An FBI news release announces that a Detroit area resident pled guilty Tuesday, August 28, 2012, in federal court in the Eastern District of Michigan for his role in managing a $13.8 million psychotherapy fraud scheme, announced the Department of Justice, the Department of Health and Human Services (HHS), and the FBI.
2. An FBI news release announces that
a Detroit area resident pled guilty
Tuesday, August 28, 2012, in federal
court in the Eastern District of
Michigan for his role in managing a
$13.8 million psychotherapy fraud
scheme, announced the Department
of Justice, the Department of Health
and Human Services (HHS), and the
FBI.
3. Jawad Ahmad, 42, pleaded guilty before
U.S. District Judge Gerald E. Rosen in
Detroit to one count of conspiracy to
commit health care fraud. At his
sentencing, scheduled for November 28,
2012, Ahmad faces a maximum
potential penalty of 10 years in prison
and a $250,000 fine.
The guilty plea 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.
4. Special Agent in Charge of the FBI’s
Detroit Field Office Robert D. Foley III; and
Special Agent in Charge Lamont Pugh III
of the HHS Office of Inspector General’s
(HHS-OIG) Chicago Regional Office.
According to court documents, beginning
in July 2008, two of Ahmad’s co-
conspirators, Tausif Rahman and
Muhammad Ahmad, acquired control over
a home health care company known as
Physicians Choice Home Health Care LLC
(Physicians Choice). From in or around
January 2009 and continuing through in or
around March 2010, Jawad Ahmad
managed the operations of Physicians
Choice.
5. Court documents indicate that Jawad
Ahmad managed numerous aspects of
the fraud at Physicians Choice,
including delivering the payment of
kickbacks to beneficiary recruiters who
obtained Medicare beneficiaries’
information needed to bill Medicare for
home health services, including
physical therapy and skilled nursing,
that were never rendered. Jawad
Ahmad also provided information to
employees of Physicians Choice to
check the billing eligibility of the
Medicare beneficiaries before
Physicians Choice began billing them.
6. In exchange for kickbacks, Medicare
beneficiaries pre-signed forms and visit
sheets that were later falsified to indicate
they received home health services they had
never received. Jawad Ahmad delivered the
pre-signed beneficiary paperwork to various
medical professionals, including nurses,
physical therapists, and physical therapy
assistants to create and/or sign fictitious
patient files to document purported home
health services that were never rendered.
From in or around January 2009 through in
or around March 2010, Medicare paid more
than $5 million for fraudulent home health
care claims submitted by Physicians Choice.
7. According to court records, from in or
around May 2010 through in or around
September 2011, Jawad Ahmad managed
Phoenix Visiting Physicians PLLC, a
company incorporated by co-conspirator
Dr. Dwight Smith. Dr. Smith signed home
health care referrals for beneficiaries he
had not seen or treated. Phoenix employed
individuals who held themselves out to be
“doctors,” but who were not, in fact,
licensed in the state of Michigan to perform
any medical services. The unlicensed
“doctors” met and purported to examine
non-homebound Medicare beneficiaries for
home health care services. Jawad Ahmad
drove one unlicensed “doctor” to meet and
purportedly examine beneficiaries who
were not, in fact, homebound.
8. Between 2008 and 2009, Ahmad’s co-
conspirators acquired beneficial ownership and
control over three additional home health care
companies: First Care Home Health Care LLC,
Quantum Home Care Inc., and Moonlite Home
Care Inc. Each of these home health companies
billed Medicare and operated in a manner the
same as or similar to Physicians Choice. Each of
these companies received fraudulent home
health referrals from Dr. Smith through Phoenix
Visiting Physicians. From in or around May 2010
through in or around September 2011, Medicare
paid more than $5 million for fraudulent home
health care claims submitted by Physicians
Choice, First Care, Quantum, and Moonlite
based on Dr. Smith’s fraudulent referrals.
9. The four home health companies at the
center of the indictment received
approximately $13.8 million from
Medicare in the course of the
conspiracy.
Eight other defendants have pleaded
guilty in this case, including Tausif
Rahman and Muhammad Ahmad, who
each pleaded guilty to one count of
conspiracy to commit health care fraud
and one count of money laundering, as
well as Dr. Dwight Smith who pleaded
guilty to one count of conspiracy to
10. The case is being prosecuted by Trial
Attorney Catherine K. Dick of the
Criminal Division’s Fraud Section. The
case was investigated by the FBI and
HHS-OIG and was brought as part of
theMedicare Fraud Strike Force,
supervised by the Criminal Division’s
Fraud Section and the U.S. Attorney’s
Office for the Eastern District of
Michigan.
11. Since its inception in March 2007, the
Medicare Fraud Strike Force, now
operating in nine cities across the
country, has charged more than 1,330
defendants who have collectively billed
the Medicare program for more than $4
billion. In addition, HHS’s Centers for
Medicare and Medicaid Services,
working in conjunction with HHS-OIG,
is taking steps to increase
accountability and decrease the
presence of fraudulent providers.
12. The public is encouraged to report any
activity which appears to be fraudulent
or illegal concerning Medicare and
Medicaid providers. To learn more
about the Health Care Fraud
Prevention and Enforcement Action
Team (HEAT).