Health Care Fraud

The U.S. Attorney’s Office places a high priority on criminal and civil enforcement in cases involving health care fraud and unauthorized health care benefits payments, as well as related activities such as fraud against the elderly and prescription drug fraud. The office works on these matters with the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), the Federal Bureau of Investigation, the Internal Revenue Service, the Drug Enforcement Administration, the Food and Drug Administration (FDA), the Office of the Pennsylvania Attorney General, District Attorney’s Offices within the Middle District, the Pennsylvania Department of State and the NEPA Insurance Fraud Task Force.

Anyone with information concerning suspected health care fraud or irregularities should contact the HHS-OIG at 1-800-HHS-TIPS (1-800-447-8477) and/or the U.S. Attorney’s Office at 717-221-4482, attention Assistant U.S. Attorneys Ravi Sharma (Criminal) or Tamara Haken (Civil), Health Care Fraud Coordinators.

Recent Cases

Criminal Cases - Health Care Fraud

Frank Suess

Frank Suess, age 79, of Wellington, Florida, pleaded guilty on April 3, 2026, to conspiracy to commit health care fraud and conspiracy to violate the anti-kickback statute. Suess admitted that he and his codefendants conspired to commit health care fraud through an arrangement designed to bill individuals’ health insurances for medically unnecessary prescription drug combinations known as “foot baths.” Suess also admitted that he and certain codefendants acquired control of pharmacies in a way that allowed Suess to conceal his involvement in their business affairs.  One such pharmacy was Sterling Pharmacy, located in Jermyn, Pennsylvania.  Suess, using a company that he controlled called Medivalue Florida LLC, financed the purchase and initial operating expenses for Sterling Pharmacy through a loan to Melissa Driscoll. In a similar manner, Suess financed the purchase of DCE Pharmacy, located in Texas, and Motto Pharmacy, located in Florida.  Once they got control of pharmacies, Suess and other defendants used those pharmacies to generate profits by steering high-cost prescription drug mail orders, including foot baths, to those pharmacies. Pharmacies were selected to fulfill prescription drug orders based on which insurance plans they could bill through and for the amounts they could bill for such drugs. When the pharmacies were investigated for those dispensing practices, Suess and his codefendants used various tactics to continue concealing Suess’s involvement. Suess admitted that the scheme to bill for fraudulent foot bath orders involved getting prechecked, templated order forms through “health fairs” in the New York area organized by certain codefendants and their associates. Suess also admitted that he and his codefendants knowingly ignored complaints from individuals who received foot baths. These complaints included not wanting foot baths, not having ever seen a foot doctor, having their insurance “charged a lot of money,” being “freaked out” because there were no instructions regarding what to do with the medications, and being “scared of the box” of foot baths because it contained “such a huge amount of meds.”  Suess also admitted that he conspired with certain codefendants to violate the federal Anti-Kickback Statute by agreeing to pay, and actually paying, kickbacks to certain defendants for providing completed orders for foot baths using the templated order forms described above.  Finally, Suess admitted that he and other codefendants obstructed the government’s investigation into Sterling Pharmacy by coming up with a document that misrepresented Sterling Pharmacy’s compliance with the Anti-Kickback Statute and contained other false information. Suess admitted that the health care fraud conspiracy generated over $700 thousand in profits through fraudulent foot bath orders from a private health insurance fund.  Four individuals who were charged along with Suess are still pending trial: Luis Salgado, age 51, of Naperville, Illinois and Davenport, Florida; Melissa Driscoll, age 44, of East Stroudsburg, Pennsylvania; Victor Velazco, age 36, of Loxahatchee, Florida; Dave Singh, age 38, of Pembroke Pines, Florida. Two defendants who were also charged along with Suess previously pleaded guilty and are awaiting sentencing: Warren Pizik, age 69, of Davie, Florida and Diana Castro, age 54, of Brooklyn, New York.  Suess is awaiting sentencing.

Ester N. Mbaya

Ester N. Mbaya, age 43, of Harrisburg, pleaded guilty and was later sentenced on February 27, 2025, to 41 months in prison and ordered to pay $3,349,550 in restitution, on charges of health care fraud and bank fraud.  Mbaya was president of Cool Waters, LLC, a home health care agency.  Mbaya submitted fraudulent Medicaid claims seeking compensation for services that were not provided or inflated claims. Mbaya submitted these fraudulent claims from January 2018 to June 2020, and obtained in excess of $1 million as a result of the fraud. Mbaya also submitted falsified records to four financial institutions to obtain loans and lines of credit. The falsified records included altered bank statements which made it appear she had more money on deposit than she did. She also submitted falsified pay checks to obtain loans.  

Rodney L. Yentzer

On April 24, 2025, Rodney L. Yentzer, age 55, of Florida and formerly of Cumberland County, Pennsylvania, was sentenced to 42 months in prison for charges of conspiracy to commit health care fraud, conspiracy to commit money laundering, and theft of public money for defrauding Medicare, Medicaid, and the U.S. Department of Health and Human Services between 2016 and 2020. Yentzer also agreed to pay $3,869,571.55 in restitution for these offenses.  Yentzer agreed with Johnson and others to defraud Medicare and Medicaid by submitting medically unnecessary urine drug tests for patients at clinics he controlled, including a group of pain clinics known as Pain Medicine of York or “PMY” (also known as All Better Wellness)(PMY absorbed Lighthouse Medical). PMY billed Medicare for more than $10 million in urine drug tests from mid-2017 through the end of 2019. As a result, Medicare paid out over $4 million for these urine drug tests. Pennsylvania’s Medicaid program was also billed for urine drug tests during this same time period. The urine drug tests ordered by PMY were sent to an in-house laboratory at PMY whenever possible. As a result, when medically unnecessary tests were billed to Medicare, the proceeds from them went to PMY itself.  

Codefendant John H. Johnson, age 62, of Hollidaysburg, a physician with specialized training in anesthesiology, was sentenced on September 17, 2024, to 97 months in prison. Johnson also agreed to pay $2.3 million in restitution to defrauded health insurance companies.  

Codefendant Paula Johnson, age 62, of Hollidaysburg, received a sentence of three years of probation, including six months of home detention with location monitoring, and was ordered to pay $249,301.36 in restitution, fines and assessments.  

Civil Cases

Eye Consultants of Pennsylvania

Eye Consultants of Pennsylvania, PC agreed to pay $790,000.00 to resolve False Claims Act allegations of civil liability for submitting claims to Medicare for Evaluation & Management (E&M) services that violated Medicare rules and regulations. Between September 1, 2018, and April 7, 2025, ECOP submitted claims to Medicare Part B for E&M services on the same date of service for beneficiaries receiving bilateral eye injections in violation of the applicable Medicare rules and regulations.

PA Lifesharing, LLC

PA Lifesharing, LLC agreed to pay $1,211,095.53 to resolve allegations that it violated the False Claims Act by submitting false claims for payment to Medicaid by allowing unqualified Direct Support Professionals to render 1:1 services in violation of the applicable Medicaid rules and regulations.  Between January 1, 2022 and December 31, 2024, PAL submitted claims to Medicaid for services rendered by Direct Support Professionals (DSPs) who PAL knew were not properly cleared and/or trained and thus unqualified to render 1:1 services.