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Date: 02-12-2024
Case Style:
Case Number: 20-CR-4590
Judge: Paula Xinis
Court: The United States Court for the District of Maryland (Prince George's County)
Plaintiff's Attorney: The United States Attorney’s Office in Greenbelt
Defendant's Attorney:
Description:
U.S. District Judge Paula Xinis sentenced Lambert Mbom, age 50, of Riverdale, Maryland, to five years in federal prison, followed by three years of supervised release, for conspiracy to commit health care fraud and wire fraud and for conspiracy to make false statements relating to health care matters in connection with a scheme to fraudulently bill Medicaid. The defendant’s conviction stems from a scheme involving services purportedly provided by Holy Health Care Services, LLC (“Holy Health”), a mental health services provider with locations in Washington, D.C. Judge Xinis also ordered Mbom to pay restitution in the full amount of the loss, $4,450,588.66. The sentence was imposed on February 8, 2024.
Mbom’s six-day trial, he was a program administrator at Holy Health. Holy Health entered into Medicaid Provider Agreements with the District of Columbia’s Department of Health Care Finance (“DHCF”), to provide healthcare services to D.C. Medicaid recipients and was certified by the District of Columbia’s Department of Behavioral Health (“DBH”) to provide mental health services as a freestanding clinic and as a Mental Health and Rehabilitation Services (“MHRS”) provider. As a certified MHRS provider, Holy Health had authority to provide and bill for a variety of mental health services including “community support” – a service for which community support workers (“CSWs”) provide rehabilitative and educational support to mental health patients both in clinical settings and in the community.
According to evidence presented at trial, Mbom and his co-conspirators paid to Medicaid beneficiaries to induce the beneficiaries to visit Holy Health for mental health services. As detailed in trial testimony, Mbom and his co-conspirators caused claims to be submitted by Holy Health to Medicaid for services, including community support services, purportedly provided to Medicaid beneficiaries.
As detailed in trial testimony, Mbom and his co-conspirators paid individuals to come into the office and then used their personally identifiable information (“PII”) to bill Medicaid for services that were not rendered or were not rendered as billed. The evidence proved that Mbom made up fake Holy Health employees who were purportedly Community Support Workers so that he could bill Medicaid for services provided by these fake employees. Witnesses testified that during the investigation, sources posing as mental health patients were sent to Holy Health to obtain community support services. Not only did the sources not receive the services as billed, but Holy Health billed for CSW services for those patients for visits that never happened.
The jury acquitted Mbom of conspiring to violate the Anti-Kickback Statute.
The owners of Holy Health, Julius Bakari, age 46, and Mboutchock Kabiwa a/k/a “Eugenie Bakari” or “Eugenie Kabiwa,” age 46, both of Silver Spring, Maryland, previously pleaded guilty to conspiracy to commit health care fraud in connection with a scheme to pay bribes and kickbacks to Medicaid beneficiaries to induce the beneficiaries to visit their company. Kabiwa was sentenced to 20 months in federal prison and was ordered to pay restitution of $3,493,681. Bakari is scheduled to be sentenced on April 9, 2024.
United States Attorney Erek L. Barron commended the FBI, the HHS OIG, and the District of Columbia Office of Inspector General’s Medicaid Fraud Control Unit for their work in the investigation and the support provided by the District Department of Health Care Finance Division of Program Integrity during the investigation. Mr. Barron thanked Assistant U.S. Attorneys Christopher M. Sarma and Megan S. McKoy, who are prosecuting the case.
For more information on the Maryland U.S. Attorney’s Office, its priorities, and resources available to help the community, please visit www.justice.gov/usao/md.
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Defendant's Experts:
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