16 fall in massive Medicare fraud sweep

By: Tiffany Esshaki | C&G Newspapers | Published June 22, 2015

METRO DETROIT — Sixteen people around metro Detroit have been charged in what the federal government is calling the largest Medicare fraud takedown in history.

Nationwide, 243 arrests were made as part of the investigation, including doctors, nurses and other licensed medical professionals for their alleged participation in schemes to defraud Medicare of $712 million through false billings. The investigation also led to the suspension of a number of health care providers.

The sweep was coordinated by the Medicare Fraud Strike Force, part of the Health Care Fraud Prevention and Enforcement Action Team. Dating back to 2009, the effort is a joint initiative between the Department of Justice and the Department of Health and Human Services to prevent and deter fraud. Since the Medicare Fraud Strike Force’s inception, more than 2,300 defendants have been charged with falsely billing Medicare for more than $7 billion.

In this most recent sweep, 16 subjects locally  — including six doctors, a social worker, a pharmacist and two physical therapists — were charged with a variety of health care fraud and kickback schemes totaling more than $122 million.

According to a release from U.S. Attorney Barbara McQuade’s office last week, the schemes allegedly involve rendering services that were medically unnecessary or not rendering service at all — including for physician visits, hospice care and home health care — and then billing for but not dispensing pharmaceuticals.

“Health care fraud has been pervasive throughout metro Detroit in recent years, at great cost to the American taxpayer,” said McQuade in the release. “We hope that cases like these will alert doctors, pharmacists and other providers that criminal investigators are now scrutinizing billing records so that we can detect fraud and hold wrongdoers accountable.”

Those charged locally in the takedown include Dr. Shahid Tahir, 45, of Bloomfield Township, and Dr. Waseem Alam, 59, of Troy. The physicians are accused of soliciting kickbacks and submitting false Medicare claims through their clinic in Bloomfield Hills, Woodward Urgent Care.

The doctors allegedly submitted claims to Medicare for unnecessary services from Livonia-based A Plus Hospice, Palliative Care, At Home Hospice and At Home Network Inc.

The scheme, McQuade’s office said, took Medicare for $58.3 million.

Also charged locally in that indictment are Muhammad Tariq, 60, of West Bloomfield, and Manaward Javed, 40, of West Bloomfield.

Dr. Gerald Daneshvar, 39, of West Bloomfield, was charged for his alleged role in a conspiracy of more than $5 million to fraudulently refer non-homebound patients to home health care services and billing for physician visits through “Mobile Doctors.”

Dr. Rizwan Qadir, 52, of Bloomfield Hills, was charged with conspiracy to commit health care fraud, allegedly paying or receiving kickbacks in a $19 million Medicare fraud scheme.

Qadir allegedly paid 52-year-old Johnny Younan, of Center Line, to bring him patients and would then bill for medically unnecessary tests and visits, and referred them for unnecessary home health care services.

Younan was also charged for his alleged role in the scheme.

Tamara Brown, 42, of Southfield, was charged for her alleged part in a $1.3 million conspiracy that involved kickbacks from two Detroit home health agencies — Cherish Home Health Services and Empirical Home Health Care — in return for providing patient referrals from a physician.

Attorneys for each of the accused were contacted by C & G staff writers. None returned requests for comment by press time except for David Griem, representing Qadir.

“Dr. Rizwan Qadir denies the government’s allegations,” said Griem in an email. “He has always treated his Medicare patients with the same dignity and high-caliber health care with which he treats all of his patients. This, despite the fact that billing Medicare is akin to trying to find a ‘safe path through a minefield.’

“Because of the government’s actions, Dr. Qadir will no longer be able to take on any new Medicare patients. His current Medicare patients will not find themselves without a doctor — he will continue to treat them, but will not charge for the medical service he renders,” Griem continued in the email. “This is Dr. Qadir’s way of demonstrating that the health and well-being of his patients far outweighs his concern over compensation for his services.”

Chief Dan Roberts, of the Franklin-Bingham Farms Police Department, wasn’t involved in the Strike Force, but as a retired former director with the FBI, he knows the priority that the bureau puts on Medicare fraud.

“(It’s because) those cases are a major crime threat,” he said. “The FBI has task forces solely dedicated to addressing this type of fraud — including in the FBI’s Detroit division — because it is such a major crime problem and the large amount of losses that occur.”

He explained that the reason  why the FBI, HHS, the IRS and other agencies all team up to bring down schemes is because there are so many complex angles to consider, from analyzing patient records and billing, to staging delicate undercover operations to identify which medical providers are cheating the system.

“It’s a huge problem, and oftentimes local law enforcement doesn’t have the expertise to address this type of sophisticated white-collar crime,” he said.

Staff Writer Cari Delamielleure-Scott contributed to this report.