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Thursday, September 19, 2024

Southern California healthcare provider indicted for $60 million Medi-Cal fraud

State AG
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Attorney General Rob Bonta | Facebook Website

California Attorney General Rob Bonta announced the grand jury indictment of Southern California healthcare provider Gerardo Santillan, along with seven other individuals, for defrauding the state Medi-Cal program of nearly $60 million through their operation of three home health agencies between 2016 and 2022.

Following grand jury proceedings, Gerardo Santillan, Ruth Elizabeth Eley, Marisol Rodriguez, Christopher Gonzalez, Vivien Kono, Maria Consorcia Pagtakhan Lim, Vivian Bonotan Pagtakhan, and Vartan Akopyan were indicted on 23 felony charges. The charges include conspiracy to commit insurance fraud, conspiracy to commit money laundering, grand theft, Medi-Cal fraud, insurance fraud, and money laundering.

"We will not tolerate fraud where individuals take advantage of Medi-Cal to profit, potentially jeopardizing critical, necessary medical services our most vulnerable residents rely on," said Attorney General Bonta. "Today's action is possible due to my team's efforts to hold accountable those that defraud Medi-Cal, and we will continue to do so."

Due to a prior conviction for defrauding the Medi-Cal program in August 2018, Santillan had been excluded from further participation in the Medi-Cal program. It is alleged in the indictment that Santillan nonetheless continued his fraudulent activities by using other home health agencies to submit fraudulent claims for medical services to Medi-Cal. Those home health agencies include Four P's Health Services (doing business as Covenant Home Health), Angel Care Home Health, and Neighborhood Home Health Care Inc.

It is important to note that a criminal indictment contains charges that must be proven in a court of law. Every defendant is presumed innocent until proven guilty.

The Division of Medi-Cal Fraud and Elder Abuse (DMFEA) receives 75% of its funding from the Department of Health and Human Services Office of Inspector General (HHS-OIG) under a grant award totaling $87,038,485 for federal fiscal year 2024. The remaining 25% is funded by the State of California. The federal fiscal year is defined as October 1, 2023 through September 30, 2024.

A copy of the indictment is available here.

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