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Detroit Man Pleads Guilty in $13.8 Million Medicare Fraud Scheme

Jawad Ahmad has pleaded guilty in federal court to managing a psychotherapy fraud scheme that defrauded the Medicare program of $13.8 million. After he is sentenced in November, Mr. Ahmad could serve as much as 10 years in prison and could have to pay a $250,000 fine.

Kickbacks and Falsified Records Were Used to Support Medicare Fraud Scheme.

 

After Mr. Ahmad’s co-conspirators acquired Physicians Choice Home Health Care LLC, Mr. Ahmad took over management of Physicians Choice operations as well as significant aspects of the Medicare fraud conspiracy. Mr. Ahmad orchestrated payment of kickbacks to patient recruiters who provided personal information about Medicare beneficiaries. Physicians Choice also had Medicare beneficiaries pre-sign visit forms in exchange for kickbacks. With this personal information and the pre-signed forms, Physicians Choice billed Medicare for physical therapy, skilled nursing, and other home health care services. These services were never actually provided to patients, however.

To support the false claims being made against the Medicare program, Mr. Ahmad had the pre-signed visit sheets falsified to show services that were never provided. According to the Federal Bureau of Investigation, he then provided paperwork to medical professionals to sign or create patient files that documented home health services the patients never received. In just over a year, Physicians Choice received over $5 million from Medicare for these fraudulent claims.

The Physicians Choice Medicare fraud scheme was working so well that Mr. Ahmad’s co-conspirators acquired three more home health care companies: Quantum Home Care Inc., First Care Home Health Care LLC, and Moonlite Home Care Inc. These companies also submitted false claims to Medicare for home health care services that were neither needed nor provided. These three companies received an additional $8.8 million from the Medicare program, making the total take for the scheme $13.8 million.

Mr. Ahmad managed a related scam through Phoenix Visiting Physicians PLLC. Phoenix Visiting Physicians provided referrals for home health care. In some cases, the doctor associated with Phoenix Visiting Physicians never met the Medicare beneficiaries on whose behalf he was making the referrals. In other cases, Mr. Ahmad sent unlicensed “doctors” to see Medicare beneficiaries who were not homebound and examine them for home health care services. Phoenix Visiting Physicians provided home health care referrals for each of the home health care companies controlled by Mr. Ahmad and his co-conspirators.

In addition to Mr. Ahmad, eight other individuals have pleaded guilty for their part in the Medicare fraud scheme.

Whistleblowers Can Provide Critical Information to Stop Medicare Fraud.

 

In a Medicare fraud scheme as complicated as this one, with five companies, numerous individuals and purported health care providers, as well as a large number of Medicare beneficiaries, there must have been many people who knew there was fraud going on. When people with information about fraud or other wrongdoing come forward to stop it, they are called whistleblowers. Whistleblowers are effectively partners with the authorities in trying to stop fraud and address the damage it causes.

Because the assistance of whistleblowers is so valuable to the authorities, the qui tam provisions of the False Claims Act allow whistleblowers to bring a lawsuit against the wrongdoers and share with the government in any financial recovery.

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