Couple Agree to Plead Guilty to more than $1 Million in Health Care Fraud
Case is part of Largest National Health Care Fraud Sweep in History
COLUMBUS, Ohio – Riyad Altallaa, 51, and Muna Alnoubani, 49, both of Hilliard, each agreed to plead guilty in U.S. District Court to conspiracy to commit health care fraud.
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 300 individuals, including 61 doctors, nurses and other medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-two state Medicaid Fraud Control Units also participated in today’s arrests.
Benjamin C. Glassman, Acting United States Attorney for the Southern District of Ohio, Lamont Pugh, Special Agent in Charge, Department of Health and Human Services Office of Inspector General, Angela L. Byers, Special Agent in Charge, Federal Bureau of Investigation (FBI), Cincinnati Field Division, Ohio Attorney General Mike DeWine and Kathy Enstrom, Special Agent in Charge, Internal Revenue Service (IRS) Criminal Investigation, announced the pleas filed today.
According to court documents, Altallaa and Alnoubani were owners of Columbus Home Health Care Services, LLC. The couple executed a fraud scheme in order to minimize expenses and maximize profits by fabricating aide training records to avoid the time and expense of training and to give the appearance that aides had completed the required training and were prepared to provide home health services to Medicare and Medicaid beneficiaries.
The defendants also had aides and nurses submit blank time sheets and nursing notes that the defendants completed with falsely inflated hours of service.
Finally, they had aides and nurses “split” their shifts on their timesheets and nursing notes to make it appear that services were provided in multiple shifts rather than one shift. Under Medicaid’s reimbursement policy, the initial hour of each shift is reimbursed at a rate that is approximately double the rate of subsequent hours.
Altallaa and Alnoubani each agreed to plead guilty to one count of conspiracy to commit health care fraud. Altallaa also agreed to plead guilty to one count of money laundering. Each crime carries a potential maximum sentence of 10 years in prison.
The couple used the fraud money to build a luxurious, $1 million home in Hilliard. As part of the plea agreements, they will forfeit that home.
“The detection, investigation and prosecution of individuals and entities who engage in committing criminal acts of fraud in the home health care arena, whether it be the Medicare or Medicaid program, is a top priority for the OIG” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “The OIG will continue to work with our law enforcement partners to protect taxpayer dollars and ensure that perpetrators of these fraud schemes are held accountable.”
Including today’s enforcement actions, nearly 1,200 individuals have been charged in national operations, which have involved more than $3.4 billion in fraudulent billings. Today’s announcement marks the second time that districts outside of Strike Force locations participated in a national sweep, and they accounted for 82 defendants charged in this effort.
The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices of the Southern District of Ohio, Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois and the Middle District of Florida; and agents from the FBI, HHS-OIG, Drug Enforcement Administration, DCIS and state Medicaid Fraud Control Units.
Acting U.S. Attorney Glassman commended the investigation of this case by the FBI, HHS-OIG Ohio Attorney General’s Medicaid Fraud Control Unit and IRS Criminal Investigation, as well as Assistant United States Attorney Kenneth Affeldt and Special Assistant United States Attorney Maritsa Flaherty, who are representing the United States in this case.