Stealing Evidence

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47631612 - doctor and businessman shaking hands

It’s not a good idea to steal evidence when you have been charged with an offense. (It can only get you deeper into trouble with the law.) A Federal Bureau of Investigation press release details how two owners of several home health care companies bilked more than $33 million from Medicare and how one of the owners stole key evidence involved in the case. (It’s not exactly a brilliant move to steal money from Medicare or key evidence.)

The press release states that the two home health care agency owners led a scheme to gain new patients for their four businesses by paying cash kickbacks to recruiters and physicians, who in turn paid more kickbacks to patients if they signed up for unnecessary home health care services through these providers. (Legitimate home health care providers provide skilled nursing services, physical and occupational therapy and speech pathology to homebound patients.)

Furthermore, the defendants and their co-conspirators falsified records to show that the Medicare beneficiaries qualified for and received more than $33 million in home health care services. (Just to be clear, the process for Medicare billing isn’t a secret. When providers participate with Medicare, they are informed about proper billing procedures, billing rules and regulations. Providers are only allowed to submit Medicare claims for services rendered and must also maintain patient records to verify that services were provided as claimed.)

Court evidence showed that one of the owners used another co-conspirator to launder the fraudulent proceeds through several shell companies under his control. After a two-week trial, jurors took less than two days to find the 49-year-old and 48-year-old home health care company owners guilty on a combined 11 health care fraud charges. They are facing years in prison when sentenced.

In a separate but related case, the older defendant was also convicted on two counts of obstruction of justice because he stole key evidence during a pretrial release visit to the Department of Health and Human Services. (The stolen evidence was previously seized during a search of his companies.) Fortunately, law enforcement later recovered the confiscated materials during a search of the fraudster’s jail cell. (There usually aren’t too many places to hide things when incarcerated.)

This case is another successful result of the Medicare Fraud Strike Force’s efforts to stop further losses to the government health care program that was set up to help those who legitimately qualify for services. These two criminals have now been added to the list of more than 2,300 defendants who have collectively billed Medicare for more than $7 billion.

Source: Today’s ”Fraud of the Day” is based on a press release titled, ”Detroit-area Home Health Care Agency Owners Convicted in $33 Million Medicare Fraud Scheme,” released by the Federal Bureau of Investigation July 27, 2015.

WASHINGTON—Two home health care agency owners were convicted today of various offenses based on their roles in a $33 million Medicare fraud scheme, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Chicago Regional Office.

Zafar Mehmood, 49, of Ypsilanti, Michigan, was convicted of conspiracy to commit health care fraud, four counts of health care fraud, one count of conspiracy to pay and receive health care kickbacks, one count of conspiracy to commit money laundering and two counts of money laundering. Mehmood also was convicted of two counts of obstruction of justice related to his theft of evidence from an HHS-OIG facility. Badar Ahmadani, 48, also of Ypsilanti, was convicted of one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive health care kickbacks.

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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.