By JOSEPH G. LARIOSA

(© 2009 Journal Group Link International)

Thirteen More People, Including Filipino Americans, Arrested and Charged With $14.5-million Medicare Fraud

C HICAGO, Illinois (JGLi) – The HEAT is on against 13 Detroit-area, Michigan, residents who were arrested by federal agents from the Department of Health and Human Services, Office of the Inspector General (HHS-OIG) and the FBI in connection with an alleged home-healthcare scheme to defraud the Medicare program of more than $14.5-million.

The HEAT is an acronym for Health Care Fraud Prevention & Enforcement Action Team, a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their joint efforts to reduce and prevent Medicare and Medicaid fraud through enhanced cooperation that has so far netted more than 40 individuals believed to include Filipino Americans.

Trial Attorney Gejaa T. Gobena of the Fraud Section of the Criminal Division of the U.S. Department of Justice in Washington, D.C., when reached by this reporter by phone would not make any comment as to the origins of nationalities of those who were arrested since last December in Southern District of Florida (Miami), Eastern District of Michigan and in Eastern District of New York.

In a six-count indictment returned on Jan. 12, and unsealed on Jan. 14, 13 individuals were alleged to have participated in a Medicare fraud scheme operated out of Patient Choice Home Healthcare (Patient Choice) and All American Home Care (All American), two Oakland County, Michigan, home-health agencies that purported to provide in-home health services.

They were Muhammad Shahab, 50; Christopher Collins, 38; Hassan Akhtar, 26; Curtis Mallory, 35; Mohammed El-Fallal, 55; Jessica Vigil, 34; Tariq Chaudhary, 36; Faisal Chaudray, 31; and Visnhu Meda, 29. They were all indicted for conspiracy to commit healthcare fraud.

In addition, Shahab, Pramod Raval, M.D., 56; Guy Ross, 48; Lura Barrett, 61; and Stephen Cartier, 50, were charged with conspiracy to violate the Anti-Kickback Statute. Shahab and Akhtar were also each charged with two counts of money laundering. The indictment seeks the forfeiture of assets of all the defendants.

Some Filipinos Earlier Indicted for Medicare Fraud in Michigan

L ast December, nine individuals some of them believed to be Filipino Americans have been charged in two indictments returned by grand juries in the Eastern District of Michigan. They include Emilio Haber, 51; Alejandro Haber, 24; Maria Haber, 44; Hans Lobato, 25; Emma King, 61; and Melvin Young, 56, all of Ritecare LLC, of 17940 Farmington Road, Livonia, Michigan; and 16904 W. Warren, Detroit; Carlos Grana, 36; Dwight Armstrong, 32; and Price Marshall, 61; all of CompleteHealth LLC, of 29240 Buckingham Street, Suite 2, Livonia, Michigan.

They were charged with submitting $11-million in fraudulent claims to Medicare for office visits and testing services from August 2007 until Oct. 2009.

In Southern District of Florida, 19 individuals, including doctors and nurses, have been charged in two separate indictments by federal grand jury in Miami for alleged Medicare fraud crimes.

The defendants include Fred Dweck, a licensed physician; Arturo Fonseca, owner of Courtesy Medical Group, Inc.; Yudel Cayro, co-owner of Courtesy; Isis Torres, Francisco Portillo, Armando Sanchez, Sheilla Rotta, Teresita Leal and Silvio Ruiz, all registered nurses; Lissbet Diaz, Marlenys Fernandez, Sheillah Rotta, Alain Fernandez and Eduardo Romero, all charged with one count of conspiring to commit health care fraud and one count of making false statements for use in determining rights to benefits or payment under Medicare; and Antonio Ochoa, who was charged with one count of conspiring to commit health care fraud and three counts of receiving kickbacks in return for referring an individual for or arranging for the furnishings of items and services payable by Medicare.

Editor’s Notes: Here are other articles published about Medicare and Medicare fraud:

Fil-Am Matriarch Pleads Guilty to Healthcare-Facility Violations

(By Romeo P. Marquez)

Reinventing the American Healthcare Industry

Reinventing the American Healthcare Industry (Part II)

Alzheimer May Prove Deadlier than Al Qaeda

Vice President Biden, Secretary Sebelius Issue New Report on Seniors and Health-Insurance Reform

T hey were charged with allegedly conspiring to defraud Medicare by signing prescriptions, medical certifications and plans of care for home health services that were not medically necessary to the tune of $40-million.

Also named defendants in a separate lawsuit were David Marrero, manager and official of the Tendercare Medical Center Inc. in Miami; Maria Volero Marrero, owner of Tendercare; Keith Ernest Humes and Lawrence Edward Humes, for allegedly defrauding Medicare of $5.8-M. and for money laundering.

According to the indictment, Shahab, Akhtar and Collins owned and operated Patient Choice and All American. The home health agencies purported to provide home health therapy services to Medicare beneficiaries.

The indictment alleges that Patient Choice and All American billed for home-health therapy services that were unnecessary and were never performed. In addition, it alleges that Collins and Mallory recruited patients and paid them kickbacks for their Medicare information and signatures on documents.

These false documents were then used to bill Medicare for home-health services that were not rendered. The indictment also alleges that El-Fallal used the identity of a licensed physician to sign physician referrals for home health therapy services that were medically unnecessary and not performed. The indictment charges Vigil, Chaudhary, Chaudary and Meda with falsifying medical records to make it appear that home-health therapy services were provided.

In addition, the indictment alleges that Shahab, Dr. Raval, Ross, Barrett and Cartier engaged in a conspiracy where Shahab would pay kickbacks to the others in exchange for patient referrals and access to Medicare beneficiaries under Dr. Raval, Ross, Barrett and Cartier’s care.

The indictment alleges that Medicare paid Patient Choice and All American more than $14.5 million for services that were medically unnecessary and not provided between August 2007 and September 2009.

The charge of healthcare fraud conspiracy carries a maximum penalty of 10 years in prison and a $250,000 fine. The charge of violating the Anti-Kickback Statute carries a maximum prison sentence of five years and a fine of up to $25,000. Each violation of 18 USC 1956 (money laundering) carries a maximum prison sentence of 20 years and a maximum fine of $500,000. Each violation of 18 USC 1957 (money laundering) carries a maximum prison sentence of 10 years in prison and a maximum fine of $250,000. (lariosa_jos@sbcglobal.net)

© opyright 2009 The Journal Group Link International. The contents provided in the JGLi may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of the Journal Group Link International.

(Editor’s Note: Watch out for the upcoming outlet-oriented, subscription-based website of Journal Group Link International that guarantees originally sourced stories, features, photos, audios and videos and multi-media contents.)