Taking Down Fraud


The Medicare Strike Force doesn’t put up with fraud and strives to prevent criminals from bilking the government program of billions of dollars from dishonest charges. They’ve been pretty successful with their efforts – especially in the Detroit area, where more than 164 individuals have been charged with approximately $244 million in fraudulent Medicare billings. This is the single largest takedown in strike force history. (Way to go!) As stated in a recent press release by the Department of Justice, an owner of a Detroit-area home health agency and his accomplices were convicted of $13.8 million in fake billings to Medicare. This amount is just a small portion of the overall amount of fraud in the area, but nonetheless, it is a significant chunk of the Medicare fraud pie.

The press release reports that the owners of a home health care agency, which provided physical therapy and skilled nursing services, paid kickbacks to patient recruiters for Medicare beneficiary information. (As you can guess, these services were never provided.) One of the owners, who was the administrator of the agency, was also responsible for submitting false claims to Medicare. (You can probably figure out where I’m going here. The files were falsified by the co-conspirators). The scam was so lucrative that the owners acquired control of three more home health care companies. Over a two-year period, Medicare paid out more than $13.8 million for the fraudulent claims submitted by the four companies.

The 50-year-old administrator pleaded guilty to one count of conspiracy to commit health care fraud. He was sentenced to five years in prison, two years of supervised release and will pay $1,734,801 in restitution, jointly and severally with his co-defendants. (What about the rest of the $13.8 million?) His two co-conspirators pleaded guilty to similar charges and are awaiting sentencing.

The Medicare Strike Force is committed to protecting American taxpayers and reducing the cost of health care by tracking down and prosecuting fraud. A big round of applause is in order for the strike force, who is doing a fabulous job of bringing to justice criminals, who violate our laws and attack our Medicare benefits program all for personal gain. As this massive operation proves, criminals usually don’t get away with the crime, and will eventually get taken down.

Source: Today’s ”Fraud of the Day” is based on press release titled, ”Home Health Agency Owner Sentenced for Role in $13.8 Million Medicare Fraud Scheme,” released by the U.S. Department of Justice on November 7, 2013.

WASHINGTON, DC – Detroit-area resident Javed Rehman was sentenced to serve 60 months in prison today for his role in a $13.8 million Medicare fraud scheme.

Acting Assistant Attorney General Mythili Raman 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 (HHS-OIG) Office of Investigations’ Detroit Office made the announcement.

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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.