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Two Arrested on Federal Fraud Charges that Allege $2 Million Scheme that Improperly Billed Medi-Cal for Substance Abuse Counseling

Posted by Fay Arfa | Apr 04, 2018 | 0 Comments

LOS ANGELES – Two executives at a South Los Angeles company that offered alcohol and drug abuse treatment services were arrested this morning on federal charges that allege they defrauded the Medi-Cal program by submitting bills seeking more than $2 million for services that did not qualify for reimbursement or simply were never provided.

Mesbel Mohamoud, 45, of Inglewood, and her mother-in-law, Erlinda Abella, 63, also of Inglewood, were taken into custody without incident.

Mohamoud and Abella were named in a 23-count indictment returned by a federal grand jury on March 29. The indictment charges both defendants with 21 counts of health care fraud and two counts of aggravated identity theft in relation to the scheme that allegedly ran from 2009 through 2015.

Mohamoud is the owner and executive director of The New You Center (TNYC). Abella, who co-founded TNYC with Mohamoud in 2005, is the program director at the company. TNYC had contracts to provide medically necessary substance abuse treatment services through the Drug Medi-Cal program to adults and teenagers in Los Angeles County.

The indictment alleges that TNYC submitted false and fraudulent bills for counseling sessions that were not conducted at all, were not conducted at authorized locations, or did not comply with Drug Medi-Cal regulations regarding the length of sessions or the number of patients. Furthermore, Mohamoud and Abella allegedly caused TNYC to bill for clients who did not have a substance abuse problem, to falsify documents related to services supposedly provided to clients, and to forge client signatures on documents such as sign-in sheets.

The charges in the indictment primarily relate to services provided to girls residing at Dimondale Adolescent Care Facility group homes in Lancaster, Long Beach and Carson, facilities where TNYC was not authorized to provide counseling.

The indictment alleges that TNYC submitted over $2 million in false and fraudulent claims for group and individual substance abuse counseling services and was paid more than $1.8 million based on these bills.

Both defendants are expected to be arraigned on the indictment this afternoon in United States District Court.

An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty in court.

If they were to be convicted of the charges in the indictment, Mohamoud and Abella each would face a statutory maximum sentence of 10 years in federal prison for each of the 21 health care fraud charges. Additionally, there is a two-year mandatory sentence associated with each of the aggravated identity theft counts.

This case is being investigated by the Federal Bureau of Investigation and the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse.

The case is being prosecuted by Assistant United States Attorney Cathy J. Ostiller of the Major Frauds Section.

Component(s): USAO – California, Central

Contact: Thom Mrozek Spokesperson/Public Affairs Officer United States Attorney's Office Central District of California (Los Angeles) 213-894-6947

Press Release Number: 18-053Updated April 3, 2018

Central District of California DOJ / 18-053 / April 3, 2018

About the Author

Fay Arfa

Fay Arfa has the distinction of being Certified as a Specialist in two separate areas of law – Criminal Law as well as Appellate Law – by the California State Bar, Board of Specialization. The National Board of Trial Advocacy has also awarded her a board Certification in Criminal Trial Advocacy. ...

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