Feds charge 18 with bilking Medicare of $28M in unneeded services
The federal government today charged 18 people with bilking Medicare of $28 million in separate health care schemes that billed the government for services that weren’t necessary or never provided, including hundreds of psychotherapy treatments for dead people.
The defendants charged in the schemes include three physicians, four clinic owners and managers, two clinic employees, one nurse and four physical therapists and physical therapy assistants. Fifteen of the defendants were arrested this morning; one defendant was arrested in July; two remain missing.
According to court documents, the defendants paid kickbacks to beneficiaries and others, and falsified medical documents in order to deceive the Medicare program.
The charges show fraud schemes in Detroit — one of the nation’s top regions for Medicare fraud — have branched out to newer areas, such as psychotherapy services that prey on vulnerable residents in adult foster care homes, said Maureen Reddy, a Detroit-based FBI special agent.
The charges also suggest that home health care scams, which are prevalent in regions such as Miami, are on the rise in Detroit, Reddy said.
“Home health fraud is the number one fraud in Detroit now,” Reddy said in an interview Wednesday. “It’s very unregulated.”
Today’s indictments come one month after the federal government charged 26 people in Metro Detroit in a massive prescription pill scheme that billed the government for more than $57 million worth of bogus prescriptions for OxyContin, Vicodin, Xanax and cough syrup with codeine.
In that case – which included 12 pharmacists, four doctors, an accountant and a psychologist -- doctors got kickbacks for writing prescriptions, as did patients who agreed to let their insurers be billed for the drugs that weren’t necessary, the indictment said.
“Medicare beneficiaries and Medicaid recipients are being used as pawns for profit,” said Lamont Pugh, special agent in charge of the federal Office of Inspector General’s Chicago region, which includes Detroit.
To date, Medicare Fraud Strike Force operations in Detroit have charged a total of 138 individuals in cases involving roughly $148 million in fraudulent billings to Medicare.
Charged in the latest alleged schemes were:
• Gerald R. Funderburg Jr., 31, of Southfield;
• Marcus Jenkins, 49, of Farmington Hills,
• Elizabeth Jenkins, 47, of Farmington Hills
• Dr. Alphonso Berry, 50, of Orchard
• Tausif Rahman, 36, of Canton
• Zahir Yousafzai, 41, of Canton
• Javed Rehman, 48, of Farmington Hills
• Muhammad aka "Sib" Ahmad, 33, of Ypsilanti
• Jawad Ahmad, 41, of Ypsilanti
• Dr. Dwight Smith, 58, of Detroit
• Dr. Paul Kelly, 74, of Bath
• Rehan Khan, 38, of Canton
• Nabeel Shaikh, 29, of Wixom
• Janaki Chettiar, 36, of Farmington Hills
• Jigar Patel, 27, of Madison Heights
• Anthony Parkman, 40, of Southfield
• Hetal Barot, 28, of Canton
• Srinivas Reddy, "Dr. Reddy", 35, of Bloomfield Hills,
• Marcus Jenkins, 49, of Farmington Hills,
• Elizabeth Jenkins, 47, of Farmington Hills
• Dr. Alphonso Berry, 50, of Orchard
• Tausif Rahman, 36, of Canton
• Zahir Yousafzai, 41, of Canton
• Javed Rehman, 48, of Farmington Hills
• Muhammad aka "Sib" Ahmad, 33, of Ypsilanti
• Jawad Ahmad, 41, of Ypsilanti
• Dr. Dwight Smith, 58, of Detroit
• Dr. Paul Kelly, 74, of Bath
• Rehan Khan, 38, of Canton
• Nabeel Shaikh, 29, of Wixom
• Janaki Chettiar, 36, of Farmington Hills
• Jigar Patel, 27, of Madison Heights
• Anthony Parkman, 40, of Southfield
• Hetal Barot, 28, of Canton
• Srinivas Reddy, "Dr. Reddy", 35, of Bloomfield Hills,
"Health care providers should be aware that the days of stealing from Medicare with impunity are over," said U.S. Attorney Barbara McQuade of the Eastern District of Michigan. "We are relentlessly investigating and prosecuting those who seek to profit from false claims for services that are medically unnecessary or, in some instances, not provided at all."
According to one indictment unsealed today, 14 individuals are charged with conspiracy to commit health care fraud for their roles in a $14 million scheme to defraud Medicare by submitting fraudulent claims for home health care services.
The conspiracy, records show, was allegedly operated out of multiple home health agencies in Livonia, including Physicians Choice Home Health Care LLC, First Care Home Health Care LLC, Quantum Home Care Inc. and Moonlite Home Care Inc.
In a separate complaint unsealed today, a physician and two other individuals were charged with health care fraud and submitting false claims in connection with a roughly $11.5 million scheme to defraud the Medicare program. The scheme allegedly involved false billings for individual and group psychotherapy services at two Detroit clinics: Quality Recreation and Rehabilitation Inc. and Procare Rehabilitation Inc.
In another indictment unsealed Wednesday, the owner of a medical clinic in Southfield was charged with conspiracy to commit health care fraud, health care fraud and identity theft for a scheme allegedly involving $2.9 million in fraudulent billings to Medicare.
According to court documents, the clinic owner used the identities of Medicare providers and beneficiaries to bill for psychotherapy services that were medically unnecessary and never performed.
Since their inception in March 2007, federal strike force operations nationwide have charged more than 1,000 individuals who collectively have falsely billed the Medicare program for more than $2.3 billion.
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