Locals arrested in $2M Medicaid fraud case
FARMINGTON — Two local residents were arrested Tuesday on allegations they defrauded the federal Medicaid program of almost $2 million, according to a U.S. Department of Justice press release.
Rosita Toledo, 46, of Kirtland, and Cory Werito, 32, of Farmington, co-owners and operators of CW Transport, are each charged with nine counts of health care fraud on allegations they used the nonemergency medical transportation company to submit falsified Medicaid reimbursements to the Arizona Health Care Cost Containment System, a Medicaid agency, according to an indictment.
CW Transport, which provided nonemergency medical transport to indigent residents, allegedly submitted 18,765 claims for reimbursement between July 2011 and July 2013, the vast majority of which were fraudulent, according to the indictment.
Investigators who audited a sample of the claims found the company claimed to transport patients who received no Medicaid-eligible services on the day of transport, the indictment states. In other instances, the company claimed to transport patients on a holiday or weekend, when the medical facility would be closed.
The federal government alleges Toledo and Werito collected at least $1,959,405 in proceeds from the scheme.
The indictment includes a request that a judge order Werito and Toledo to forfeit to the United States that same amount.
Werito is further charged with an aggravated currency structuring offense on allegations he conducted financial transactions in a manner to avoid scrutiny by law enforcement authorities, the affidavit states.
Werito allegedly withdrew $800,000 from bank accounts between August 2011 and July 2013, but withdrew less than $10,000 at a time to avoid the filing of currency transaction reports, which must be filed by financial institutions on daily transactions involving more than $10,000, according to the release.
CW Transport is a New Mexico limited liability company founded by Cory Werito in November 2012, according to the New Mexico Department of Corporations website. The website lists a Farmington address as the company's headquarters, but a visit to the site today revealed it was a vacant lot.
Susie Werito is listed as the registered agent for the company. Attempts to reach her at her Farmington residence today were unsuccessful.
Officials with the Arizona Health Care Cost Containment System did not respond to a request for comment, but according to the program's website, the AHCCCS is a $9 billion program that funds medical services for low-income residents in Arizona.
The Office of the Inspector General is responsible for the integrity of the program, according to the website. The office investigated more than 5,000 fraud cases in fiscal year 2014, and those investigations resulted in 27 convictions, the website states.
Werito and Toledo face up to 10 years of imprisonment on each of the 10 counts of the indictment, the release states.
Both defendants told a federal magistrate judge during an initial appearance in Farmington on Tuesday that they would need a public defender.
Steve Garrison covers crime and courts for The Daily Times. He can be reached at 505-564-4644.