DETROIT MAN GOES TO PRISON FOR PART IN MEDICARE FRAUD SCHEME

FROM:  U.S. DEPARTMENT OF JUSTICE
Thursday, June 7, 2012
Co-Owner of Detroit-Area Therapy Company Sentenced to 30 Months for Medicare Fraud Scheme
WASHINGTON – The co-owner of a Detroit-area physical and occupational therapy company was sentenced today to 30 months in prison for his leading role in a more than $1.9 million Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Victor Jayasundera, 59, was sentenced by U.S. District Judge Avern Cohn in the Eastern District of Michigan.  In addition to his prison term, Jayasundera was sentenced to three years of supervised release and was ordered to pay $855,484 in restitution, joint and several with his co-defendants.

Jayasundera pleaded guilty on Jan. 18, 2012, to the charges against him in a superseding indictment:  one count of conspiracy to commit health care fraud and six counts of health care fraud.  According to the superseding indictment, Jayausundera co-owned a company known as Jos Campau Physical Therapy with co-defendant Fatima Hassan.  Jos Campau Physical Therapy did not have a Medicare provider number and was not entitled to bill Medicare for therapy services.

According to the superseding indictment and evidence presented at the trial of a co-defendant, Jos Campau paid kickbacks to recruiters who obtained Medicare beneficiary information and signatures needed to create fictitious physical and occupational therapy files.  The Medicare beneficiaries pre-signed forms and visit sheets that were later falsified to indicate that they received therapy services that were never provided.

Jayasundera, a physical therapist, falsified patient evaluation forms and fictitious patient notes for physical therapy services that were never rendered.  Jayasundera and his co-owner also hired and paid an occupational therapist and an uncertified occupational therapy assistant to falsify medical files.  The occupational therapist created patient evaluation forms for beneficiaries whom she had never met, seen or evaluated.  The uncertified therapy assistant fabricated and signed patient notes for occupational therapy visits.  The uncertified therapy assistant did not provide the services reflected in the fictitious patient notes.

Jayasundera and his co-owner sold the fictitious physical and occupational therapy files to multiple fraudulent therapy companies that had obtained Medicare provider numbers.  Those companies billed the fictitious files created by Jos Campau Physical Therapy to Medicare and paid kickbacks to Jos Campau Physical Therapy based on these billings.  Jayasundera and his co-owner split the profits from the sale of the falsified files.

Between approximately June 2005 and May 2007, the false files created and sold by Jos Campau Physical Therapy resulted in the submission of approximately $1.9 million in fraudulent claims to the Medicare program for physical and occupational therapy services that were never rendered.

Jayasundera’s co-owner, Fatima Hassan, pleaded guilty on Aug. 25, 2011, for her role in the scheme, and on May 17, 2012, was sentenced to 48 months in prison.  Carol Gant, the occupational therapist, and Vanessa Dowell, the uncertified occupational therapy assistant, also pleaded guilty in 2011.  Tariq Mahmud, the owner of a Medicare provider company that bought and billed Jos Campau Physical Therapy’s fake files, was convicted at trial on Feb. 2, 2012, for his role in the scheme and is scheduled to be sentenced on July 19, 2012.

Today’s sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

This case was prosecuted by Trial Attorney Catherine K. Dick and Assistant Chief Benjamin D. Singer of the Criminal Division’s Fraud Section.  It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,330 individuals who collectively have falsely billed the Medicare program for more than $4 billion.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

DETROIT MEDICARE FRAUDSTER SENTENCED TO PRISON

The following is from the Department of Justice website:

Friday, December 2, 2011
“Detroit-Area Clinic Owner Sentenced to 78 Months in Prison for Role in $9.1 Million Medicare Fraud Scheme
WASHINGTON – Joaquin Tasis was sentenced today to 78 months in prison for his role in a $9.1 million Detroit-area Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).
Tasis was sentenced by U.S. District Judge Arthur Tarnow in the Eastern District of Michigan. In addition to his prison term, Tasis was sentenced to three years of supervised release and was ordered to pay $6 million in restitution, jointly and severally with his co-defendants.
Joaquin Tasis and co-defendants Martin Tasis and Leoncio Alayon were convicted by a jury in May 2011 after a five-day trial. Evidence presented at trial showed that the Tasis brothers and their co-conspirators helped relocate a highly lucrative infusion therapy fraud scheme to Michigan from South Florida after increased law enforcement scrutiny there, and that Alayon helped the conspirators launder proceeds from the scheme. Martin Tasis was sentenced in October 2011 to 10 years in prison and two years of supervised release for his role in the scheme.
According to evidence presented at trial, Martin and Joaquin Tasis were partners in a Detroit-area clinic called Dearborn Medical Rehabilitation Center (DMRC). Evidence at trial showed that Medicare beneficiaries were not referred to DMRC by their primary care physicians, or for any other legitimate medical purpose, but rather were recruited to come to the clinic through the payment of cash kickbacks. DMRC then billed Medicare for expensive and exotic medications, purportedly administered to treat HIV and Hepatitis-C. However, the medications were never administered.
Once Medicare started paying the co-conspirators, Martin Tasis enlisted Alayon, a family friend, to help him launder the proceeds of the fraud through a shell corporation in Florida called Infinity Research Corp. Evidence at trial showed that Infinity Research Corp. had no employees, did no research and was based at Alayon’s residence. Alayon, after taking a commission for himself, distributed the laundered proceeds to Martin and Joaquin Tasis and their co-conspirators.
Between November 2005 and March 2007, DMRC billed approximately $9.1 million in claims to Medicare for injection therapy services that were never provided and/or were not medically necessary. Medicare paid approximately $6 million of those claims. Evidence at trial showed that DMRC purchased only $36,000 in medication and medical supplies.
Joaquin Tasis was convicted of one count of conspiracy to commit health care fraud, one count of conspiracy to pay health care kickbacks and three counts of health care fraud.
Today’s sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (HHS-OIG) Chicago Regional Office.
The case was prosecuted by Trial Attorney Gejaa T. Gobena of the Criminal Division’s Fraud Section and Assistant U.S. Attorney for the Eastern District of Michigan Philip A. Ross. The FBI and HHS-OIG conducted the investigation.
Since its inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,140 individuals and organizations that collectively have billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.”

DETROIT MAN ARRESTED FOR $30 MILLION HOME HEALTH CARE MEDICARE FRAUD SCHEME

Thursday, November 3, 2011
The following is an excerpt from the SEC website:

“WASHINGTON – A Detroit-area resident was charged and arrested today in the Eastern District of Michigan for his alleged leading role in a $30 million Medicare fraud scheme involving home health services, announced the Department of Justice, the Department of Health and Human Services (HHS), the FBI and the HHS-Office of Inspector General (OIG). In addition to the arrest, law enforcement agents executed search warrants at five locations, seizure warrants for 31 bank accounts related to the scheme and suspended Medicare payments to 16 health care companies associated with the scheme.
According to a criminal complaint unsealed today in U.S. District Court in Detroit, Zafar Mehmood, 45, allegedly masterminded a $30 million scheme involving the submission of fraudulent claims submitted to Medicare for services that were medically unnecessary and/or never provided through at least four home health agencies. The four home health agencies named in the complaint are Access Care Home Care Inc. and Patient Care Home Care Inc., in Ypsilanti, Mich., and Hands On Healing Home Care Inc. and All State Home Care Inc., in Detroit.
Mehmood is alleged to have paid kickbacks to patient recruiters and billed Medicare for services that were not medically necessary and/or not performed through Access, Patient Care, Hands On Healing and All State. Mehmood is also accused of laundering the proceeds of the scheme through sham companies and intermediaries.
Mehmood is scheduled to make his initial appearance today before U.S. Magistrate Judge Mona K. Majzoub.
Today’s charges were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the HHS-OIG Office of Investigation. Including today’s charges, Medicare Fraud Strike Force operations in Detroit have charged a total of 139 individuals in cases involving approximately $174 million in fraudulent billings to Medicare.
The case is being prosecuted by Trial Attorney Gejaa T. Gobena and Catherine Dick of the Criminal Division’s Fraud Section. The investigations were conducted jointly by the FBI and HHS-OIG, as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Eastern District of Michigan and the Criminal Division’s Fraud Section.
Since their inception in March 2007, the strike force operations in nine districts have charged more than 1,140 individuals who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
Criminal complaints contain merely charges and defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.”