Criminal charges have been filed against a group of six defendants concerning alleged schemes to defraud $2.75 billion with false Medicare claims.
The charges were filed in federal court in Detroit on Thursday (June 27) as part of the Justice Department’s 2024 National Health Care Fraud Enforcement Action.
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The charges are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 147 defendants for their alleged participation in healthcare fraud and opioid abuse schemes that resulted in the submission of over $2.5 billion in alleged false billings.
Court documents say the defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the government, in connection with the enforcement action, seized over $150 million in cash, luxury vehicles, gold, and other assets.
The six people have been charged in the Eastern District of Michigan:
- Ibrahim Sammour, 63, and Bashier Sammour, 28, of Wayne County, were indicted with conspiracy to pay illegal kickbacks. Ibrahim was additionally charged with conspiracy to commit health care fraud and health care fraud, and Bashier was additionally charged with making false statements relating to health care matters, all in connection with an alleged scheme to obtain over $2 million from Medicare fraudulently. According to charging documents, the Sammours operated Individualized Home Health Care, P.C., through which they submitted false and fraudulent claims to Medicare for home health care services that were medically unnecessary, not provided as represented, or not rendered.
- Five others—two registered nurses, two group home owners, and a licensed practical nurse—were also charged with information for their involvement in the conspiracies.
- Yvette Hardy, 60, of Wayne County, was charged by information with healthcare fraud in connection with an alleged scheme to obtain over $3.4 million in Medicare funds fraudulently. According to the information, Hardy, who owned and operated Pebble Brook Care Agency LLC, caused the submission of false and fraudulent claims to Medicare for psychotherapy services that were not provided as represented or not rendered at all.
- Ruby Scott, 53, of Oakland County, was charged by indictment with a conspiracy to defraud the United States and to pay illegal healthcare kickbacks, as well as with paying illegal healthcare kickbacks in connection with an alleged scheme to obtain over $2.2 million in Medicare funds fraudulently. According to the indictment, Scott, who owned and operated Delta Home Health Care LLC, caused the submission of claims to Medicare for home health care services obtained through the payment of illegal kickbacks to patient recruiters violating the Anti-Kickback Statute.
- Dr. Vijil Rahulan, 52, of Hyderabad, India, was indicted with conspiracy to commit healthcare fraud and healthcare fraud in connection with an alleged scheme to obtain over $82 million in Medicare funds fraudulently. As alleged in the indictment, Rahulan caused the submission of false and fraudulent claims for DME and genetic testing that were medically unnecessary or otherwise ineligible for reimbursement through Medicare because they were not the product of a doctor-patient relationship and examination. The indictment further alleges that Rahulan’s fraudulent conduct resulted in Medicare paying over $28.7 million.
- Amro Sharafeldin, 40, of Michigan, was charged by criminal complaint with a scheme to violate the Anti-Kickback Statute and illegally purchase Medicare beneficiary information in connection with Sharafeldin’s operation of Prestige Specialty Pharmacy (“Prestige”) in Sterling Heights, Michigan. As alleged in the complaint, Sharafeldin, through Prestige, agreed to pay kickbacks and bribes to illegally acquire Medicare beneficiary information, which he and others then used in February and March 2023 to bill Medicare more than $1 million for OTC COVID-19 tests, regardless of whether the Medicare beneficiary requested the test kits.