Woman Found Guilty of $24M Medicare DME Scam

LOS ANGELES—A South Bay woman was found guilty on Tuesday, June 27 of nearly two dozen felonies for billing Medicare more than $24 million by submitting fraudulent claims for medically unnecessary durable medical equipment—mostly power wheelchairs (PWC)—and PWC repairs, many of which were never performed.

Tamara Yvonne Motley, 54, also known as “Tamara Ogembe,” of Redondo Beach, was found guilty by a federal jury of 20 counts of health care fraud, two counts of aggravated identity theft and one count of conspiracy to commit money laundering.

Following the reading of the guilty verdicts, United States District Judge Stanley Blumenfeld Jr. remanded Motley into custody.

According to evidence presented at her five­-day trial, from July 2006 to August 2014, Motley was the de facto owner of the Hawthorne-based Action Medical Equipment and Supplies. From January 2013 to November 2016, Motley was the de facto owner of the Ventura-based Kaja Medical Equipment & Supply. Both companies were enrolled with Medicare in the names of Motley’s out-of-state relatives.

Motley orchestrated a scheme in which she paid marketers for patient referrals and then directed them to take patients to corrupt physicians, who prescribed medically unnecessary durable medical equipment, such as PWCs, that Motley’s companies used to submit fraudulent bills to Medicare.

In January 2011, when Medicare changed the reimbursement rules for PWCs to make the upfront payments less lucrative to suppliers, Action switched to billing Medicare for PWC repairs, and continued that scheme at Kaja once Action was shut down. These repairs were not medically necessary because the patients did not need the PWCs to begin with, were not needed to make the PWCs serviceable in any event and often simply were not performed. These repairs were expensive—often billed for $3,000-$4,000—and accounted for nearly half of Action’s billings and almost all of Kaja’s.

Over an eight-year period, Action billed Medicare more than $18.2 million for DME—most for PWCs, but also for PWC accessories, knee braces and back braces—and the repair or replacement of PWCs. Medicare paid Action nearly $10.3 million.

Between July 2013 and November 2016, Kaja billed Medicare $6.3 million, primarily for PWC repairs. Medicare paid Kaja approximately $2.8 million for those claims.

Blumenfeld scheduled an Oct. 3 sentencing hearing, at which time Motley will face up to 10 years in federal prison for each health care fraud count, up to 20 years in federal prison for the money laundering conspiracy count and a mandatory sentence of two years in federal prison consecutive to the other sentences for the aggravated identity theft counts.

Two other defendants have been convicted in this case:

• Cynthia Karina Marquez, 47, of Paramount, who worked as an office manager at both Action and Kaja, pleaded guilty in December 2019 to two counts of making false statements affecting a health care program. She received a time-served sentence, was placed on supervised release for three years and was ordered to pay $9,886,646 in restitution.
• Juan Roberto Murillo, 46, of Montebello, who worked at both medical supply companies as a repair technician, pleaded guilty in November 2019 to one count of conspiracy to commit money laundering. He was sentenced to three years’ probation and was ordered to pay $2,504,119 in restitution.

The United States Department of Health and Human Services, Office of Inspector General; the FBI; and the California Department of Justice investigated this matter.

Assistant United States Attorneys Kristen A. Williams and David H. Chao of the Major Frauds Section are prosecuting this case.