The Medicare Fraud Strike Force working with the Department of Justice has been particularly active in Detroit and in Miami, two of the eight cities singled out for special attention by the government for fraud of the government. There seems to be some kind of special axis between Detroit and Miami perhaps reflected by the recent by the migration of Cuban emigres Caridad and Clara Guiarte, who operated a medicare fraud scheme in Miami before moving to Dearborn, Michigan when things got too hot, both literally and figuratively, in Miami. They bilked the government out of millions of dollars for providing (or not providing as the case may be) infusion therapy for treatment of the AIDS virus. Most of these schemes involve paying kickbacks to “patients” for the use of their Medicare numbers and money laundering. The sisters Guiarte were recently sentenced to 14 years in prison following their arrests in Columbia. Interesting Medicare continued to pay for a therapy that has been obsolete for a decade due to the development of new antiretroviral drugs.
Home Health care services seems to have been a particular target. Zafar Mehmoud of Ypsilanti and Detroit, apparently made off with 30 Million Dollars for medically unnecessary or non provided home health services, some of which he took with him to Pakistan. One psychotherapist was able to bill for therapy services for more than 24 hours a day, but I suppose you can do that if some of your patients are dead, which apparently a number of them were. A good case can be made that psychotherapy for the dead is medically unnecessary.
A proctologist billed $6.5 million dollars for the removal of hemorrhoids. Defendants include toe nail clipping podiatrists who up coded to partial toe nail removal. There were also DME suppliers and physician and occupational therapy providers involved. In addition to the obvious concern about the need for greater Medicare oversight before the money is spent (tax payers loose the Medicare dollars and then have to pay for the room and board of the defendants in prison), but also the apparent number of immigrants involved in the scams, just judging from the names. Here are the names of two groups of defendants charged in Detroit.
Charged were Joann McGhee, 45, of Southfield, Michigan; Tariq Mahmud, 53, of Canton, Michigan; Fatima Hassan, 43, of Dearborn, Michigan; Victor Jayasundera, 57, of Southfield, Michigan; Carol Gant, 65, of Berkley, Michigan; Vanessa Dowell, 49, of Oak Park, Michigan; Karina Hernandez, 26, of Doral, Florida; Marieva Briceno, 45, of Doral, Florida; Dora Binimelis, 57, of Miami, Florida; Jonathan Agbebiyi, 61, of Rochester Hills, Michigan; Santiago Villa-Restrepo, 33 of Doral, Florida; Juan Villa, 28, of Doral, Florida; Isaac Carr, 28, of Belleville, Michigan; Diana Brown, 50, of Farmington Hills, Michigan; Jasmine Oliver, 32, of Oak Park, Michigan; Henry Briceno, 57, of Miami, Florida; Mehran Javidan, 48, of West Bloomfield, Michigan; Vishnu Pradeep Meda, 30, of Troy, Michigan; Ram Naresh Rajulapati, 31, of Canton, Michgan; Errol Sherman, 63, of West Bloomfield, Michigan; and Surya Nallani, 43, of Troy, Michigan.
Those charged in connection with the separate schemes include:
— Gerald R. Funderburg Jr., 31, of Southfield
— Marcus Jenkins, 49, of Farmington Hills
— Elizabeth Jenkins, 47, of Farmington Hills
— Dr. Alphonso Berry, 50, of Orchard Lake
— Tausif Rahman, 36, of Canton Township
— Zahir Yousafzai, 41, of Canton Township
— Javed Rehman, 48, of Farmington Hills
— Muhammad aka "Sib" Ahmad, 33, of Ypsilanti
— Jawad Ahmad, 41, of Ypsilanti
— Dr. Dwight Smith, 58, of Detroit
— Dr. Paul Kelly, 74, of Bath Township
— Rehan Khan, 38, of Canton Township
— Nabeel Shaikh, 29, of Wixom
— Janaki Chettiar, 36, of Farmington Hills
— Jigar Patel, 27, of Madison Heights
— Anthony Parkman, 40, of Southfield
— Hetal Barot, 28, of Canton Township
— Srinivas Reddy, 35, of Bloomfield Hills