Two Women Sentenced for Health Care Fraud and Defrauding Medi-Cal.

Two Women Sentenced for Health Care Fraud and Defrauding Medi-Cal.

A woman from Inglewood and her mother-in-law, who both operated a drug-and-alcohol abuse rehabilitation program in South Los Angeles, were on 28th April 2021, sentenced to federal prison for conspiring to steal Medi-Cal out of more than 500,000 U.S. dollars for services to clients who never medically required substance abuse rehabilitation and for services that were never offered.

Mesbel Mohamoud, age 48, from Inglewood, was convicted to one year and six months in federal prison by Philip S. Gutierrez, United States District Judge, who further sentenced Erlinda Abella, Mohamoud’s mother-in-law, age 66, from Inglewood, to twelve months and one day in federal prison. Besides, Each of the accused was directed to reimburse 260,101 U.S. dollars in restitution.

Mesbel Mohamoud and Erlinda Abella admitted guilty in Nov. 2020 to one health care fraud count.

Mesbel Mohamoud was the executive director and owner of The New You Center Inc., based in the Vermont Knolls. Erlinda Abella, who co-founded The New You Center with Mesbel Mohamoud in 2005, was the program director for the firm. The New You Center was approved to give medically necessary substance abuse rehabilitation services via the Drug Medi-Cal program to teenagers and adults in Los Angeles County.

Between Jan. 2009 and Dec. 2015, The New You Center submitted fraudulent and false counseling session claims that were not provided at all, were not carry out at approved locations or never complied with Drug Medi-Cal rules concerning the sessions length or the number of patients.

Mesbel Mohamoud and Erlinda Abella further caused The New You Center to charge for clients who never had a substance abuse problem, to fabricate documents linked with services supposedly offered to clients, and to fake client signatures on documents like sign-in sheets.

 In Sept. 2013, The New You Center submitted a false claim for Medi-Cal payment in the amount of 62.15 U.S. dollars for a 3-hour counseling session for a patient on 17th August 2013,  the similar day when the patient was hospitalized and never obtained any counseling from The New You Center.

According to her plea deal, Mesbel Mohamoud confessed she knew that Erlinda Abella instructed The New You Center counselors to recruit clients in The New You Center’s substance abuse rehabilitation program even if the patients had used alcohol or drugs just occasionally or even only once.

The New You Center submitted about 527,313 U.S. dollars in fraudulent and false claims for individual and group substance misuse counseling services and was reimbursed 260,101 U.S. dollars on those claims.

The Federal Bureau Investigations carried out the matter’s investigations, together with the California Justice Department, the U.S. Health & Human Services Department – Office of Inspector General, and Bureau of Medi-Cal Fraud and Elder Abuse.

The Major Frauds Section United States Assistant Attorney Cathy J. Ostiller handled this matter’s prosecution.

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