Justice News

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Thursday, December 5, 2013
20 Detroit-area Residents Charged in Medicare Fraud Strike Force Takedown for Approximately $34 Million in False Billing

Twenty Detroit-area residents have been charged for their roles in physician home visit, home health care, chiropractic and psychotherapy schemes to submit more than $34 million in false billing to Medicare.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office made the announcement.

“Medicare fraud hits every taxpayer and harms so many who are in need of critical health care,” said Acting Assistant Attorney General Raman.  “The defendants arrested yesterday and today include doctors, physical therapists and home health care agency owners who were entrusted by Medicare to provide their patients with necessary care and services.  Instead, they abused that trust for their own profit.  The Strike Force’s operation reflects our continuing and unflagging commitment to put an end to these harmful fraud schemes.”

“Doctors and clinic owners should take note that we are scrutinizing billing data to detect fraud and bring offenders to justice,” said U.S. Attorney McQuade. “We are committed to recovering tax dollars intended for patient care.”

“These charges clearly send the message to criminals that committing fraud against government health care programs puts them squarely in the sights of the Medicare Fraud Strike Force,” said HHS-OIG Special Agent in Charge Pugh. “Taxpayers and patients should know that OIG with its Strike Force partners will continue to root out, expose, and hold accountable those who attack the Medicare program.”

“When medical doctors, physical therapists, and other health care providers conspire to defraud our government health care programs and undermine the public trust, they not only betray their profession, but also steal directly from the American people,” said FBI Special Agent in Charge Abbate. “The FBI and our law enforcement partners in the Medicare Fraud Strike Force will continue our efforts on behalf of the American taxpayer to prevent health care fraud and bring these criminal perpetrators to justice.”

Court documents unsealed this week in the Eastern District of Michigan charge defendants including physicians, owners and operators of companies, office employees and patient recruiters with submitting fraudulent claims for services that were never rendered and with paying kickbacks to obtain patients to be billed. Nineteen of the defendants were arrested or surrendered to authorities yesterday morning and this morning, and one defendant remains at large. In addition, law enforcement agents yesterday and 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. Goldfein, et al.

Two individuals, both medical doctors, were charged in an indictment with conspiring to commit health care fraud for their roles in a $5.4 million scheme to defraud Medicare by submitting fraudulent claims for physician home services that were not provided. The indictment alleges that the fraudulent claims were submitted by a physician clinic that provides both in-home and outpatient health care services. The clinic, with locations in Livonia, Mich., and Swartz Creek, Mich., is known as Tri City Medical Centers P.C.

The defendants charged in the indictment are Aaron Scott Goldfein, 49, of Bloomfield Hills, Mich., and William Clay Sokoll, 58, of Royal Oak, Mich.

 

United States v. Elhorr, et al.

Three individuals, one of whom is a medical doctor and one of whom is a nurse, were charged in a superseding indictment with conspiracy to commit health care fraud for their roles in an $11.5 million scheme to defraud Medicare by submitting fraudulent claims for physician home services that were not provided. The superseding indictment alleges that the fraudulent claims were submitted by a home visiting physician practice. The practice, located in Allen Park, Mich., was known as House Calls Physicians P.L.L.C.

The defendants charged in the superseding indictment are Ali Elhorr, 44, of Dearborn, Mich.; Lama Elhorr, 31, of Hollywood, Fla. (formerly of Dearborn, Mich.); and Kelly White, 44, of Dearborn, Mich.

 

United States v. Khan, et al.

Ten individuals were charged in an indictment with conspiracy to commit health care fraud or conspiracy to pay and receive illegal kickbacks for their roles in a $7 million scheme to defraud Medicare. The defendants include two medical doctors and three owners of home health care agencies, one of whom is also a physical therapist, as well as patient recruiters and office staff. The indictment alleges that the defendants caused the submission of fraudulent claims to Medicare for medically unnecessary home health care services and paid kickbacks in the form of cash payments and prescription narcotics to Medicare beneficiaries for the use of their Medicare beneficiary numbers. The indictment also alleges that physicians received kickbacks in the form of cash payments to certify Medicare beneficiaries for medically unnecessary home health care services. The fraudulent claims were submitted by two home health care agencies, Advance Home Health Care Services Inc. and Perfect Home Health Care Services LLP.

The defendants charged in the indictment are Walayat Khan, 65, of Ypsilanti, Mich.; Adelina Herrero, 72, of Ann Arbor, Mich.; Amer Ehsan, 44, of Canton, Mich.; Haroon Ur Rashid, 47, of West Bloomfield, Mich.; Mohammad Rafiq, 47, of West Bloomfield, Mich.; Salman Ali Sapru, 51, of Ypsilanti, Mich.; Farhan Khan, 25, of Ann Arbor, Mich.; James Zadorski, 48, of Detroit, Mich.; Cynthia Bell, 55, of Detroit, Mich.; and John Sanders, 59, of Pontiac, Mich.

 

United States v. Hassan, et al.

Two individuals were charged in an indictment with conspiracy to commit health care fraud and conspiracy to pay and receive illegal kickbacks for their roles in a $4.5 million scheme to defraud Medicare. The indictment alleges that the defendants, the owner of a home health care agency who is also a physical therapist and a recruiter, caused the submission of fraudulent claims to Medicare for medically unnecessary home health care services and paid kickbacks in the form of cash payments to Medicare beneficiaries for the use of their Medicare beneficiary numbers. The indictment also alleges that physicians received kickbacks in the form of cash payments to certify Medicare beneficiaries for medically unnecessary home health care services. The fraudulent claims were submitted by Cherish Home Health Services LLC.

The defendants charged in the indictment are Zia Hassan, 47, of Saline, Mich., and Nathaniel Miller, 52, of Detroit, Mich.

 

United States v. Minhas

Naseem Minhas, 47, of West Bloomfield, Mich., was charged with conspiracy to commit health care fraud and conspiracy to pay and receive illegal kickbacks for his role in a $5.7 million scheme to defraud Medicare. The indictment alleges that the defendant, the beneficial owner of a home health care agency, caused the submission of fraudulent claims to Medicare for medically unnecessary home health care services and paid kickbacks in the form of cash payments to marketers to recruit Medicare beneficiaries and to certify Medicare beneficiaries for medically unnecessary home health care services. The indictment alleges that the fraudulent claims were submitted by Tricounty Home Care Services Inc.

 

United States v. Lovett, et al.

The owners of a Detroit-area billing company were charged in a criminal complaint for their roles in a health care fraud scheme involving claims for chiropractic and psychotherapy services. The complaint alleges that the operators of ABIX LLC obtained the Medicare numbers of licensed medical service providers in and around Detroit and used this information to bill Medicare for chiropractic and psychotherapy services that were not provided.

The defendants charged in the criminal complaint are Elaine Lovett, 58, of Wayne County, Mich., and Michelle Freeman, 54, of Livingston County, Mich.

An indictment or criminal complaint is merely an allegation, and the defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

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 the Department of Health and Human Services to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

These cases were investigated by the FBI and HHS-OIG and were brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. These cases are being prosecuted by Trial Attorney William G. Kanellis, Trial Attorney Matthew C. Thuesen, and Special Trial Attorney Katie R. Fink of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov .

 

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