DETROIT – Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division announced Friday a health care fraud law enforcement action in Detroit, Chicago and Minnesota.
Charges were filed against 20 individuals in the Eastern District of Michigan for their alleged involvement in Medicare fraud schemes resulting in $144.8 million in illegitimate billings.
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In the Northern District of Illinois, charges were filed against 12 individuals for their alleged involvement in Medicare fraud schemes resulting in over $103 million in illegitimate billings.
Of those charged in the two federal districts, seven were doctors or licensed medical professionals. In addition, in the state of Minnesota, 21 defendants, including two licensed medical professionals, have been charged with defrauding Medicaid for almost $3 million. Minnesota’s Medicaid Fraud Control Unit (MFCU) investigated these cases.
The charges announced Friday aggressively target schemes billing Medicare, Medicaid and private insurance companies for medically unnecessary procedures, medical procedures that were never provided and prescription medications that often were never purchased and/or distributed to beneficiaries.
“Health care fraud robs taxpaying Americans and corrupts the relationship between doctors and patients,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “Today’s actions in the Midwest are further proof of the Department’s steadfast commitment to investigating and prosecuting those who put their personal greed above the public good.”
Here is a list of Michigan residents who were charged:
Regina Black, 50, of Shelby Township, owner of Rehabilitative Counseling and Behavior Services of America of Clinton Township, Michigan, was charged in an indictment filed Sept. 17 and unsealed today with five counts of health care fraud and three counts of wire fraud. The charges stem from Black’s alleged role in a $4.9 million health care fraud scheme, in which she advertised and offered services, such as dancing, field trips and other social activities for Medicare enrollees at senior residential buildings. Using the enrollees’ Medicare numbers, Black allegedly caused Medicare to be billed for individual and group psychotherapy services that were not medically necessary, not rendered and/or not otherwise eligible for reimbursement through Medicare. The FBI and HHS-OIG investigated the case. Trial Attorneys Steven Scott and Claire Sobczak of the Fraud Section are prosecuting the case.
Robert Cornfield, D.P.M., 55, of Rochester, a podiatrist and owner of Robert H. Cornfield, DPM PC of Rochester, Michigan, was charged in an indictment filed Sept. 17 and unsealed today with five counts of health care fraud. The charges stem from Cornfield’s alleged role in a $1.7 million health care fraud scheme in which Cornfield submitted or caused the submission of claims to Medicare for podiatric services he never provided. Specifically, Cornfield allegedly defrauded Medicare by submitting claims for nail avulsions without actually performing the service. From January 2010 through July 2019, Cornfield allegedly billed Medicare for more than 17,000 nail avulsion procedures, ranking him among the highest in the country for that procedure. The FBI and HHS-OIG investigated the case. Trial Attorneys Steven Scott and Jay McCormack of the Fraud Section are prosecuting the case.
Anthony Weinert, D.P.M., 48, of Oakland, owner of Anthony Weinert DPM P.C. in Warren, Michigan, and Troy Surgicare in Troy, Michigan, was charged in an indictment filed Sept. 24 and unsealed yesterday with eight counts of health care fraud. The charges stem from Weinert’s alleged role in a $1.7 million health care fraud scheme, in which Weinert submitted or caused the submission of claims to Medicare for podiatric services he did not provide. Specifically, Weinert allegedly defrauded Medicare by submitting claims for nail avulsions, capsulotomies and mass removals without actually providing the services. The FBI and HHS-OIG investigated the case. Trial Attorneys Jay McCormack and Steven Scott of the Fraud Section are prosecuting the case.
Christopher Fratine, 52, of West Branch, owner of Unity Home Health Care LLC of West Branch, Michigan, was charged in an indictment filed Sept. 26 with nine counts of health care fraud and three counts of wire fraud. The charges stem from Fratine’s alleged role in an $18.2 million home health care fraud scheme in which he submitted or caused the submission of claims for home health episodes that were not provided. The FBI, HHS-OIG, and Michigan State Police investigated the case. Trial Attorney Steven Scott of the Fraud Section is prosecuting the case.
Sharon King, 66, of Bloomfield Hills, was charged in a superseding indictment filed Sept. 19 and unsealed today with three counts of conspiracy to pay and receive health care kickbacks. One of the counts alleges that King engaged in these acts while on supervised release. These charges come in addition to her original charge for conspiracy to commit health care fraud, which was originally filed in June 2018 and which remains pending. The charges stem from King’s alleged role in a scheme to fraudulently bill Medicare in excess of $2.5 million for physician and home health services that were medically unnecessary, never provided and induced by kickbacks. As part of the scheme, King allegedly provided kickbacks, including prescriptions for controlled substances, to Medicare beneficiaries who agreed to accept physician services from Thomas Mays, M.D. and referrals for home health services provided by Personal Touch, Inij Home Healthcare and other home health agencies. These purported home health and physician services were allegedly often medically unnecessary, not actually provided and/or induced by health care kickbacks. The FBI and HHS-OIG investigated the case. Trial Attorney Jay McCormack is prosecuting the case, which Trial Attorney Tom Tynan of the Fraud Section initially handled.
Farzana Haris, 59, of Canton, owner and operator of Inij Home Health Care, was charged in an information filed Sept. 26 with one count of conspiracy to commit health care fraud. The charge stems from Haris’ alleged role in a scheme with co-conspirators Sharon King and Dr. Thomas Mays, M.D. to fraudulently bill Medicare approximately $1.1 million for home health services that were medically unnecessary, never provided and induced by kickbacks. The FBI and HHS-OIG investigated the case. Trial Attorney Jay McCormack is prosecuting the case, which Trial Attorney Tom Tynan initially handled.
Charles Hobson Sr., 78 of Southfield, co-owner and operator of Personal Touch Home Health Care, and Charles Hobson, Jr., 50, of Lathrup Village, Michigan, co-owner and operator of Personal Touch Home Health Care were charged in an information filed Aug. 23 with one count of conspiracy to pay and receive kickbacks and bribes in connection with a federal health care program. The charge stems from the Hobsons’ alleged role in a scheme with co-conspirator Sharon King, in which the Hobsons paid kickbacks to King and other patient recruiters in exchange for recruiting Medicare beneficiaries to Personal Touch. The FBI and HHS-OIG investigated the case. Trial Attorney Jay McCormack is prosecuting the case, which Trial Attorney Tom Tynan initially handled.
Mohamed Gomaa, 28, of Dearborn Heights, a licensed pharmacist and owner of MedlifeRx Pharmacy of Auburn Hills, Michigan, was charged in an indictment filed Sept. 26 with four counts of mail fraud. The charges stem from Gomaa’s alleged role in a $3.48 million scheme that dispensed expensive and medically unnecessary medications, using forged or fraudulent prescriptions, and sent them by mail to Medicare, Medicaid, BCBS and other private insurance beneficiaries who did not want or need them. Gomaa then allegedly billed Medicare and the other various insurance programs and insurers for the high-cost drugs. The FBI and HHS-OIG investigated the case. Trial Attorney Patrick Suter of the Fraud Section is prosecuting the case.
Yogesh Pancholi, 40, of Northville, owner of Shring Home Health Care (Shring) of Livonia, Michigan, was charged in an indictment filed Sept. 24 and unsealed yesterday with one count of conspiracy to commit health care fraud and wire fraud, two counts of health care fraud and two counts of money laundering. The charges stem from Pancholi’s alleged role in a $2.8 million home health “bust out” scheme for the submission of request for advance payments or RAPs. Pancholi allegedly submitted RAP claims through Shring for services not prescribed or rendered to Medicare. The FBI and HHS-OIG investigated the case. Trial Attorney Patrick Suter is prosecuting the case.
Kenneth Mitchell, D.P.M., 57, of Southfield, a licensed podiatrist and minority owner of Urban Health Care Group LLC of Southfield, Michigan, was charged in a superseding indictment filed Sept. 17 and unsealed yesterday with one count of falsification of records in a federal investigation. These charges come in addition to Mitchell’s original charges filed Sept. 17 consisting of one count of conspiracy to commit health care fraud and wire fraud and three counts of health care fraud. The charges stem from Mitchell’s alleged role in a $1.8 million scheme by which he and co-conspirators submitted false and fraudulent claims for medically unnecessary podiatry and other services on behalf of Urban Health Care Group LLC. HHS-OIG investigated the case. Trial Attorney Patrick Suter of the Fraud Section is prosecuting the case.