Defendants Allegedly Defrauded Arizona-Based Medicaid Funded Health Benefit Care Program of Almost $2 Million
ALBUQUERQUE – U.S. Attorney Damon P. Martinez and Special Agent in Charge Waldemar Rodriguez of Homeland Security Investigations (HSI) in El Paso announced the filing of health care fraud charges against two San Juan County residents.
Cory Werito, 32, of Farmington, N.M., and Rosita Toledo, 46, of Kirtland, N.M., are charged in a ten-count indictment that was filed on June 15, 2016. Werito and Toledo were arrested on June 28, 2016, by Deputy U.S. Marshals and made their initial appearances on the indictment in federal court in Farmington yesterday afternoon. Both remain in custody pending arraignment and detention hearings, which are scheduled for June 30, 2016, in federal court in Albuquerque, N.M.
The indictment includes nine health care fraud charges against Werito and Toledo and one aggravated currency structuring charge against Werito only. The health care fraud charges stem from the defendants’ role in creating and operating a medical transportation company, CW Transport, a New Mexico company located in Farmington that provided non-emergency medical transportation to Arizona Medicaid recipients. The indictment alleges that over the course of two years between 2011 and 2013, CW Transport collected more than $1.9 million in Medicaid reimbursements from an Arizona-based Medicaid agency by submitting more than 18,000 claims for reimbursement, the vast majority of which were wholly or substantially false and fraudulent.
Count 10 of the indictment, the aggravated currency structuring charge, alleges that Werito conducted financial transactions involving the proceeds of the health care fraud in a manner that avoided the filing of Currency Transaction Reports (CTRs). CTRs are reports which must be filed by financial institutions on transactions involving more than $10,000 during any business day and are used by law enforcement authorities to undercover a broad range of illegal activities including money laundering. According to the indictment, from Aug. 2011 to July 2013, Werito conducted at least 200 cash withdrawals, each for several thousands of dollars but less than $10,000 and totaling at least $800,000, to avoid the filing of CTRs.
The indictment includes forfeiture provisions seeking an order requiring Werito and Toledo to forfeit to the United States at least $1,959,405, the proceeds allegedly derived from the health care fraud alleged in Counts 1 through 9 of the indictment.
If convicted, Werito and Toledo face up to ten years of imprisonment on each of the ten counts of the indictment. Charges in indictments are merely accusations and defendants are presumed innocent unless found guilty in a court of law.
The Albuquerque office of HSI investigated the case with assistance from the FBI, U.S. Marshals Service, San Juan County Sheriff’s Office, the Arizona Health Care Cost Containment System and New Mexico Office of the Attorney General. Assistant U.S. Attorney Jeremy Peña is prosecuting the case.