New Mexico medical transport operator sentenced to 30 months in prison for Medicaid fraud

A New Mexico medical transportation founder and operator who pleaded guilty to defrauding Medicaid $1.96 million dollars was sentenced to 30 months in prison Sept. 6.  

Co-defendants Cory Werito and Rosita Toledo were charged in a 10-count indictment June 15, 2016. The indictment alleged the defendants defrauded Medicaid through their nonemergency medical transportation company, CW Transport in Farmington, N.M. CW Transport, which serviced Arizona Medicaid beneficiaries, was founded and operated by the defendants.

CW Transport filed claims with Arizona's Medicaid program, the Arizona Health Care Cost Containment System. The company collected more than $1.9 million in Medicaid reimbursement from AHCCCS between 2011 and 2013. Of the more than 18,000 claims filed within the time frame, "the vast majority of … were wholly or substantially false and fraudulent," concluded U.S. Immigration and Customs Enforcement's Homeland Security Investigations, which investigated the case.

Mr. Werito pleaded guilty March 9 and was ordered to pay $1.2 million in restitution to those affected by the scheme. Ms. Toledo pleaded guilty to her role in the scheme March 30, and her sentencing date is not scheduled. The defendants are required to pay the federal government $1.9 million for the healthcare fraud.

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