‘Worker Bees’ Avoid Jail in $7 Million Home Health Fraud Case

A New Jersey couple has avoided jail time for their involvement in a plan to bill Medicaid millions for home health care services administered by unlicensed aides or not completed at all.

Nelson and Sonia Mesa, of Elizabeth, New Jersey, were sentenced to three years of probation last week, and Sonia Mesa additionally received four months of home detention. They last year admitted their roles in a plan involving two New Jersey home health care agencies—HHCH of Linden and People’s Choice of Elizabeth—that bilked Medicaid out of approximately $7 million, NJ.com reported.

As part of the scheme, Sonia Mesa secured a state licenses to work as a home health aide from 2003 to 2007, though she is living in the U.S. illegally, Assistant U.S. Attorney Anthony Moscato said. However, she continued to administer home health services through 2013, signing off on time sheets under other people’s names and then receiving cash payments from them. She also billed for services not rendered, convincing patients to sign off on paperwork they knew was false.

Meanwhile, Nelson Mesa drove Sonia Mesa to and from jobs, knowing that she was participating in the scheme.

Attorneys for Nelson and Sonia Mesa minimized their roles in the scheme, with Sonia Mesa’s attorney calling her “a worker bee,” while Nelson Mesa’s attorney called him “the lowest man on the totem pole.”

In addition to their probation sentences, Nelson and Sonia Mesa were assessed joint restitution of $223,702, according to NJ.com. Sonia Mesa could also face a deportation hearing.

Five other women involved in the operation pleaded guilty and are on probation or served jail time. The principals behind the scheme, Irinia Krutoyarsky and Paul Mil, both of Springfield, New Jersey, pleaded guilty to charges including conspiracy, money laundering and tax evasion and face 35 years and 25 years in prison, respectively.

Written by Kourtney Liepelt