Twenty-Two Detroit-Area Residents Charged in Nationwide Medicare Fraud Strike Force Takedown

May 3, 2012

The Federal Bureau of Investigation (FBI) on May 2, 2012 released the following:

Total of 107 Defendants Charged in Seven Cities for Approximately $452 Million in False Billing

DETROIT—Twenty-two Detroit-area residents were charged today for their roles in psychotherapy, home health care, and infusion therapy schemes to submit more than $58 million in false billing to Medicare, announced the Departments of Justice and Health and Human Services. Including these charges, Medicare Fraud Strike Force operations in Detroit have charged a total of 164 individuals in cases involving approximately $244 million in fraudulent billings to Medicare.

The charges in Detroit are part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that led to charges against 107 individuals for their alleged participation in schemes to collectively submit more than $452 million in fraudulent claims to Medicare. This takedown involved the highest amount of false Medicare billing in a single takedown in strike force history.

“The results we are announcing today are at the heart of an administration-wide commitment to protecting American taxpayers from health care fraud, which can drive up costs and threaten the strength and integrity of our health care system,” said Attorney General Eric Holder. “We are determined to bring to justice those who violate our laws and defraud the Medicare program for personal gain. As today’s takedown reflects, our ongoing fight against health care fraud has never been more coordinated and effective.”

United States Attorney for the Eastern District of Michigan Barbara L. McQuade stated, “A disturbing new trend we are seeing is the exploitation of adults in foster care. Providers bill Medicare for home health and psychotherapy services for disabled adults that are unnecessary or not provided.”

“Those who seek to steal from Medicare and exploit the system will be vigorously pursued and brought to justice,” stated Special Agent in Charge of the FBI’s Detroit Division Andrew G. Arena. “These arrests are the result of a tremendous amount of hard work by FBI and HHS-OIG agents.”

“Today’s indictments and arrests in the areas of home health care, psychotherapy, or infusion therapy fraud demonstrate that HHS-OIG agents will untangle even the most complex fraud schemes and hold those responsible accountable for their criminal actions,” said Lamont Pugh III, Special Agent in Charge of the Department of Health & Human Services Office of Inspector General for the Chicago Region, which includes Detroit. “Through collaboration with our law enforcement partners, HHS-OIG will bring to justice those who waste Medicare’s limited resources and prevent the most vulnerable members of our society from receiving vital health care services.”

Court documents unsealed today in the Eastern District of Michigan charge defendants including owners and operators of companies, social workers, office employees, and patient recruiters with submitting fraudulent claims for services that were never rendered. Eighteen of the defendants were either arrested this morning or will be self surrendering this week and four defendants remain at large. In addition, law enforcement agents today executed search warrants at nine locations and seizure warrants of 14 bank accounts related to the alleged fraud schemes. The following charges were unsealed:

United States v. Rahman, et al.

Five individuals were charged in a superseding indictment with conspiracy to commit health care fraud for their roles in a $13.8 million scheme to defraud Medicare by submitting fraudulent claims for home health care services. One of the defendants was also charged with conspiracy to pay or receive kickbacks to refer Medicare beneficiaries for the fraudulent services. The indictment alleges that the fraudulent claims were submitted by four home health agencies operating in Livonia, Michigan: Physicians Choice Home Health Care, LLC; First Care Home Health Care, LLC; Quantum Home Care, Inc.; and Moonlite Home Care, Inc.

The defendants charged in the superseding indictment are: Bilal Akbar, 49, formerly of Canton, Michigan; Joann Terrell, 49, of Detroit; Madhur Thawani, 27, of Auburn Hills, Michigan; Shahzad Mirza, 41, of Canton, Michigan; and Ankit Patel, 27, of Plymouth, Michigan.

United States v. Mehmood, et al.

Two individuals were charged in a superseding indictment with conspiracy to commit health care fraud for their roles in a $33 million scheme to defraud Medicare by submitting fraudulent claims for home health care services, as well as conspiracy to pay or receive illegal kickbacks. The indictment alleges that the fraudulent claims were submitted by four home health agencies operating in Ypsilanti, Michigan and Detroit, Michigan: Access Care Home Care, Inc.; Patient Care Home Care, Inc.; Hands On Healing Home Care, Inc.; All State Home Care, Inc.

The defendants charged in the superseding indictment are: Badar Ahmadani, 45, of Ypsilanti Michigan and Falusic Ashford, 47 of Detroit, Michigan.

United States v. Sharma, et al.

Four individuals were charged in an indictment with conspiracy to commit health care fraud for their roles in a $23 million scheme to defraud Medicare by submitting fraudulent claims for home health care services and psychotherapy services. Three of the individuals were also charged with conspiring to pay or receive illegal kickbacks. The indictment alleges that the fraudulent claims were submitted by three home health agencies and an adult day care center. The home health agencies operating in Madison Heights, Michigan and Sterling Heights, Michigan are: Reliance Home Care, LLC; First Choice Home Health Care Services, Inc.; and Associates in Home Care, Inc. The adult day care center operating in Detroit Michigan is Haven Adult Day Care Center, LLC.

The defendants charged in the indictment are: Sachin Sharma, 36, of Shelby Township, Michigan; Dana Sharma, 29, of Shelby Township, Michigan; Abdul Malik Al- Jumail, aka “Tony,” 52, of Brownstown, Michigan; and Felicar Williams, 49, of Dearborn, Michigan.

United States v. English, et al.

Six individuals were charged in an indictment with conspiracy to commit health care fraud for their roles in a $2.8 million scheme to defraud Medicare by submitting fraudulent claims for psychotherapy services. Two of the defendants are also charged with additional health care fraud counts. The indictment alleges that the fraudulent claims were submitted by an adult day care center operating in Flint, Michigan: New Century Adult Day Program Services, LLC.

The defendants charged in the indictment are: Glenn English, 52, of Detroit, Michigan; Gregory Lawrence, 54, of Detroit, Michigan; Richard Hogan, 65, of Flint, Michigan; Donald Berry, 65, of Detroit, Michigan; Felicia Marsh, 44, of Detroit, Michigan; and Jamie Moreau, 34, of Davison, Michigan.

United States v. Thompson, et al.

Two individuals were charged in an indictment with conspiracy to commit health care fraud and additional counts of health care fraud for their roles in a $20 million scheme to defraud Medicare by submitting fraudulent claims for psychotherapy services. The indictment alleges that the fraudulent claims were submitted by two psychotherapy clinics and an adult day care center operating in Detroit, Michigan: TGW Medical, Inc.; Caldwell Thompson Manor, Inc. And P&C Adult Day Care Center, LLC.

The defendants charged in the indictment are: Louisa Thompson, 62, of Detroit, Michigan and Checarol Robinson, 41, of New Baltimore, Michigan.

United States v. Edwards, et al.

Two individuals were charged in an indictment with conspiracy to commit health care fraud and additional counts of health care fraud for their roles in a $3 million scheme to defraud Medicare by submitting fraudulent claims for psychotherapy services. The indictment alleges that the fraudulent claims were submitted by a psychotherapy clinic operating in Southfield, Michigan and Detroit, Michigan: Funderburg Clinical and Community Services, Inc.

The defendants charged in the indictment are: Sanyani Edwards, 32, of Taylor, Michigan and Angel Williams, 27, of Southfield, Michigan.

United States v. Raymond Arias

Raymond Arias, 40, of Troy, Michigan was charged in an indictment with six counts of health care fraud for his leading role in a $12.5 million scheme to defraud Medicare by submitting fraudulent claims for infusion therapy treatments. The fraudulent claims were submitted by Arias’s clinic Elite Wellness, LLC, operating in Westland, Michigan.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The cases announced today are being prosecuted and investigated by Medicare Fraud Strike Force teams comprised of attorneys from the Fraud Section of the Justice Department’s Criminal Division and from the U.S. Attorney’s Offices for the Southern District of Florida, the Eastern District of Michigan, the Southern District of Texas, the Central District of California, the Middle District of Louisiana; the Northern District of Illinois, and the Middle District of Florida; and agents from the FBI, HHS-OIG, and state Medicaid Fraud Control Units.

The cases in the Eastern District of Michigan are being prosecuted by Assistant Chief Gejaa T. Gobena and Trial Attorneys Catherine K. Dick and William G. Kanellis of the Criminal Division’s Fraud Section, and Assistant United States Attorney Philip Ross of the U.S. Attorney’s Office for the Eastern District of Michigan.

An indictment is merely a charge and defendants are presumed innocent until proven guilty.”

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Douglas McNabb – McNabb Associates, P.C.’s
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To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Eighteen Charged for Alleged Medicare Fraud Schemes in Detroit Involving $28 Million in False Billings

September 1, 2011

The Federal Bureau of Investigation (FBI) on September 1, 2011 released the following:

“DETROIT—Eighteen individuals were charged in court documents unsealed today and yesterday in the Eastern District of Michigan for their participation in a series of separate Medicare fraud schemes involving home health and psychotherapy services, announced the Department of Justice, the Department of Health and Human Services (HHS), the FBI and the HHS Office of Inspector General (HHS-OIG).

According to court documents unsealed today and yesterday in U.S. District Court in Detroit, the separate schemes allegedly involved a total of more than $28 million in fraudulent claims submitted to Medicare for services that were medically unnecessary and/or never provided. Fifteen of the defendants were arrested this morning, one defendant was arrested in July 2011, and two defendants remain at large. In addition, law enforcement agents today executed search warrants at 11 locations and seizure warrants of 28 bank accounts related to the alleged fraud schemes.

Including these charges, Medicare Fraud Strike Force operations in Detroit have charged a total of 138 individuals in cases involving approximately $148 million in fraudulent billings to Medicare.

“Today we have charged physicians, nurses, clinic owners and other medical professionals for submitting millions of dollars in false claims to Medicare,” said Assistant Attorney General Lanny A. Breuer of the Criminal Division. “According to court documents, these defendants paid kickbacks to beneficiaries and others, and falsified medical documents in order to deceive the Medicare program. As our strike force efforts have consistently shown, we will not allow criminals to steal from government health care programs.”

“Health care providers should be aware that the days of stealing from Medicare with impunity are over,” said U.S. Attorney Barbara McQuade of the Eastern District of Michigan. “We are relentlessly investigating and prosecuting those who seek to profit from false claims for services that are medically unnecessary or, in some instances, not provided at all.”

“Health care fraud affects every American,” said FBI Special Agent in Charge Andrew G. Arena. “As Americans live longer, health care costs are expected to rise. The FBI, together with its federal, state, and local partners, is working aggressively to pursue health care fraud criminals and bring them to justice.”

“The Medicare Fraud Strike Force in Detroit continues to demonstrate a concentrated and sustained effort in combating health care fraud,” said Lamont Pugh III, HHS-OIG Special Agent in Charge of regional operations. “The Office of Inspector General will continue to work with our strike force partners to focus a spotlight on those who attack the Medicare program and ensure that they are held accountable.”

“These arrests are good news for American taxpayers and a powerful warning to health care ripoff artists,” said Donald M. Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services. “In this instance, the system worked as it should: Medicare detected suspicious behavior and got the information quickly to law enforcement for appropriate follow-up. Together with our law enforcement partners, we helped minimize the theft of taxpayer dollars and maximize criminal consequences to thieves. CMS will continue to relentlessly pursue fraudsters across the country and aggressively feed leads to our law enforcement partners.”

Fourteen individuals are charged in one indictment with conspiracy to commit health care fraud for their roles in a $14 million scheme to defraud Medicare by submitting fraudulent claims for home health care services. The defendants include three physicians, four clinic owners and managers, two clinic employees, one nurse, and four physical therapists and physical therapy assistants. According to court documents, the conspiracy was operated out of multiple home health agencies located in Livonia, Mich., including Physicians Choice Home Health Care LLC, First Care Home Health Care LLC, Quantum Home Care Inc. and Moonlite Home Care Inc.

In a separate complaint unsealed today, a physician and two other individuals are charged with health care fraud and the submission of false claims in connection with an approximately $11.5 million scheme to defraud the Medicare program. The scheme allegedly involved false billings for individual and group psychotherapy services at two clinics located in Detroit, Quality Recreation and Rehabilitation Inc. and Procare Rehabilitation Inc. According to court documents, the defendants billed Medicare for services that were medically unnecessary and/or never provided.

In another indictment unsealed yesterday, the owner of a medical clinic located in Southfield, Mich., was charged with conspiracy to commit health care fraud, health care fraud and identity theft for a scheme allegedly involving $2.9 million in fraudulent billings to Medicare. According to court documents, the clinic owner is alleged to have used the identities of Medicare providers and beneficiaries to bill for psychotherapy services that were medically unnecessary and never performed.

Defendants charged include: Gerald R. Funderburg Jr., 31, of Southfield, Mich.; Marcus Jenkins, 49, of Farmington Hills, Mich.; Elizabeth Jenkins, 47, of Farmington Hills; Dr. Alphonso Berry, 50, of Orchard, Mich.; Tausif Rahman, 36, of Canton, Mich.; Zahir Yousafzai, 41, of Canton, Mich.; Javed Rehman, 48, of Farmington Hills; Muhammad aka “Sib” Ahmad, 33, of Ypsilanti, Mich.; Jawad Ahmad, 41, of Ypsilanti, Mich.; Dr. Dwight Smith, 58, of Detroit; Dr. Paul Kelly, 74, of Bath, Mich.; Rehan Khan, 38, of Canton, Mich.; Nabeel Shaikh, 29, of Wixom, Mich.; Janaki Chettiar, 36, of Farmington Hills; Jigar Patel, 27, of Madison Heights, Mich.; Anthony Parkman, 40, of Southfield; Hetal Barot, 28, of Canton; and Srinivas Reddy aka “Dr. Reddy”, 35, of Bloomfield Hills, Mich.

The charges were announced by Assistant Attorney General Breuer of the Criminal Division, U.S. Attorney McQuade of the Eastern District of Michigan, Special Agent in Charge Arena of the FBI’s Detroit Field Office and Special Agent in Charge Pugh of the HHS-OIG Office of Investigation.

The cases are being prosecuted by Trial Attorneys Gejaa T. Gobena and Catherine K. Dick of the Criminal Division’s Fraud Section. The investigations were conducted jointly by the FBI and HHS-OIG, as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Eastern District of Michigan and the Criminal Division’s Fraud Section.

Since their inception in March 2007, the strike force operations in nine districts have charged more than 1000 individuals who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

Indictments and criminal complaints contain merely charges and defendants are presumed innocent until proven guilty.”

To find additional federal criminal news, please read Federal Crimes Watch Daily.

Douglas McNabb and other members of the U.S. law firm practice and write extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition and OFAC SDN Sanctions Removal.

The author of this blog is Douglas McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.

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