Attorney General Lockyer Announces Arrests of Six Supspects in Sophisticated $1.4 Million Medi-Cal Fraud and Identity Theft Scheme
(LOS ANGELES) -Attorney General Bill Lockyer today reported the arrests of six individuals to break-up an alleged Medi-Cal fraud ring operating in the greater Los Angeles area that bilked the Medi-Cal program of more than $1.39 million dollars.
The criminal complaint filed in the Los Angeles County Superior Court accuses Benjamin Provo (42, of Chino) and Sharon West (36, of Las Vegas, NV) of illegally purchasing physicians' medical licenses and identification from Los Angeles area hospitals employees in a sophisticated fraud, identity theft, and money laundering conspiracy. After committing the identity theft, Provo and West submitted phony applications to the Department of Health Services under these doctors' names requesting Medi-Cal provider numbers that are required in order to bill the State's $20 billion Medi-Cal program.
Defendants Provo and West then recruited co-defendants Tenisha Taylor (25, of Hawthorne) and Lydia Davis (33, of Los Angeles) and brought them into the conspiracy. Taylor and Davis illegally provided defendants Provo and West with the names and identifications of several thousand hospital patients who were Medi-Cal beneficiaries. As with the victimized doctors, the names and identifications of these beneficiaries were taken from various hospitals without the knowledge nor consent of either the hospitals or the patients. Defendants Provo and West then submitted fraudulent Medi-Cal claims which falsely represented that the victimized doctors had rendered services to these patients.
To mask their criminal operation and launder the proceeds, the defendants established phony businesses and used mail drops to receive checks (known as state warrants) made payable to the doctors whose identities were stolen. Defendants Provo and West then recruited co-defendants David Griffin (32, of Corona), Patricia Edwards (49, of Los Angeles), Jana Burton (33, of West Covina), and Monique Jackson (32, of Compton) and brought them into the conspiracy by having them open bank accounts in the doctors' names and/or by having them cash the state warrants paid to the doctors, using bogus identification or using no identification at all.
In a final step to avoid detection and evade law enforcement, defendants Provo and West then brought defendant James Myles, Sr. (57, of Rancho Palos Verdes) into the conspiracy by having Myles launder the stolen money through his business, Mr. J's Liquor, Inc.
"This organized crime ring stole more than $1.4 million dollars from a vital state program which serves as the primary means of health care for many of California's poor, elderly, and disabled," Lockyer said. "The Bureau of Medi-Cal Fraud and Elder Abuse within my office has shut down this conspiracy and will now aggressively prosecute each defendant to the fullest extent of the law."
Lockyer added, "Schemes such as this one victimize not just the taxpayers, but also patients and medical doctors. Seven physicians and more than a thousand patients had their identities stolen, and it has resulted in well over a million dollars in fraudulent claims being paid by Medi-Cal."
Today's arrests are the latest enforcement actions in the largest and most effective crackdown on Medi-Cal fraud in the state's history. The Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse has yielded more than 139 arrests and 90 criminal convictions in just the last eleven months - - - more arrests and convictions involving Medi-Cal fraud than was produced in the previous two years combined.