Four Area Pharmacists, One Doctor, and One Patient Recruiter Charged with Scheme to Bill Insurance for Medications Not Dispensed
An indictment was unsealed today charging Samir Berri, R.Ph.; Anthony Cole, R.Ph.; Shamimur Rahman, R.Ph.; Ghassan Hamka, R.Ph.; Asm Akter Ahmed, M.D.; and Fouzi Ramouni with multiple health care fraud offenses, U.S. Attorney Matthew Schneider announced today. Berri, Ahmed and Ramouni are also charged with distributing and conspiring to distribute controlled substances (all opioids).
Schneider was joined in the announcement by Special Agent in Charge Timothy Slater of the FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office.
Charged in the indictment are:
Samir Berri, R.Ph., 42, of West Bloomfield
Anthony Cole, R.Ph., 38, of Wyandotte
Shamimur Rahman, R.Ph., 41, of Clinton Township
Ghassan Hamka, R.Ph., 31, of Dearborn
Fouzi Ramouni, 42, of Madison Heights
Dr. Asm Akter Ahmed, 58, of Hamtramck,
According to the indictment, between January 2011 and August 2017, the four pharmacists were co-owners and pharmacists-in-charge of four area pharmacies – Conant Plaza Pharmacy, 3611 Carpenter Street in Detroit; Buckley’s Pharmacy of Hazel Park, 20721 Dequindre in Hazel Park; Buckley’s Pharmacy of Detroit, 14313 Greenfield in Detroit; Buckley’s Eastside Pharmacy, 15014 Eight Mile in Detroit; and Buckley Brands, 18021 Conant Street in Detroit.
The indictment alleges that all four pharmacies fraudulently billed Medicare, Medicaid, and Blue Cross Blue Shield for controlled substances, that were dispensed, and high-priced medications that were not dispensed. The scheme was detected by Medicare, in part, because of a deficit between each pharmacy’s recorded inventories and the claims that each submitted for insurance reimbursement. The fraudulent billings netted the pharmacies combined profits in excess of five million dollars, which the co-owners then converted to their own personal use. As one part of the scheme to defraud, the defendants billed insurance companies for providing medications to people who had died prior to the claimed date of delivery.
The indictment further alleges that some of the fraudulent billings were generated in connection with a related conspiracy between defendants Samir Berri, Dr. Akter Ahmed and Fouzi Ramouni. According to the indictment, Ramouni recruited and paid Medicare and Medicaid beneficiaries to visit Dr. Akter Ahmed. Without a genuine examination or a showing of medical necessity, Dr. Ahmed prescribed opioids for these patients, including Carisoprodol and promethazine codeine syrup. In addition to prescribing opioids, Dr. Ahmed also prescribed unnecessary and expensivemedications. Ramouni and/or the “patient” then took the opioid prescriptions to Conant Plaza Pharmacy, where Samir Berri would fill them without questions. Berri would, in turn, bill insurance for dispensing the controlled substances, and fraudulently bill insurance for dispensing the expensive maintenance medications. According to the indictment, the controlled substances diverted for sale on the street had a street value in excess of $1,000,000.
United States Attorney Schneider stated, “Today’s opioid epidemic is fueled, in part, by the greed of certain doctors and pharmacists who knowingly divert legitimate pain medications and narcotics to drug dealers for illegal distribution in our communities. To make matters worse, these doctors and pharmacists sometimes defraud Medicare, Medicaid and private insurance in order to generate even greater profits for themselves. We will continue to use every means available to investigate and prosecute these cases.”
“Today’s operation highlights the FBI’s commitment to combating the illegal distribution of opioids and narcotics by doctors, pharmacists, and dealers”, said Timothy R. Slater, Special Agent in Charge, Detroit Division of the FBI. “This investigation makes it clear that dishonest health care professionals who exploit Medicare, Medicaid, and private insurance companies through fraudulent billing and other schemes will be held accountable for their crimes”.
“Medical professionals have an obligation to ensure the appropriate prescribing and dispensing of Opioid medications”, said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “When they choose to turn their back on this obligation in order to fulfill their appetite for improper financial gain they will be held accountable. The OIG has made combatting the opioid crisis a top enforcement priority and will continue to work with our law enforcement partners to investigate those who act illegally and put patient’s health and safety at risk”.
An indictment is only a charge and is not evidence of guilt. Each defendant is entitled to a fair trial in which it will be the government's burden to prove guilt beyond a reasonable doubt.
If convicted of a health care fraud charge, the defendants face a maximum sentence of imprisonment of ten years, and a maximum fine of $250,000.
The case was investigated by Special Agents of the HHS and FBI, with cooperation and assistance from the Michigan Department of Health and Human Services - Office of Inspector General.
Anyone with information about suspected health care fraud in Michigan is encouraged to contact the FBI’s Detroit Field Office at 313-965-2323.
The case is being prosecuted by Assistant U.S. Attorneys John Engstrom and Brant Cook.