A 41-year-old Kenyan woman in the United States (US), Winnie Waruru, has been charged for involvement in a Ksh10 billion scam targeting theft of US healthcare funds.
Waruru and her suspected accomplice, Faith Newton, were taken to court to answer charges of being involved in paying and receiving kickbacks, money laundering and making false statements.
Newton was part owner and operator of Arbor Homecare Services from January 2013 to January 2017 according to court documents. On the other hand, Waruru was a licensed practical nurse working as a home health nurse at Arbor.
According to the made allegations made, Newton and Waruru conspired to use Arbor to obtain at least Ksh10 billion from health insurance providers by committing healthcare fraud and paying kickbacks to induce referrals.
File image of Kenyan bank notes
Through Newton and others, Arbor failed to train staff that they were supposed to train to provide home health services that were unnecessary and also unauthorized and billed for them.
They developed relationships to pay for patient referrals, regardless of medical necessity requirements.
It is also alleged that Newton targeted vulnerable patients especially the low-income earners, disabled or suffering from depression or addiction.
Prosecutors further state that Waruru passed cash payments from Newton to their Arbor patient in order to retain them.
The money laundered is alleged to have been used by Newton in a number of financial transactions, to buy multiple homes and a Maserati as well as fund investment accounts and a lavish lifestyle.
The case seeks to take away five properties in different towns and cities in the US as well as enable access to 40 bank accounts belonging to Arbor.
It is said that Newton and a family member paid themselves approximately Ksh4 billion from the profits and also paid Waruru over Ksh45 million.
The agencies that are involved in the healthcare sector scam are the US Department of Health and Human Services, Office of the Inspector General, Internal Revenue Services (IRS), Federal Bureau of Investigation (FBI), and the US Attorney General’s Office.
Waruru was released on a Ksh5 million unsecured bond.
The charges of health care fraud, conspiracy to commit health care fraud, money laundering conspiracy and money laundering each provide for a sentence of up to 10 years in prison, three years of supervised release and a fine of up to $250,000 or twice the amount of the money involved in the laundering. The conspiracy to pay kickbacks, make false statements and make false statement in health care matter each provide for a sentence of up to five years in prison, three years of supervised release and a fine of up to $250,000. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.