BOSTON – A Lowell woman has pleaded guilty in federal court in Boston to a $100 million home health care fraud scheme.
Winnie Waruru, 42, of Lowell, pleaded guilty to a charge of conspiracy to commit healthcare fraud on September 8, 2022; a healthcare fraud case – abetting and abetting; a charge of conspiracy to pay and receive bribes; two counts of false statements; and a count of making a false statement in a health care matter. US Supreme Court Justice George A. O’Toole Jr. scheduled sentencing for January 12, 2023. Waruru was arrested and charged along with co-defendant Faith Newton in February 2021. Newton has pleaded not guilty and is on trial.
According to the indictment, Newton co-owned and operated Arbor Homecare Services LLC from January 2013 to January 2017. Waruru was a licensed practical nurse employed as a home nurse at Arbor. Waruru and allegedly Newton conspired to use Arbor to defraud MassHealth and Medicare of at least $100 million by committing healthcare fraud and paying kickbacks to initiate referrals. Newton then allegedly laundered the ill-gotten gains.
Specifically, it alleges that Arbor, through Newton and others, including Waruru, failed to train staff, bill for home healthcare services that were never provided or were not medically necessary, and to bill for home healthcare services that were unauthorized . Arbor has been developed by Newton and others to pay kickbacks for patient referrals, regardless of medical need. They also allegedly entered into bogus employment relationships with patients’ family members to provide home nursing services that were not medically necessary and were routinely billed for fictitious visits that did not occur. As alleged in the civil complaint, Newton targeted, either directly or through Arbor, high-risk patients who were low-income, disabled and/or suffering from depression and/or addiction.
Waruru and Arbor billed MassHealth for Waruru’s qualifying care visits, many of which it failed to perform, were medically unnecessary, or were not authorized by a physician. Waruru was personally responsible for causing Arbor to bill MassHealth over $1.2 million for visits from qualified nurses, much of which was fraudulent. Waruru also forwarded cash payments allegedly from Newton to two Arbor patients in order to keep those patients.
The charges of healthcare fraud, healthcare fraud conspiracy, money laundering conspiracy, and money laundering each carry a prison sentence of up to 10 years, three years under supervision, and a fine of up to $250,000, or twice that of money laundering money involved. The conspiracy to pay bribes, provide false information, and provide false health information each carries a sentence of up to five years in prison, three years of supervised release, and a fine of up to $250,000. Penalties are imposed by a federal district court judge based on the US Sentencing Guidelines and the statutes governing the determination of a sentence in a criminal proceeding.
US Attorney Rachael S. Rollins; Phillip M. Coyne, Acting Special Agent, US Department of Health and Human Services, Office of the Inspector General, Office of Investigation; Joleen D. Simpson, special agent in charge of the Boston Internal Revenue Service criminal investigation; and Joseph R. Bonavolonta, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division, made the announcement. Assistant US Attorneys Rachel Y. Hemani of Rollins’ Health Care Fraud Unit, David G. Tobin of Rollins’ Major Crimes Unite and Carol Head, head of Rollins’ Asset Recovery Unit, are prosecuting the case.
The information contained in the court records are allegations. The remaining accused will be presumed innocent until proven guilty in a court of law.