LOS ANGELES– On April 28, 2021, an Inglewood woman and her mother-in-law, who both ran a South Los Angeles drug-and-alcohol abuse treatment program, were sentenced to federal prison for scheming to defraud Medi-Cal out of more than $500,000 for services to clients who did not medically need substance abuse treatment and for services that were never provided.
Mesbel Mohamoud, 48, was sentenced to 18 months’ imprisonment and her mother-in-law, Erlinda Abella, 66, also of Inglewood, was sentenced to one year and one day in federal prison. Each woman was ordered to pay $260,101 in restitution.
Mohamoud and Abella pleaded guilty in November 2020 to one count of health care fraud.
Mohamoud was the owner and executive director of The New You Center Inc. (TNYC), located in the Vermont Knolls neighborhood of South Los Angeles. Abella, who co-founded TNYC with Mohamoud in 2005, was the company’s program director. TNYC was authorized to provide medically necessary substance abuse treatment services through the Drug Medi-Cal program to adults and teenagers in Los Angeles County.
From January 2009 to December 2015, TNYC submitted false and fraudulent claims 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 clients.
Mohamoud and Abella also 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.
In September 2013, TNYC submitted a fraudulent claim for Medi-Cal reimbursement in the amount of $62.15 for a three-hour counseling session for a client on August 17, 2013 – the same day when the client was hospitalized and did not receive any counseling from TNYC.
In her plea agreement, Mohamoud admitted she knew that Abella directed TNYC counselors to enroll clients in TNYC’s substance abuse treatment program even if the clients had used drugs or alcohol only occasionally or even just once.
TNYC submitted approximately $527,313 in false and fraudulent claims for group and individual substance abuse counseling services and was paid $260,101 on those claims.
“Investigating a case involving seven years of health care fraud can be lengthy and complicated, but federal and state investigators pulled their resources together and got the job done,” said California Statewide Law Enforcement Association (CSLEA) President Alan Barcelona.
The FBI, the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse, and the U.S. Department of Health and Human Services, Office of Inspector General investigated this matter.