probation and ordered forfeiture of $275,338 and restitution of the same amount to Medicare.
On June 17, 2014, co-defendants Sogbein, Adebimpe, and Abad, who were all convicted after trial, were sentenced to prison terms of 144 months, 51 months, and 12 months and 1 day, respectively. Sogbein is in custody. Adebimpe began serving her sentence yesterday. Abad remains out of custody pending his appeal.
Denise Marie Barton and Randy Luskey are the Assistant U.S. Attorneys who are prosecuting the case with the assistance of Assistant U.S. Attorney David Countryman, Beth Margen, and Bridget Kilkenny. The prosecution is the result of an investigation by the Federal Bureau of Investigation in San Francisco and Office of Inspector General, Department of Health and Human Services in Los Angeles.