BUFFALO, N.Y.- Acting U.S. Attorney James P. Kennedy, Jr. announced today that a grand jury has returned a 48 count indictment charging Umar Adeyola 46, of Amherst, NY, with health care fraud, conspiracy to commit health care fraud, aggravated identity theft, making false statements in a health care matter, wire fraud, and theft of government money. The charges carry a maximum penalty of 22 years in prison and a $250,000 fine.
Assistant U.S. Attorney Maura K. O’Donnell, who is handling the case, stated that according to the indictment, the defendant founded, organized, and managed the HEART Foundation, a not-for-profit organization intended to assist area youths, and Heart Community Alliance (“HCA”), a related for-profit organization, intended to provide clinical services, such as counseling and psychotherapy, to youths. Through his role with those organizations, Adeyola is accused of engaging in two major fraud schemes.
The first scheme involved attempts by the defendant, on behalf of HCA, to defraud private insurance companies Blue Cross Blue Shield, Independent Health, and Univera. Adeyola arranged for the submission of false and fraudulent bills for office visits using the names and/or provider numbers of healthcare providers who had not actually rendered the services claimed. The bills falsely represented that the services had been rendered by properly licensed and credentialed social workers when, in fact, the services had actually been provided by other individuals, including interns. The scheme included the submission to the same insurance companies of bills for services which purported to have been rendered by a social worker who was actually hospitalized and/or deceased on the dates of service claimed.
In addition, Adeyola is accused of falsifying documents in response to an audit of HCA by Independent Health. During the course of the audit, the defendant allegedly made materially false statements to representatives of Independent Health, with respect to the deceased social worker who he claimed had rendered services at HCA.
The second scheme involved Adeyola’s theft of government funds in the form a federally funded grant received by the Heart Foundation. Specifically, in April 2013, the Heart Foundation was selected to be a recipient of a Department of Labor grant, administered by the Latino Coalition, an entity in California. Adeyola submitted in excess of 30 false and fraudulent reimbursement requests for grant funds, resulting in payment of approximately $135,000 to the Heart Foundation.
The defendant was arraigned this morning before U.S. Magistrate Judge Michael J. Roemer and released.
The indictment is the result of an investigation by the U.S. Department of Labor, Office of Inspector General, Office of Labor Racketeering and Fraud Investigations, under the direction of Michael C. Mikulka, Special Agent-in-Charge of the New York Region, the Federal Bureau of Investigation, under the direction of Special Agent in Charge Adam S. Cohen, and the Department of Health and Human Services, Office of Inspector General, Office of Investigations under the direction of Special Agent in Charge Scott Lampert.
The fact that a defendant has been charged with a crime is merely an accusation and the defendant is presumed innocent until and unless proven guilty.
CONTACT: Barbara Burns
PHONE: (716) 843-5817
FAX: (716) 551-3051