Houston woman sentenced to 20 years for $50m healthcare fraud

Daniela Gozes-Wagner, 36, was today sentenced to serve 20 years in prison for her role in a $50 million medicaid and medicare fraud. She also has to pay $15.2 million in restitution. The announcement was made by the US Attorney’s Office in the Southern District of Texas.

A jury convicted Ms Gozes-Wagner in September 2017. She was originally arrested in February 2015.

Three others were arrested at the same time. Aliksandr Beketav, then 53, of Calabasas, California (but formerly of Katy, Texas) was the alleged ringleader. Also arrested was Mikhail Shiforenko, then 43, and Alexsandr Voronov, then 46, both of Houston. The charges against Mr Beketav were later dropped as it was ruled that he was mentally unfit to stand trial. Mr Shiforenko and Mr Voronov have each pleaded guilty to one count and will be sentenced later.

The scheme started in 2009. The conspirators set up 24 entities that were purportedly providing diagnostic testing in 28 locations, mostly around the Gulfton area of Houston. The entities, although controlled by the conspirators, were actually owned by other individuals acting as straw men.

Offices were rented, though they were empty and saw no patients. ‘Seat warmers’ were employed i.e. young women were hired to sit in these empty offices and answer phones as if a legitimate clinic existed. The seat warmers had instructions to prevent Medicare auditors from inspecting the premises. Otherwise they watched streaming movies all day.

Fake diagnostic testing technicians were also employed as well as nurses and doctors who were paid to act as a ‘rubber stamp’ to allow the conspirators to submit bills to Medicare and Medicaid. The fake technicians also visited purportedly homebound beneficiaries to conduct fake tests.

Ms Gozes-Wagner was convicted of submitting $50 million in fraudulent claims, of which Medicare and Medicaid paid out $15 million. She was also convicted on money laundering charges.

https://www.justice.gov/usao-sdtx/pr/houston-woman-sentenced-conspiring-commit-50-million-health-care-fraud-and-money

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