News that doesn't receive the necessary attention.

Saturday, April 2, 2016

In $33 million Detroit area Medicare scam, 2 physicians, Wasseem Alam, Hatem Ataya, and 3 hospice and home care owners plead guilty. 'Health care fraud has been pervasive throughout metro Detroit in recent years'-Justice.gov

3/24/16, "Last of Five Defendants Pleads Guilty in Multimillion-Dollar Medicare Fraud Scheme involving Detroit-Area Home Health Companies," justice.gov

"The last of five defendants pleaded guilty for his role in a $33 million Medicare fraud scheme involving Detroit-area home health care and hospice companies. The other four defendants have all pleaded guilty since March 15, 2016....

Muhammad Tariq, 60, of West Bloomfield, Michigan, an owner of home health care and hospice companies in the Detroit area, pleaded guilty yesterday before U.S. District Judge Sean F. Cox of the Eastern District of Michigan to one count of conspiracy to commit health care fraud and wire fraud.  

On March 15 and March 18, 2016, respectively, Shahid Tahir, 45, and Manawar Javed, 40, both of Bloomfield, Michigan, two other owners of the home health care and hospice companies, each pleaded guilty before Judge Cox to one count of conspiracy to commit health care fraud and wire fraud.  On March 18 and March 22, 2016, respectively, Waseem Alam 60, of Troy, Michigan, and Hatem Ataya, 47, of Flushing, Michigan, two physicians involved in the fraud scheme, pleaded guilty before Judge Cox to one count of conspiracy to commit health care fraud and wire fraud. Alam additionally pleaded guilty to an additional count of structuring. The defendants are scheduled to be sentenced in July 2016.  All five defendants were charged in an indictment returned on June 11, 2015.

According to admissions made as part of their guilty pleas, Tahir, Javed and Tariq paid kickbacks, bribes and other inducements to Alam, Ataya and other physicians, as well as to marketers and patient recruiters, for beneficiary referrals to companies they owned, including A Plus Hospice and Palliative Care, At Home Hospice and At Home Network Inc. Tahir, Javed and Tariq admitted that they would then bill Medicare for home care and hospice services that were often medically unnecessary and not provided.  

Alam was the top referring physician to the entities owned by the defendants and as such, was responsible for millions in Medicare reimbursements, he admitted. As part of his guilty plea, Alam admitted that he received kickbacks and other inducements from the owners of At Home Network in exchange for home health referrals. Alam bribed his patients into accepting services from At Home Network by providing them with medically unnecessary controlled substance prescriptions both personally and through unlicensed individuals, he admitted. Co-owner Tariq admitted that he knew about Alam’s controlled substances bribes to patients. Alam also instructed others to falsify patient files to hide the fact that the prescriptions were medically unnecessary, according to his plea agreement.      

Ataya was the second-highest referring physician to At Home Network and the top referring physician to At Home Hospice.  As part of his guilty plea, he admitted that he accepted kickbacks and other inducements in exchange for home health and hospice referrals. Ataya also admitted that the Tahir-associated companies would submit false billing based on his referrals for purported home health and hospice services, when, at times, these services were neither medically necessary nor provided.

The FBI and HHS-OIG investigated the case, which 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. Trial Attorneys Shubhra Shivpuri, Malisa Dubal and Tom Tynan of the Criminal Division’s Fraud Section prosecuted the case.

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, the HHS 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."

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From 2015 press release announcing charges:
 
6/18/2015, "Sixteen Charged in Detroit Area as Part of Largest National Medicare Fraud Takedown in History," justice.gov, Detroit, Mich.

"“Health care fraud has been pervasive throughout metro-Detroit in recent years, at great cost to the American taxpayer.  We hope that cases like these will alert doctors, pharmacists and other providers that criminal investigators are now scrutinizing billing records so that we can detect fraud and hold wrongdoers accountable,” said Barbara L. McQuade U.S. Attorney for the Eastern District of Michigan."...


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4/1/16, "Dem Donors Plead Guilty to $33 Million Medicare Fraud Scheme," Washington Free Beacon, Joe Schoffstall

"Five individuals who have donated to Democratic politicians pleaded guilty to a scheme that drained Medicare out of $33 million dollars

Two physicians and three owners of hospice and home care companies based out of Detroit, Mich., were charged on June 18, 2015 as part of the largest Medicare fraud case in history for submitting fraudulent claims for home health care and hospice services that were either not provided or deemed medically unnecessary.

The elaborate operation revolved around Muhammad Tariq, Shahid Tahir, and Manawar Javed—the owners of the home health care and hospice companies—paying kickbacks and bribes to physicians for referrals to their companies that included A Plus Hospice and Palliative Care, At Home Hospice, and At Home Network Inc.

Wasseem Alam, a physician who was the top referrer to the companies, admitted he was responsible for millions in Medicare reimbursements and said he received kickbacks, along with other inducements, in exchange for those referrals.

“Alam bribed his patients into accepting services from At Home Network by providing them with medically unnecessary controlled substance prescriptions both personally and through unlicensed individuals, he admitted,” the Justice Department said. “Co-owner Tariq admitted that he knew about Alam’s controlled substances bribes to patients. Alam also instructed others to falsify patient files to hide the fact that the prescriptions were medically unnecessary, according to his plea agreement.”

Hatem Ataya, a physician who was the second highest referrer to the At Home Network and the top referrer to At Home Hospice, also admitted to accepting kickbacks for his referrals.

“Ataya also admitted that the Tahir-associated companies would submit false billing based on his referrals for purported home health and hospice services, when, at times, these services were neither medically necessary nor provided,” the Justice Department said.

Ataya was separately charged last year in connection with the death of three patients and hit with three counts of delivering a controlled substance and another three counts of delivering a controlled substance causing death, according to WNEM TV in Flint, Michigan.

Tariq, Tahir, and Javed pleaded guilty to one count to commit health care fraud and wire fraud.

Alam and Ateya both pleaded guilty to one count of conspiracy to commit health care and wire fraud, while Alam additionally pleaded guilty to one count of structuring.

All five individuals have combined to give tens of thousands of dollars to Democratic politicians.

Shahid Tahir, one of the owners of the companies, has made 63 contributions totaling at least $33,000 to Democratic politicians such as Hillary Clinton and Reps. Keith Ellison (D., Minn.) and Gary Peters (D., Mich.), among many others.

Muhammed Tariq, another owner, added five donations to Democratic politicians including the likes of John Edwards and Reps. Debbie Stabenow (D., Mich.) and Bobby McKenzie (D., Mich.). Tariq contributed $2,000 to Democrats throughout the years.

Manawar Javed, the third owner, made two contributions to Democrats that totaled $750.

The first physician involved in the scheme, Waseem Alam, made $3,250 worth of donations that included a $1,000 contribution to both Hillary Clinton and Rep. Stabenow.

Hatem Ateya, the second physician, made four separate donations to Democrats that came to $2,500.

Together, they have donated more than $40,000 to Democratic politicians nationwide, compared to just $2,000 to Republicans within Michigan.

The group was initially caught last year during a nationwide sweep led by the Medicare Fraud Strike Force.

The sweep resulted in charges against 243 individuals including 46 doctors, nurses, and other medical professionals for $712 million in false billings—the largest Medicare fraud bust in history.

Requests for comment were not returned."


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