Trail of Evidence

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All fraudsters leave a trail of evidence when committing crimes, no matter how good they are at burying it. An article posted on NorthJersey.com tells the story of how tens of thousands of fraudulently submitted Medicaid claims led investigators to the mastermind of one of the most extensive Medicaid fraud schemes in New Jersey history.

According to the article, the owner of a string of imaging centers bribed a plethora of medical professionals with cash and luxury items in exchange for patient referrals. He paid between $50 and $150 per MRI or CT scan to physicians or chiropractors who referred their patients to his chain of imaging centers located across New Jersey.

Over a six year period, the man, his wife and her brother – all officers within the company – paid out several million dollars in kickbacks. (Some of the illegal gifts included gift cards to luxury stores and a boating supplier, cash, airline tickets, admission to baseball games and Broadway shows, donations to charities and renovation work performed in the offices of cooperating doctors.) The scam also included filing tens of thousands of claims that generated millions in fraudulent Medicaid payments.

At the time of the imaging center owner’s arrest, he and his family – including his parents – lived in a 9,000 square foot home. (Officials seized several luxury vehicles including a Lamborghini, Rolls-Royce, Ferrari and Mercedes-Benz. They also captured expensive jewelry and more than $100,000 in cash.) During the sting operation, also arrested were the imaging center owner’s father, his wife, her brother and 10 others.

The 46-year-old owner admitted guilt and will be sentenced to 10 years in prison; however, he agreed to help prosecutors investigate other participants involved in the scam. In return for his assistance, the owner’s sentence will be reduced by six months for every five people he turns in up to a total of 20. (There’s nothing like less jail time to provide an incentive to help catch the bad guys.)

The story also mentions that this run-in with the law is not his first. The fraudster was previously barred from participating in the state Medicaid program for 12 years and actually served 10 months in prison for receiving kickbacks for involvement in an unrelated scheme. (The prior conviction coupled with the current one is grounds for deportation since he is a Pakistani citizen.) Because of his willingness to assist prosecutors, the state has agreed to write a letter to immigration officials requesting that he not be deported and that he receive parole at his first eligibility hearing. (Well, that is awfully nice of them to do that.

Following the hearing, the man travelled to yet another court where he made a plea deal in yet another criminal case involving charges of faking reports of damage to expensive imaging equipment. (As a result, he received insurance payments totaling more than $600K.) He pleaded guilty to one count of conspiracy to commit theft by deception and agreed to a five-year sentence to run concurrently with the other sentence he will receive shortly. (He’s one very busy criminal.)

The man’s 39-year-old wife will receive three months of probation when sentenced. The owner, his wife and her brother also have to pay $1 million in restitution. (You’ll be relieved to know that the imaging center owner will no longer be able to participate in state or federal health programs.) Three other employees have also pleaded guilty to other charges and are currently awaiting sentencing.

Congratulations to investigators for bringing these criminals to justice by putting a stop to their illegal activities. The ringleader is officially done with stealing money from those who deserve assistance from Medicaid. It looks like he will be headed to prison very soon, followed by a trail of co-conspirators who participated in the scam.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”North Jersey Man’s Plea Deal in MRI Fraud has Incentive Clause,” written by Lindy Washburn and posted on NorthJersey.com on May 11, 2015.

The owner of a string of imaging centers that bribed doctors with cash and luxury goods for patient referrals agreed in court on Monday to help fraud prosecutors investigate others in the scheme — a deal that will reduce his prison time the more doctors he turns in.

Rehan ”Ray” Zuberi described in state Superior Court in Morristown how he and others in his organization paid ”anywhere from $50 to $150” per MRI or CT scan to physicians and chiropractors who referred their patients to his centers. Authorities said his organization paid several million dollars in kickbacks over six years.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.