NURSING COMPANY OWNER SENT TO PRISON FOR $12.6 MILLION ROLE IN FRAUD SCHEME

FROM:  U.S. JUSTICE DEPARTMENT 

Friday, July 24, 2015

Owner of Detroit Home Health Care Companies Sentenced to 80 Months in Prison for Role in $12.6 Million Fraud Scheme

A Michigan resident was sentenced to 80 months in prison late yesterday for his leading role in a $12.6 million Medicare fraud and tax fraud scheme.  Eleven other individuals have been convicted in this case.

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 Paul M. Abbate of the FBI’s Detroit Field Office, 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 and Special Agent in Charge Jarod Koopman of the Internal Revenue Service-Criminal Investigation (IRS-CI) Detroit Field Office made the announcement.

Mohammed Sadiq, 67, of Oakland County, Michigan, pleaded guilty on March 13, 2015, to one count of health care fraud and one count of filing a false tax return.  In addition to imposing the prison term, U.S. District Judge Denise Page Hood of the Eastern District of Michigan ordered Sadiq to pay $14.1 million in restitution and entered a forfeiture judgment for the same amount, which represents the proceeds traceable to his criminal conduct.

Sadiq owned and directed operations at two home health care companies in Detroit.  In connection with his guilty plea, Sadiq admitted that, working with co-conspirators, he billed Medicare for home health services that were not provided.  Sadiq also admitted to paying kickbacks to patient recruiters in order to obtain the information of Medicare beneficiaries, which he then used to bill Medicare for services that were not medically necessary or were not provided at all.  Sadiq further admitted that he created fake patient files to fool a Medicare auditor by making it appear as if home health services were provided and medically necessary.  Medicare paid $12.6 million for these services.

In connection with his guilty plea, Sadiq also admitted that he received proceeds of the fraud through bank accounts that he controlled, that he withdrew substantial sums for his personal use and that he failed to report these amounts on his individual federal income tax return in 2008.  In total, Sadiq admitted that he owes approximately $1.5 million in taxes, interest and penalties for tax years 2008 through 2010.

This case was investigated by the FBI, HHS-OIG and IRS-CI, 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 of the Eastern District of Michigan.  The case is being prosecuted by Trial Attorneys William Kanellis, Christopher Cestaro, Brooke Harper and Elizabeth Young of the Criminal Division’s Fraud Section, as well as Assistant U.S. Attorney Patrick Hurford of the Eastern District of Michigan.

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.

MICHIGAN DOCTOR SENTENCED FOR ROLE IN $2.1 MILLION MEDICARE FRAUD

FROM:  U.S. JUSTICE DEPARTMENT 

Wednesday, January 14, 2015

Michigan Physician Sentenced to 15 Months in Prison for her Role in a $2.1 Million Medicare Fraud Scheme

A Michigan physician involved in a $2.1 million home health care fraud scheme was sentenced today to 15 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 Paul M. Abbate of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations Detroit Office made the announcement.

Dr. Paula Williamson, 69, of Redford Township, Michigan, was sentenced by U.S. District Judge Paul D. Borman of the Eastern District of Michigan.  In addition to her prison term, Williamson was ordered to pay $1,343,261.61 in restitution.

According to her plea agreement, from August 2009 through October 2012, Williamson conspired with others to commit health care fraud by referring Medicare beneficiaries for home health care services that were medically unnecessary and never provided.  Williamson also falsified documents that were used to support false and fraudulent claims to Medicare.

According to her admissions, Williamson signed referrals for a home health care agency known as AMB Healthcare Inc. (AMB), which was located in Farmington Hills, Michigan, and owned by a co-conspirator.  AMB needed a physician’s referral to bill Medicare for purported home health care services.  Williamson admitted that, at the request of her co-conspirators, including the owner of AMB, she falsified medical documentation and certified Medicare beneficiaries as homebound—a requirement for Medicare reimbursement—when, in fact, she had never examined nor even met the beneficiaries, and they were not homebound.  AMB used the falsified documents to support fraudulent claims to Medicare for home health care services that were never rendered and not medically necessary.

Between April 2009 and December 2012, Medicare paid AMB approximately $2.1 million for purported home health care services.  Of that amount, approximately $1.3 million was based on Williamson’s false home health referrals.

This case was investigated by the FBI and HHS-OIG, and was brought by 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.  The case was prosecuted by Trial Attorneys Matthew C. Thuesen and Niall M. O’Donnell of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion.  In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.