Rx for Plunder

She did not mention that she'd filed a suit as the relator in a qui tam action against Cleveland Clinic the year before.

It's unclear if Issa was eyeing the possibility of getting more money by whistleblowing or if any investigations were launched as a result of her complaint. But by December 2001, Washti Bajnath, First Coast Service Options' auditor, had his own suspicions about Oakland. Bajnath, a native of Trinidad, had a nose for fraud and a gift for math, making him perfectly suited for forensic accounting. Judging by his comments in court documents, few things pleased him more than to follow a money trail straight back to thieves and pin them in a corner with data.

Bajnath noticed that Bernard, Althea, and Yvonne had been sharing addresses for years. He noticed that the man they were paying to drive the van and clean the office was Yvonne's brother, Andrew Howell. The company they were paying for staffing? Owned by Stenneth Robinson, Yvonne's son. Robinson also leased Oakland its office space ($1,908 per month) and its furniture ($2,351 monthly). Various cousins, wives, and in-laws came and went as nurses or assistants at Oakland. None of this had been disclosed under the "related party" rule.

Bajnath also saw that Althea claimed to have master's and bachelor's degrees from some place called Columbia State University; Bernard had supposedly earned a Ph.D there.

Althea had gotten hers for $2,995 and Bernard his for $3,400. Not only had Bernard and Althea claimed higher salaries because of these credentials but they sought reimbursement for their education on Medicare cost reports. CSU was a diploma mill shut down by the FBI in 1998.

Furthermore, Bajnath noticed that Oakland never billed patients for coinsurance. CMHCs were supposed to bill Medicare for 80 percent of a patient's care and charge the patient for the other 20 percent, like a copayment. If a patient couldn't afford it, Medicare would pick up the costs. But Oakland didn't even bother to bill until being investigated.

Bajnath also found that Yvonne charged Medicare $60 an hour for duties Harrell should have performed for a sixth of the price. Yvonne got paid as a clinical director and then paid again as a consultant to review the same files she had prepared.

Had Bajnath not been scrutinizing Oakland already, an anonymous letter would certainly have got him started. On May 1, 2002, he received a note that read: "I would like this matter to remain in strict confidence. I am an employee of Oakland Community Health Center. I am writing to report the illegal activities of this center. I am very frustrated and tired of the unprofessionalism as well as the unethical practices of the administrators of this company."

Lawyers in this case later determined that the letter came from Mashama Brannigan. But it could have been written by anyone working at the Oakland center. In January 2002, Harrell had been accused of stealing from Basic Home Care; in February, she was dismissed, she would tell the FBI, "like the common field slave." Multiple therapists had left voluntarily; one got fired for dressing sloppily, another for taking paperwork home. In April, the administrators had security cameras installed.

Somewhere along the way, the profitable little business had become a hive of bitterness. As a family friend would later observe, "sweet turns sour."

The FBI raided Oakland's offices in February 2003, but the company's principals roamed free for three years while investigators sifted through records in Miramar and conducted dozens of interviews — at federal offices, at Dunkin' Donuts, at Denny's.

Dr. Zimmer says he never again set foot in Oakland Community Health Center. With no patient files to work with, a plummeting reputation, and no more Medicare money, the facility went out of business.

In the course of its investigation, the FBI — mainly, the raven-haired Agent Nazworth — only unearthed more dirt. Documents indicated that sometime after Oakland opened, Althea had started another business called Guiding Light. When it failed to qualify for a Medicare provider number, she put its bills through under Oakland. Canceled checks and testimony from employees showed that she and Bernard took bills for improvements made to their home and put them through to Medicare as though work had been done at Oakland.

To strengthen its case, the government used a powerful technique: offering various degrees of immunity to some co­operators in exchange for information or testimony against defendants it deemed more culpable.

Once Michael Evans, the biller, was offered such a deal, he dropped a bomb: He told investigators that from the earliest days he worked with Oakland, he'd given kickbacks to the facility. Terminally ill and desperate for money, he would have lost the contract otherwise, he explained. He claimed that Bernard once threatened him and that his motorcycle was mysteriously sabotaged. So Evans gave Oakland 50 percent of what he'd made from Medicare — ranging from $51,000 to $116,00 annually over the years.

The feds also claimed that Oakland was offering kickbacks to clients. Emmins Henry, owner of the Shalom Manor assisted living facility, said she received rewards from Oakland: Yvonne would give her boxes of diapers and supplies for the patients and provide turkeys at Christmas. On at least one occasion, she told the FBI, she got an envelope that contained $50 to $100 in cash for the patients.