Patient Recruiter Convicted In Massive Social Security And Immigration Fraud Scheme
For Immediate Release
U.S. Attorney's Office, Southern District of California
United States Attorney Laura E. Duffy announced that Nawal Talia of Spring Valley pled guilty today and admitted recruiting patients as part of a multi-year fraud scheme to falsify medical certifications to the federal government.
As revealed in her guilty plea, Talia recruited patients for the mastermind of the health care fraud scheme, Dr. Roberto Velasquez. Earlier this year, Velasquez was sentenced to 21 months in prison, and ordered to pay more than $1.5 million in restitution to the Social Security Administration — the largest single restitution order in Social Security’s history.
For the past several years, Talia served as a paid advocate for immigrants seeking assistance in obtaining U.S. citizenship or Social Security benefits. In this role, Talia submitted documents to federal agencies on behalf of her clients, certifying that her clients were mentally disabled. Rather than obtaining benefits legitimately, Talia and Velasquez worked together to falsify medical certifications and fabricate patient histories. In her plea, Talia admitted that she helped Velasquez falsify two different types of disability reports: (1) Medical Certification for Disability Exception Forms (Forms N-648), which are used by the Department of Homeland Security during the naturalization process; and (2) Medical Letters, which are used by the Social Security Administration to award Supplemental Security Income and disability payments. On each of these forms, Talia lied about the length of time her clients had been under the care of Velasquez. In one case, Talia certified that a patient had been treated by Dr. Velasquez for a year, when the patient had actually only met Velasquez once. In another, she filed a Social Security appeal, falsely certifying that the patient had been treated by Dr. Velasquez for 11 months. In reality, Talia simply made up that number so that her client appeared to be eligible for disability benefits, when in fact Talia knew he was not.
The fraud was uncovered through an undercover operation conducted jointly by the Department of Homeland Security, Immigration and Customs Enforcement/Homeland Security Investigations, and the Office of Inspector General, Social Security Administration. Although Talia held herself out as a legitimate patient advocate, the investigation revealed her blatant disregard for federal disability requirements. Investigators established that Talia repeatedly lied about the duration of the treatment in order to create a “track record” that would satisfy reviewers at the Social Security Administration and Citizen and Immigration Services (“CIS”).
This prosecution is a part of the United States Attorney’s ongoing Health Care Fraud initiative. United States Attorney Duffy noted, “Combating health care fraud is a top priority of the Department of Justice. Patient recruiters like Talia help perpetuate fraud when they falsify documents and corrupt the integrity of the system.” The United States Attorney noted that this type of fraud is particularly egregious as it improperly helps undeserving individuals obtain citizenship and other benefits that may then not be available to the truly deserving.
Sentencing was set for December 16, 2013, at 9 a.m. before U.S. District Judge Marilyn L. Huff
|DEFENDANT||CRIMINAL CASE NO. 13cr3393-H|
|SUMMARY OF CHARGES|
Count One - Title 18, United States Code, Section 1546 – False Statements in Immigration Documents
United States Immigration and Customs Enforcement’s Homeland Security Investigations
Updated July 23, 2015