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Pair arrested in South LA Medi-Cal fraud scheme

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Two executives at a South Los Angeles company that offered substance abuse treatment were arrested this week on nearly two dozen federal charges alleging they defrauded Medi-Cal by billing at least $2 million for ineligible services.

Mesbel Mohamoud, 45, and her mother-in-law, Erlinda Abella, 63, were taken into custody without incident, according to the U.S. Attorney’s Office.

A 23-count indictment returned by a Los Angeles federal grand jury on March 29 charges both Inglewood women with 21 counts of health care fraud and two counts of aggravated identity theft stemming from the scheme that allegedly ran from 2009 through 2015.

Mohamoud is the owner and executive director of The New You Center, while her mother-in-law, who co-founded the company, is the firm’s program director. TNYC had contracts to provide medically necessary substance abuse treatment services through the Drug Medi-Cal program to adults and teenagers in Los Angeles County.

The indictment alleges that TNYC submitted bogus bills for counseling sessions that were not conducted at all, were not conducted at authorized locations, or did not comply with Drug Medi-Cal regulations regarding the length of sessions or the number of patients.

Mohamoud and Abella caused TNYC to bill for clients who did not have a substance abuse problem, to falsify documents related to services supposedly provided to clients, and to forge client signatures on documents such as sign-in sheets, the indictment alleges.

The charges primarily involve services provided to girls residing at Dimondale Adolescent Care Facility group homes in Lancaster, Long Beach and Carson — facilities where TNYC was not authorized to provide counseling, according to the U.S. Attorney’s Office. Prosecutors allege that TNYC submitted more than $2 million in false and fraudulent claims for group and individual substance abuse counseling services and was paid more than $1.8 million based on those bills.

Both defendants were expected to be arraigned Tuesday afternoon in Los Angeles federal court. If convicted as charged, Mohamoud and Abella each would face up to 10 years in prison for each of the 21 health care fraud charges. Additionally, there is a two-year mandatory sentence associated with each of the aggravated identity theft counts, prosecutors said.

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