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Monday, December 21, 2015

DETROIT-AREA MEDICARE FRAUDSTER SENTENCED FOR ROLE IN $7 MILLION HEALTH CARE FRAUD

FROM:  U.S. JUSTICE DEPARTMENT 
Wednesday, December 16, 2015
Home Health Care Agency Owner Sentenced to 80 Months for Directing Detroit-Area Medicare Fraud Scheme

The owner and operator of a Detroit-area home health care agency who directed a $7 million health care fraud scheme was sentenced today to 80 months in prison.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge David P. Gelios 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 (HHS-OIG) Chicago Regional Office made the announcement.

Amer Ehsan, 44, of Canton, Michigan, was sentenced by U.S. District Judge Paul D. Borman of the Eastern District of Michigan, who also ordered Ehsan to pay $4,567,967.12 in restitution.

In connection with his guilty plea, Ehsan admitted that as he owner and operator of Advance Home Health Care Services Inc. (Advance), a home health care agency in the Detroit area, he conspired with physicians, physical therapists and patient recruiters to bill the Medicare program for unnecessary home health care and therapy services and that he paid co-conspirator physicians to refer Medicare beneficiaries to Advance and sign medical documents falsely certifying that they required home health care.  Ehsan also admitted that at his direction, Medicare beneficiaries received cash kickbacks in exchange for signing multiple blank physical therapy records.

Additionally, Ehsan admitted that he owned and controlled Michigan Rehab and Management Services LLC, which he used to sell information about Medicare beneficiaries and corresponding fictitious patient files to other Detroit-area home health care agencies.  Medicare paid a total of more than $4.5 million as a result of Ehsan’s conduct with these two companies.

Ehsan was part of a wide-ranging scheme that involved 12 defendants, all of whom have pleaded guilty.

The FBI and HHS-OIG investigated this case, which was 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 of the Eastern District of Michigan.  Trial Attorney Elizabeth Young of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Katherine Wagner and Special Trial Attorney Katie R. Fink of the Eastern District of Michigan prosecuted this case.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,300 defendants who have collectively billed the Medicare program for more than $7 billion.  In addition, HHS’ Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

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