Long Island Man Sentenced to 12 Years in Prison for Massive Health Care Fraud, Wire Fraud and Identity Theft Scheme

Source: Office of United States Attorneys

CENTRAL ISLIP, NY – Mathew James was sentenced today by United States District Judge Joanna Seybert to 12 years in prison for a massive health care fraud scheme in which he and his co-conspirators, including physicians throughout the country, defrauded multiple health insurance companies out of hundreds of millions of dollars.  James was sentenced to 10 years on the fraud charges and two years to be served consecutive on the aggravated ID theft charges.  The Court also ordered restitution in the amount of $336,996,416.85 and forfeiture of $63,382,049.02. 

Breon Peace, United States Attorney for the Eastern District of New York, Nicole M. Argentieri, Acting Assistant Attorney General of the Justice Department’s Criminal Division, and James Smith, Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI), announced the sentence.

“James went to great lengths to carry out a complex fraud scheme that caused insurance companies to pay hundreds of millions of dollars in fraudulent claims,” stated United States Attorney Peace.  “The defendant not only falsified medical records and forged signatures, but also brazenly impersonated patients and their family members, all of which justifies a significant jail sentence to deter others from such audacious conduct.”

“Today, Mathew James was justly punished with a lengthy sentence in prison for his immense and brazen health care fraud scheme.  James took extreme steps to carry out his more than half-billion-dollar fraud – faking signatures, impersonating well known figures in the world of sports, and utilizing fraudulent documents,” stated FBI Assistant Director-in-Charge Smith.  “The FBI will continue to take the lead in investigating and holding accountable anyone attempting to illegally profit from deceptive and fraudulent health care schemes.”

James operated medical billing companies to provide billing services for physicians, primarily plastic surgeons throughout the United States, and used his companies to carry out a massive scheme to defraud insurance companies. As a third-party medical biller, James submitted claims to insurance companies and when necessary, requested reconsideration or appeals of denied claims. James billed for procedures that were either more serious or entirely different than those his doctor-clients performed. For example, the government presented evidence that James impersonated Jeff Pash, the National Football League’s general counsel, and Marcus Smart, a professional basketball player then of the Boston Celtics of the National Basketball Association, in calls the defendant made to insurance companies in which he exaggerated medical procedures. James made thousands of impersonation calls resulting in over tens of millions of dollars in additional reimbursement to his doctor-clients and from which he received a percentage of the fraudulent proceeds.

James also directed his doctor-clients to schedule elective surgeries through the emergency room so that insurance companies would reimburse at substantially higher rates. When insurance companies denied the inflated claims, James impersonated patients to demand that the insurance companies pay the outstanding balances of tens or hundreds of thousands of dollars.

Assistant U.S. Attorneys Catherine Mirabile and Antoinette N. Rangel of the Eastern District of New York, and Trial Attorney Miriam Glaser Dauermann of the Justice Department’s Fraud Section are prosecuting the case.  Assistant U.S. Attorney Tanisha Payne of the Eastern District of New York’s Asset Recovery Section is handling forfeiture matters.

The Defendant:

MATHEW JAMES
Age:  54
East Northport, Long Island

E.D.N.Y. Docket No. 19-CR-382 (JS)

Lyons man pleads guilty to child pornography charge

Source: Office of United States Attorneys

ROCHESTER, N.Y.-U.S. Attorney Trini E. Ross announced today that that Randall Seeley, Jr., 45, of Lyons, NY, pleaded guilty to receipt of child pornography before U.S. District Judge Charles J. Siragusa. The charge carries a minimum penalty of five years in prison, a maximum of 20 years and a $250,000 fine.

Assistant U.S. Attorney Kyle P. Rossi, who is handling the case, stated that in July 2023, the New York State Police received a report that Seeley had been involved in sexually explicit online communications with a 13 to 14-year-old minor. During an investigation, Seeley admitted knowing the minor and engaging in sexual communications, during which he solicited and received explicit images and videos of the minor. A review of the minor’s social media accounts revealed the sexually explicit communications with Seeley, going back as far as July 2022. A search warrant was executed at Seeley’s residence, during which his electronic devices were seized. A preliminary forensic analysis of the devices uncovered hundreds of images and videos of child pornography depicting the known minor and other, unknown minors. 

The plea is the result of an investigation by the New York State Police, Lyons, under the direction of Major Miklos Szoczei II, and Homeland Security Investigations, under the direction of Special Agent-in-Charge Matthew Scarpino.

Sentencing is scheduled for May 23, 2024, at 9:15 a.m. before Judge Siragusa.    

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Wayne County going to prison for possession of child pornography

Source: Office of United States Attorneys

ROCHESTER, N.Y.-U.S. Attorney Trini E. Ross announced today that Frederick Trevitt, 63, of Newark, NY, who was convicted of possession of child pornography involving a prepubescent minor, was sentenced to serve 144 months in prison by U.S. District Judge Charles J. Siragusa.

Assistant U.S. Attorney Meghan K. McGuire, who handled the case, stated that on January 4, 2023, Trivett possessed a laptop, which contained 368 images and 26 videos of child pornography. Some of the images and videos depicted prepubescent minors and included violence or the sexual abuse of an infant or toddler. Trevitt also admits that he engaged in a pattern of activity involving the sexual abuse of a minor for approximately seven years.

The sentencing is the result of an investigation by Homeland Security Investigations, under the direction of Special Agent-in-Charge Matthew Scarpino and the New York State Police, under the direction of Major Miklos Szoczei II. Additional assistance was provided by the Wayne County District Attorney’s Office.   

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Operators of High-End Brothel Network Indicted by Grand Jury

Source: Office of United States Attorneys

BOSTON – Three individuals previously arrested and charged in November 2023 in connection with operating sophisticated high-end brothels in greater Boston and eastern Virginia have been indicted by a federal grand jury in Boston, Mass. 

The following individuals have each been indicted on one count of conspiracy to persuade, induce, entice, and coerce one or more individuals to travel in interstate or foreign commerce to engage in prostitution; and one count of money laundering conspiracy: 

  • Han Lee, a/k/a “Hana,” 41, of Cambridge, Mass.;
  • James Lee, 68, of Torrance, Calif.; and
  • Junmyung Lee, 30, of Dedham, Mass.

According to the charging documents, from at least July 2020, the defendants operated an interstate prostitution network with multiple brothels in Cambridge and Watertown, Mass., as well as in Fairfax and Tysons, Va. It is alleged that the defendants collectively established the infrastructure for brothels in multiple states which they used to persuade, induce and entice women – primarily Asian women – to travel to Massachusetts and Virginia to engage in prostitution. 

Specifically, the defendants allegedly rented high-end apartment complexes as brothel locations, which they furnished and regularly maintained. It is further alleged that the defendants coordinated the women’s airline travel and transportation and permitted women to stay overnight in the brothel locations so they did not have to find lodging elsewhere, therefore enticing women to participate in their prostitution network. According to court documents, the defendants established house rules for the women during their stays in a given city to protect and maintain the secrecy of the business and ensure that the women did not draw attention to the prostitution work inside apartment buildings. 

The defendants allegedly advertised their prostitution network primarily on two websites – bostontopten10.com and browneyesgirlsva.blog – which offered appointments with women in either greater Boston or eastern Virginia, respectively. It is alleged that the defendants purchased and registered the bostontop10.com domain in August 2016. Both websites purported to advertise nude models for professional photography at upscale studios as a front for prostitution offered through appointments. 

According to court documents, each website described a verification process that interested sex buyers undertook to be eligible for appointment bookings– including requiring clients complete a form providing their full names, email address, phone number, employer and reference if they had one. It is alleged that the defendants persuaded the women to work for this prostitution network because the business maintained a regular customer base of men that were adequately screened, ensuring that the customers were not members of law enforcement or men who posed a risk to the safety and security of the commercial sex workers.

It is further alleged that the defendants maintained local brothel phone numbers which they used to communicate with verified customers and schedule appointments via text messages; send customers a “menu” of available options at the brothel, including the women and sexual services available and the hourly rate; and to text customers directions to the brothel’s location where they engaged in commercial sex with the women. 

According to the charging documents, the defendants charged sex buyers a premium price for appointments with the women advertised on their websites, which ranged from approximately $350 to upwards of $600 per hour depending on the services and were paid in cash. 

 The defendants also allegedly concealed the proceeds of the prostitution network through depositing hundreds of thousands of dollars of cash proceeds into their personal bank accounts and peer-to-peer transfers. Additionally, it is alleged that the defendants regularly used hundreds of thousands of dollars of the cash proceeds from the prostitution business to purchase money orders (in values under an amount that would trigger reporting and identification requirements) to conceal the source of the funds. These money orders were then used to pay for rent and utilities at brothel locations in Massachusetts and Virginia.

Members of the public who have questions, concerns or information regarding this case should contact USAMA.VictimAssistance@usdoj.gov.

The charge of conspiracy to persuade, induce, entice, and coerce one or more individuals to travel in interstate or foreign commerce to engage in prostitution provides for a sentence of up to five years in prison, three years of supervised release and a fine of up to $250,000. The charge of money laundering conspiracy provides for a sentence of up to 20 years in prison, three years of supervised release and a $500,000 fine or twice the value of funds laundered, whatever is greater. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and statutes which govern the determination of a sentence in a criminal case.

Acting United States Attorney Joshua S. Levy; Michael J. Krol, Special Agent in Charge of Homeland Security Investigations in New England; and Cambridge Police Commissioner Christine Elow made the announcement today. Valuable assistance was provided by the Central District of California; Eastern District of Virginia; U.S. Postal Service; and Watertown Police Department. Assistant U.S. Attorney Lindsey E. Weinstein of the Criminal Division and Assistant U.S. Attorney Raquelle Kaye, of the Asset Recovery Unit are prosecuting the case.

The details contained in the charging documents are allegations. The defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

Colombian National Sentenced To Over 17 Years For Recruiting Mariners To Traffic More Than 12,000 Kilograms Of Cocaine To The Sinaloa Cartel

Source: Office of United States Attorneys

Tampa, FL – U.S. District Judge Richard A. Lazzara has sentenced Alonso Pineda-Torres (52, Colombia), a/k/a “Galladita,” to 17 years and 6 months in federal prison for conspiring to distribute cocaine on board vessels subject to the jurisdiction of the United States. Pineda-Torres entered a guilty plea on October 11, 2019, after his arrest and extradition from Colombia.

According to court records, Pineda-Torres was a member of a transnational criminal organization that dispatched self-propelled semi-submersible (SPSS) vessels from Colombia into the Pacific Ocean, destined for Sinaloa Cartel members in Oaxaca, Mexico. Pineda-Torres recruited SPSS crew members for these trips, delivered money to them, and assisted in the departure of an SPSS. Two of these SPSS vessels were interdicted in international waters, resulting in the seizure of over 12,000 kilograms of cocaine and the prosecution of the crewmembers in the Middle District of Florida.

This case was investigated by the Panama Express Strike Force, a standing Organized Crime Drug Enforcement Task Force (OCDETF) comprised of agents and analysts from the Drug Enforcement Administration, the Federal Bureau of Investigation, Homeland Security Investigations (HSI), the U.S. Coast Guard Investigative Service, the Naval Criminal Investigative Service, and the U.S. Southern Command’s Joint Interagency Task Force South. The principal mission of the OCDETF program is to identify, disrupt, and dismantle the most serious drug trafficking and money laundering organizations and those primarily responsible for the nation’s drug supply. The Justice Department’s Office of International Affairs and the Narcotic and Dangerous Drug Section’s Judicial Attaché’s office at the U.S. Embassy in Bogota provided critical assistance in securing the arrest and extradition of Pineda-Torres. The case was prosecuted by Assistant United States Attorney Dan Baeza.

Miami felon convicted at trial of armed Hobbs Act robbery

Source: Office of United States Attorneys

MIAMI – On Jan. 24, a federal jury found a Miami felon guilty of Hobbs Act robbery conspiracy, Hobbs Act robbery, discharge of a firearm in furtherance of a crime of violence, and of being a felon in possession of a firearm and ammunition.

During a six-day trial, the government presented DNA, firearms and ballistics, cell-site data, surveillance footage, photographic, testimonial, forensic, and other evidence showing that on April 3, 2022, Frederick Lee Alvin, 39, of Miami, Florida, robbed a market in Little Havana. After Alvin entered the store wearing a mask and dressed in all black, he demanded money from the register, fired a gun at the cashier’s feet, and fled with $3,400 from the register and the cashier’s wallet. Alvin was later arrested at a local motel in possession of the same firearm that he used during the market robbery.

Sentencing is scheduled for April 17 before U.S. District Judge Patricia A. Seitz. Alvin faces up to life in prison. Alvin had been previously convicted of three prior felony offenses, which triggered the Armed Career Criminal Act (ACCA) enhancement.

U.S. Attorney Markenzy Lapointe for the Southern District of Florida and Special Agent in Charge Christopher A. Robinson of the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF), Miami Field Division, announced the conviction.

ATF Miami Field Office investigated the case. Assistant U.S. Attorneys Will Rosenzweig and Abbie Waxman are prosecuting it. Assistant U.S. Attorney Annika Miranda is handling asset forfeiture.

This prosecution is a part of the U.S. Department of Justice’s Project Safe Neighborhoods (PSN) program.  PSN is the centerpiece of the Department’s violent crime reduction efforts.  PSN is an evidence-based program proven to be effective at reducing violent crime.  Through the PSN program a broad spectrum of law enforcement and community stakeholders work together to identify the most pressing violent crime problems in the community and develop comprehensive solutions to address them.  As part of this strategy, PSN focuses enforcement efforts on the most violent offenders and partners with locally based prevention and reentry programs to reduce violence crime and gun violence, and to make our local neighborhoods safer for everyone.

Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov, under case number 22-cr-20244.

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Terrebonne Parish Man Pleads Guilty to Distributing Methamphetamine

Source: Office of United States Attorneys

NEW ORLEANS, LOUISIANA – CHRISTOPHER CARTER, JR., age 30, a resident of Gray, Louisiana, pleaded guilty on February 1, 2024 to two counts of distribution of methamphetamine, in violation of Title 21, United States Code, Sections 841(a)(1), 841(b)(1)(B), and 841(b)(1)(A), announced U.S. Attorney Duane A. Evans.

According to court documents, Drug Enforcement Administration agents utilized a confidential source to conduct two audio-video recorded controlled purchases of methamphetamine from CARTER.  The first controlled purchase was for 49 grams of methamphetamine on May 19, 2021. The second controlled purchase was for 126 grams of methamphetamine on June 17, 2021.

For Count 1, CARTER faces a mandatory minimum sentence of five (5) years, up to forty (40) years imprisonment, a fine of up to $5,000,000, and at least four (4) years of supervised release following any term of imprisonment. For Count 2, CARTER faces a mandatory minimum sentence of ten (10) years, up to life imprisonment, a fine of up to $10,000,000, and at least five (5) years of supervised release following any term of imprisonment. For both counts, CARTER faces payment of a $100 mandatory special assessment fee. 

This case was investigated by the Drug Enforcement Administration and Terrebonne Parish Sherriff’s Office. The prosecution is being handled by Assistant United States Attorney J. Benjamin Myers of the Financial Crimes Unit.

Georgia Man Sentenced To Five Years In Federal Prison For Tax Fraud And Operation Of Bogus Credit Repair Businesses

Source: Office of United States Attorneys

Jacksonville, Florida – U.S. District Judge Marcia Morales Howard has sentenced Kevin Edward Hargrave a/k/a “Kevin Edward Wade,” of Locust Grove, Georgia, to five years in federal prison for conspiring to commit wire fraud and to defraud the United States for the purpose of impeding the lawful functions of the Internal Revenue Service (IRS). As part of his sentence, the court also entered an order of forfeiture in the amount of $1.5 million, the proceeds of the wire fraud conspiracy. Hargrave was also ordered to pay restitution to his victims, including $418,115 to the IRS. Hargrave entered a guilty plea on October 4, 2022.

According to court documents, Hargrave controlled a number of companies, including WSA Optimization Firm, Inc., that purported to offer “credit repair services” to the public. Hargrave promoted these services through multiple company-specific websites, radio advertising, emails, text messages, and posts on YouTube.com and other social media sites. These marketing campaigns promised to “erase bad credit” information from consumers’ credit reports within 90 days – “guaranteed.” Notwithstanding these promises, multiple customers reported to federal investigators that they paid for credit repair services, saw no such results, and were denied refunds.

When an undercover federal agent called to inquire about these credit repair services, he was told that WSA Optimization used “federal laws to remove all negative derogatory items off your credit.” Further, the agent was told “we are able to remove those items off your credit without you paying [creditors] back.” A company representative also claimed that WSA Optimization employed a team of 5 attorneys and 23 paralegals who worked to remove negative credit information from credit reports.

In reality, Hargrave did not employ a team of attorneys or paralegals.  Instead, supposedly to improve its customers’ credit scores, company representatives would send form letters to each credit reporting agency and falsely claim that all negative credit information on the customers’ credit reports was the product of identity theft or fraud. These letters – which did not disclose that they were mass produced by WSA Optimization – were sent in envelopes listing a fictional return address. 

An analysis of bank records established that more than $8 million in deposits were made into the business bank accounts controlled by Hargrave and a family member, and that significant funds were diverted from those accounts to pay for luxury vehicles, mortgage payments on their residence, personal credit cards, jewelry, items at retail stores, utilities, restaurants, and other living expenses. For example, funds were used to make over $128,000 in mortgage payments on Hargrave’s residence in Fernandina Beach, which he sold in 2022 for $870,000. Similarly, approximately $300,000 was used to make down-payments and monthly financing payments on automobiles owned by Hargrave and a family member, including a Lamborghini Gallardo, a Rolls Royce Wraith, a Porsche Boxster, a Range Rover, a Ford F-150, and two Mercedes Benz vehicles.

An analysis of Hargrave’s real and personal property, certain business records, credit card statements, and the bank records collectively demonstrate that his joint tax returns for tax years 2016 through 2019 underreported taxable income and improperly claimed certain business expenses. A financial investigator with the IRS estimated that since 2015, by underreporting his and a family member’s tax liability, Hargrave has caused the United States to lose approximately $418,115 in tax revenue.

“It was clear that Mr. Hargrave believed the law did not apply to him,” stated IRS Criminal Investigation Acting Special Agent in Charge Lani Rosado-Espinal.  “Despite being in the midst of a global pandemic, he stole millions of dollars from vulnerable people, who were struggling financially and defrauded the IRS. IRS-CI and the FBI will continue to partner with the United States Attorney’s Office to identify, investigate and assist in the prosecution of criminals like Mr. Hargrave, whose greed leads them to prey on others, including U.S. taxpayers.” 

“Fraud and corruption pose a fundamental threat to our national security and our way of life,” said Michael C. Malsch, Assistant Special Agent in Charge of the FBI Jacksonville Division. “The FBI is committed to coordinating with our partners and aggressively pursuing those who take advantage of others for their personal gain. This sentencing should serve as a warning to others who might engage in these types of schemes.”  

This case was investigated by the Internal Revenue Service – Criminal Investigation and the Federal Bureau of Investigation. It was prosecuted by Assistant United States Attorney Michael J. Coolican. 

Mexican National Sentenced To 10 Years In Prison For Trafficking Methamphetamine

Source: Office of United States Attorneys

Tampa, FL – U.S. District Judge William F. Jung has sentenced Benancio Pineda (50, Mexico) to 10 years in federal prison for conspiring to possess with the intent to distribute methamphetamine. Pineda entered a guilty plea on September 28, 2023.

According to court documents, on December 20, 2022, Pineda met with an individual at a gas station in Wimauma and sold him approximately 1 kilogram of methamphetamine. This methamphetamine was 96% pure. On June 16, 2023, Pineda drove to meet the same person in Wimauma to sell him 2 kilograms of methamphetamine, but Pineda was pulled over by law enforcement near Sun City Center. Law enforcement recovered approximately 2 kilograms of methamphetamine from inside of Pineda’s car. This methamphetamine was 97% pure.  

This case was investigated by the Drug Enforcement Administration. It was prosecuted by Assistant United States Attorney David Pardo.

This case was part of an Organized Crime Drug Enforcement Task Force (OCDETF) investigation. OCDETF identifies, disrupts, and dismantles the highest-level criminal organizations that threaten the United States using a prosecutor-led, intelligence-driven, multi-agency approach. Additional information about the OCDETF Program can be found at www.justice.gov/OCDETF.

Madison Man Sentenced for Receipt and Distribution of Child Pornography

Source: Office of United States Attorneys

SIOUX FALLS – United States Attorney Alison J. Ramsdell announced today that U.S. District Judge Karen E. Schreier has sentenced a Madison, South Dakota, man convicted of Receipt and Distribution of Child Pornography. The sentencing took place on January 30, 2024.

Treton Anderson, age 26, was sentenced to 15 years and six months in federal prison, followed by five years of supervised release, and a special assessment to the Federal Crime Victims Fund in the amount of $100. Anderson will also need to register as a sex offender upon his release.

Anderson was indicted by a federal grand jury in August of 2022. He pleaded guilty on October 2, 2023.

The conviction stemmed from incidents between December 18, 2021, and June 29, 2022, when Anderson, using his cellular phone to access the internet, and using his Kik account, distributed digital files containing child pornography.

This case was investigated by Homeland Security Investigations, the South Dakota Internet Crimes Against Children Task Force, the National Center for Missing and Exploited Children, and the Madison Police Department. Assistant U.S. Attorney Jeffrey C. Clapper prosecuted the case.

This case was brought as part of Project Safe Childhood, a nationwide initiative to combat the growing epidemic of child sexual exploitation and abuse, launched in May 2006 by the Department of Justice. Led by the U.S. Attorneys’ Offices and the DOJ’s Child Exploitation and Obscenity Section, Project Safe Childhood marshals federal, state, and local resources to locate, apprehend, and prosecute individuals who exploit children, as well as identify and rescue victims. For more information about Project Safe Childhood, please visit https://www.justice.gov/psc.

Anderson was immediately remanded to the custody of the U.S. Marshals Service.