Nine California Suspects Arrested in Medi-Cal Fraud Scam

California Attorney General Edmund G. Brown Jr. announced the arrests of nine people in a San Bernardino County Medi-Cal fraud case in which employees of a skilled nursing facility and their associates falsified documentation and stole more than $150,000 from patients and their families for their own personal use.

The investigation was launched in January by the Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse after an initial investigation by the state’s Department of Health Care Services.

Brown’s office charged employees and associates at Community Extended Care Hospital of Montclair with committing Medi-Cal fraud in order to steal assets from the trust accounts of elderly patients, which were held by the facility.

From 2006 to 2009, the AG said several employees of the extended care hospital conspired with a former San Bernardino County employee who fraudulently submitted documentation to the Medi-Cal program so that Medi-Cal would pay the entire monthly bill for more than 50 patients in the facility.

According to the AG, the conspirators then told patients and their families they were required to pay a share of the cost of their care directly to the facility. The payments made by the patients and their families were then placed in patient trust accounts, and the suspects took that money for their own personal gain.

The scam involved hospital employees writing checks, ranging from $250 to $6,900, from the patient accounts to individuals in the gang, including a UPS driver, their own relatives, and a next door neighbor, who would then cash the checks, take a percentage of the stolen funds and return most of the cash to the hospital employees. The checks were approved by officials at the hospital.

Nine suspects were arrested. Bail was set for $1 million on each defendant. One suspect, Maribel Velazquez, is still at large.

The ten individuals charged in the crime are:

• Johannes Simanjuntak, 59, of Pomona, a former administrator at the hospital
• Peggy Lee Hoskins, 58, of Upland, a former personnel manager at the hospital
• Laurie Diane Powell, 46, of Riverside, former San Bernardino County employee
• Sean Matthew Ashton, 22, of Riverside, Powell’s son
• Andy Perry Tricas, 46, of Duarte, boyfriend of suspect (now deceased)
• Arnon Graham, 50, of Rancho Cucamonga, UPS driver
• Claudia Zaragoza, 34, of Bloomington, Social Services designee
• Orelious Antonio Peevy, 41, of Chino, Social Services designee
• Maribel Velazquez, 36, of Chaparral, New Mexico, administrative worker at the hospital (not in custody)
• David Carmona, 74, of LaVerne, neighbor of deceased employee

Source: AG