DETROIT – The government says 243 people, including 16 in Michigan, have been charged in health care fraud sweeps around the country. That includes doctors, nurses and pharmacy owners accused of bilking Medicare and Medicaid.
Attorney General Loretta E. Lynch said the all the cases and fraudulent billings allegedly total $712 million.
Lynch said the defendants billed for equipment that wasn't provided, care that wasn't needed, and services that weren't rendered.
While the individual cases may be unrelated, law enforcement agencies often coordinate the announcement of health fraud charges and arrests to send a message to fraudsters and the general public alike.
In the Detroit area, sixteen individuals, including six doctors, a social worker, a pharmacist and two physical therapists were charged with a variety of health care fraud and kickback schemes totaling over $122 million. In addition, law enforcement agents executed search warrants at eight locations and seizure warrants of 24 bank accounts related to the alleged schemes. The Centers for Medicare and Medicaid Services has moved to suspend 14 providers associated with the schemes.
The following charges were filed or unsealed:
United States v. Tahir, et al.
Five individuals, two physicians and three owners of hospice and home health care companies, were charged in an indictment with conspiring to commit health care fraud for their roles in a $58.3 million scheme to defraud Medicare by submitting fraudulent claims for home health care and hospice services that were medically unnecessary or not provided. The owners of the home health care and hospice companies, two of whom are also physical therapists, paid physicians and recruiters kickbacks for referring patients, then billed Medicare for medically unnecessary services, which were often never provided. The companies, located in Livonia, Michigan, are A Plus Hospice and Palliative Care, At Home Hospice, and At Home Network Inc., a home health care agency. The physicians who solicited and received kickbacks also submitted claims to Medicare for medically unnecessary physician services through their companies, Waseem Alam, M.D., P.C., Woodward Urgent Care, and Hatem Ataya, M.D., P.C. Those physicians prescribed beneficiaries medically unnecessary prescriptions, including controlled substances, for which Medicare also paid.
The defendants charged in the indictment are Shahid Tahir, 45, of Bloomfield, Michigan, Waseem Alam, 59, of Troy, Michigan, Hatem Ataya, 47, of Flushing, Michigan, Muhammad Tariq, 60, of West Bloomfield, Manawar Javed, 40, of West Bloomfield, Michigan.
United States v. Goldfein, M.D., et al.
Four individuals, a physician and three owners of home health care companies, were charged in a superseding indictment with conspiracy to commit health care and wire fraud, health care fraud, wire fraud and conspiracy to pay or receive health care kickbacks. The indictment alleges that the fraudulent claims were submitted by physicians who took kickbacks to refer home health care, then billed medically unnecessary services and prescribed unnecessary medications billed to Medicare.
The defendants charged in the indictment are William Binder, M.D., 58, Muhammad Zafar, 43, of Brownstown, Michigan, Tariq Khan, 47, of Woodhaven, Michigan, and Ghulam Shakir, 43.
United States v. Daneshvar, M.D.
Gerald Daneshvar, M.D., 39, of West Bloomfield, Michigan, was charged by indictment with his role in an over $5 million conspiracy to commit health care fraud by referring non-homebound patients for home health care services as well as billing for upcoded physician visits through Lake MI Mobile Doctors, PC ("Mobile Doctors"). The owner of Mobile Doctors and another physician employee were indicted in the Northern District of Illinois in 2013 for their roles in the same scheme.
United States v. Lerner, M.D., et al.
Laran Lerner, M.D., 59, of Northville, Michigan, a physician, and Mohamad Bazzi, 42, of Dearborn, Michigan, a licensed pharmacist and pharmacy owner, were charged by complaint with an over $24 million health care fraud scheme. Dr. Lerner provided medically unnecessary prescriptions for expensive pharmaceuticals for which Bazzi's pharmacy, Advanced Pharmacy Services (APS) would bill Medicare, but not dispense. In addition, Dr. Lerner billed for unnecessary physician visits and referred beneficiaries for medically unnecessary home health care services through his clinic Greater Detroit Physical Therapy & Rehabilitation, located in Westland, Michigan.
United States v. Qadir, M.D.
Rizwan Qadir, M.D., 52, of Bloomfield Hills, Michigan, a physician, was charged by complaint with conspiracy to commit health care fraud and to pay or received kickbacks in a $19 million Medicare fraud scheme. Qadir paid patient recruiter Johnny Younan to bring him patients, for whom he would bill medically unnecessary tests and visits. Qadir also referred the beneficiaries for medically unnecessary home health care services.
United States v. Younan
Johnny Younan, 52, of Centerline, Michigan, was charged by complaint with conspiracy to pay or receive health care kickbacks to a physician, who would also prescribe Medicare beneficiaries controlled substances as an inducement to provide their Medicare information for billing.
United States v. Celestine Brown
Celestine Brown, 50, of Ypsilanti, Michigan, a licensed social worker, was charged by information with one count of health care fraud and one count of structuring in connection with her role in a $3.8 million scheme to defraud Medicare through the submission of false claims for psychotherapy services that were never rendered. Brown submitted the false claims through her company CBC Services, LLC located in Ypsilanti, Michigan. Brown is also alleged to have then structured cash withdrawals from her bank accounts in amounts of less than $10,000 to avoid reporting requirements.
United States v. Tamara Brown
Tamara Brown, 42, of Southfield, Michigan, was charged by complaint with her part in a $1.3 million kickback conspiracy. The complaint alleges that Brown solicited and received kickbacks from two Detroit area home health care agencies, Cherish Home Health Services, LLC, and Empirical Home Health Care, Inc., in return for providing patient referrals from a physician.
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