Four Gilbert residents and a Tempe man face different legal actions from state and federal authorities for their roles in various schemes that allegedly swindled over $140 million from Medicaid and Medicare.
State and federal court records show that two of those residents allegedly colluded with others accused of fraud – including a Scottsdale couple who were ordered to remain in jail pending trial on charges they cheated Medicare out of $600 million and collected another $300 million in illegal kickbacks.
Those two Gilbert residents – Bethany Jameson and Daud Koleosho – are among over 200 people nationwide accused of federal criminal cases alleging health care schemes that cost taxpayers over $2.7 billion. Jameson and Koleosho also are among seven Arizonans who were indicted on federal charges related to Medicaid and Medicare fraud.
The other two Gilbert residents – Thomas Lamar Heard and Kanisha Elaine Heard, who live at the same Gilbert address – are not charged with any crime.
However, the Arizona Attorney General has alleged in Maricopa County Superior Court that the Heards and three of their companies received over $34.8 million from the Arizona Health Care Cost Containment System (AHCCCS) and the American Indian Health Plan by “billing for services never provided to patients as well as billing for deceased patients.”
In at least one case, their Tempe clinic allegedly obtained $33,000 in AHCCCS payments for bills claiming treatments of a 2½-year-old child for alcohol abuse.
The AG has filed a notice of forfeiture against the Heards for nearly $1.7 million in cash, 39 vehicles, 13 various homes and commercial buildings and scores of luxury handbags, watches, purses, shoes and other clothing items.
Many of those luxury items were seized during an April 2 raid on their E. Tiffany Court home, according to a notice of seizure for forfeiture filed May 30.
Court records also show that a grand jury subpoena was filed in Maricopa County Superior Court in March involving the Heards, although that document is sealed.
The Heards’ lawyer, Jamal F. Allen, on June 18 asked Superior Court to order the return of the seized items, stating the AG “has not shown through clear and convincing evidence that the seized assets are subject to forfeiture” and that his clients “did not empower any employee or person to act in an unlawful manner.”
Here is a look at the legal actions filed against the four Gilbert residents and the various schemes authorities have accused them of perpetrating.
Bethany Jameson
Jameson, a 53-year-old nurse practitioner, filed on June 20 in U.S. District Court a request to change her plea to guilty in connection with a federal indictment accusing her of conspiracy to commit wire fraud involving $71 million in false and fraudulent claims from Medicare. A hearing on that plea is set in federal court for Aug. 14. Jameson had a relatively minor role in a far bigger alleged scheme.
From the $71 million in claims she filed, Medicare paid just under $50 million to two companies owned by a Scottsdale couple accused in the largest of the Arizona fraud cases.
That couple, Jeffrey King, 49, and his wife Alexandra Gehrke, 38, face multiple counts alleging kickbacks and money laundering “to fraudulently bill Medicare $900 million for highly expensive amniotic allografts,” the U.S. Justice Department said in a release.
King and Gehrke “targeted elderly Medicare patients, many of whom were terminally ill in hospice care, through their companies—Apex Mobile Medical LLC, Apex Medical LLC, Viking Medical Consultants LLC, and APX Mobile Medical LLC,” the Justice Department said in a release.
The couple through those companies “caused unnecessary and extremely expensive amniotic grafts to be applied to these vulnerable patients’ wounds indiscriminately, without coordination with the patients’ treating physicians, without proper treatment for infection, to superficial wounds that did not need this treatment, and in sizes excessively larger than the wound,” the Justice Department said.
“In just 16 months, Medicare paid the defendants more than $600 million as a result of their fraud scheme, paying on average more than a million dollars per patient for these unnecessary grafts,” it continued. “The defendants received more than $330 million in illegal kickbacks from the graft distributor in exchange for purchasing and ordering the grafts billed to Medicare.
“Significant assets were seized upon the defendants’ arrests, including luxury vehicles, gold, and bank accounts totaling more than $70 million,” the release said.
Gehrke and King were arrested and alleged in court records to be flight risks. A federal judge on July 8 denied their request for bail and ordered their pre-trial detention.
Jameson is tied to two of the couple’s four companies in a federal indictment.
Between November 2022 and August 2023, it states, she “agreed with others to order and apply amniotic allografts that were procured through illegal kickbacks and bribes, medically unnecessary, ineligible for Medicare reimbursement, and/or not provided as represented.”
It says Jameson earned $230,512 “in exchange for ordering and applying the amniotic allografts billed to Medicare.”
Daud Koleosho
Gilbert nurse practitioner Daud Koloesho, 44, allegedly partnered with Adam Mutwol, 45, of Tempe, in a conspiracy to illegally bill AHCCCS for substance abuse treatments that earned them over $51.6 million, according to a separate federal indictment.
Their Tempe outpatient substance abuse treatment clinic, Community Hope Wellness Center, largely targeted Native Americans, the indictment states.
“Mutwol and Koleosho offered and paid kickbacks and bribes to owners of residences that housed substance abuse treatment patients, in exchange for these residence owners referring patients for treatment to” Community Hope Wellness Center, Justice Department officials said in a release.
“Mutwol and Koleosho submitted $57 million of false and fraudulent claims to Arizona Medicaid for treatment services that were not provided, were not provided as billed, were not provided by qualified personnel, were so substandard that they failed to serve a treatment purpose, were not part of any treatment plan, and were medically unnecessary,” it said.
The indictment echoes various schemes that ultimately resulted in the suspension of scores of clinics and other facilities from AHCCCS for targeting mostly Native Americans and virtually holding them prisoners while billing the state Medicaid system for their non-existent treatment.
Native Americans were specifically targeted, according to the indictment against Koleosho and Mutwol, because the American Indian Health Plan’s paid higher reimbursements than Medicaid.
The state identified Community Hope Wellness in 2022 as “one of the top providers billing AHCCCS,” the indictment states.
It also alleges that out of $51.6 million Community Hope Wellness received between March 2022 and September 2023, Koleosho “received approximately $25,833,070 from those payments as gross proceeds, and used the funds to purchase, among other things, multi-million-dollar real estate, vehicles, and luxury interior design.”
Koleosho and an unidentified third person conspired “to unjustly enrich themselves by, among other things: (a) submitting and causing the submission of false and fraudulent claims to AHCCCS; (b) concealing the submission of false and fraudulent claims to AHCCCS, and the receipt and transfer of fraud proceeds; and (c) diverting the fraud proceeds for their personal use and benefit, the use and benefit of others, and to further the fraud,” the indictment also states.
The Heards
The Arizona Attorney General has not filed any criminal charges against Thomas Lamar Heard and Kanisha Elaine Heard. Nor are they part of the various schemes that federal authorities have accused Jameson, Koleosho and others of participating in.
However, the civil action the AG filed against them in May lays out the reasons why it is asking state Superior Court to order the forfeiture of the cash and personal possessions seized in the April 2 search of their home.
That document implicates the Heards and three limited liability companies – Heard Health Care, T&K Transportation and Mia Investing – in “a fraudulent billing scheme” involving the payment of over $34 million, mostly to Heard Health Care (HHC).
“A review of the billing records shows HHC engaged in excessive amounts of ‘ghost billing’ or billing for services never provided to patients, as well as billing for deceased patients,” the forfeiture request states.
“Moreover, billing records also revealed significant occurrences of ‘duplicate billing’ or bills submitted by HHC for patients that were receiving treatment at other hospitals at the same time.”
It also states, “in one instance, records indicate HHC billed for services after a patient’s date of death. Investigation revealed that AHCCCS paid out approximately $33,090 to HHC in claims for services after the patient’s death.”
It also says some bills claimed treatment for “alcohol dependence” for children as young as 2½ years and that “children between the ages of 2-14 accounted for over $3 million” paid to Heard Health Care by the state.
One patient for whom $1.22 million in claims was paid to Heard Health Care never heard of the clinic, the forfeiture request states, while “HHC was submitting claims to AHCCCS for 18 patients who were likely incarcerated at the time billing was submitted.”
On May 15, 2023, AHCCCS formally notified Heard Health Care it was suspended from the program, according to a letter obtained by this newspaper through the state open records law. Dozens of other clinics and treatment centers have similarly been suspended, many for submitting millions in claims for treating Native Americans for drug and alcohol abuse.
Court records show Thomas Heard, 45, was convicted in 2015 of forgery and identity theft. He was sentenced to probation and ordered to pay $4,655 in restitution.
He did not return phone calls and an email seeking comment.
No hearing date has been set on the forfeiture challenge filed by the Heards’ lawyer.
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