Left Holding the Bag

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What would you do with $14.9 million? Would you buy a mansion on a lake, take a trip around the world and stay at every five-star hotel you could find, or would you put this small fortune in the bank and watch it grow? An article in Crain’s Detroit Business describes the case of three men who reaped nearly $15 million from a scheme they set up to falsely bill Medicare.

The story states that over a three-year time period, a physical therapist, a physical therapy assistant and a medical school graduate involved four home health care companies in their scheme to bilk the government benefits program of $14.9 million for services that were never provided. One of the companies hired unlicensed physicians to visit patients, provide them with prescriptions and collect their Medicare number to bill for unnecessary home health care services. (Did I mention that these fraudsters paid kickbacks to patient recruiters including cash and access to narcotic prescriptions?)

All three men were found guilty of conspiracy to commit health care fraud. The 43-year-old physical therapist and 30-year-old physical therapy assistant also were found guilty on two counts of health care fraud, while the 38-year-old medical school grad was found guilty of three counts of health care fraud. The physical therapy assistant also was found guilty of money laundering through a company he created to funnel the fraud proceeds.

Congratulations to the Medicare Fraud Strike Force once again. Thanks to their efforts, this gang of fraudsters didn’t get away with a fortune. The criminals got stuck holding the bag and will now have to pay a hefty price for their devious acts.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”3 Guilty in Medicare Fraud Scheme Related to 4 Livonia-based Home Care Companies,” written by Bridget Vis and published in Crain’s Detroit Business on May 1, 2014.

A physical therapist, physical therapy assistant and medical school grad were found guilty this week in what the U.S. Department of Justice calls a $14.9 million Medicare fraud scheme.

Jurors found physical therapist Shahzad Mirza, 43, of Canton Township, physical therapy assistant Jigar Patel, 30, of Madison Heights, and Srinivas Reddy, 38, of Bloomfield Hills, an unlicensed foreign medical school graduate, all guilty on one count of conspiracy to commit health care fraud. They all await sentencing dates at U.S. District Court in Detroit, Justice said in a statement.

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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.