LANSING, Mich. (Michigan News Source) – The U.S. Justice Department announced on Tuesday that 23 Michiganders have been charged for their alleged involvement in two schemes to defraud Medicare of more than $61.5 million by paying kickbacks and bribes and also billing Medicare for unnecessary medical services that weren’t provided.
Assistant Attorney General Kenneth A. Polite Jr., of the Justice Department’s Criminal Division said, “As alleged, the defendants and their co-conspirators repeatedly paid illegal bribes and kickbacks so they could submit claims for medically unnecessary home health services throughout the Detroit metropolitan area, exposing patients to needless physician services and drug testing and costing Medicare tens of millions of dollars. As these actions demonstrate, we will work tirelessly to tackle complex, illegal schemes that take advantage of vulnerable populations and defraud federal programs of taxpayer dollars meant to provide health care to millions of Americans.”
In the case, United States v. Jamil, according to court documents that have been released, Walid Jamil, 62, and Jalal Jamil, 69, both of Oakland County, owned and operated several home health agencies in the Detroit metropolitan area. They allegedly concealed their ownership interest in these agencies using straw owners that included family members and other associates – and submitted approximately $50 million in fraudulent home health care claims to Medicare. Specifically, Walid and Jalal Jamil allegedly paid bribes to other co-conspirators to recruit patients in violation of the Federal Anti-Kickback Statute. These patients did not need home health care, did not qualify for home health care under Medicare rules and in many instances were not actually provided the care for which Medicare was billed.
The Jamils allegedly entered into quid pro quo relationships with physician clinics to receive necessary information to fraudulently bill Medicare. The Justice Department says they received more than $43 million from Medicare, which they misappropriated for their personal benefit.
U.S. Attorney Dawn Ison for the Eastern District of Michigan said, “The alleged actions of these defendants is an astonishing abuse of our health care system. By allegedly submitting fraudulent claims and paying illegal kickbacks, these defendants looted Medicare in order to line their own pockets at great cost to taxpayers.”
In a second case, United States v. Malas, et al., the Justice Department says that Radwan Malas operated Infinity Visiting Physician Services PLC as a home visiting physician company and allegedly ordered the physicians he employed to certify patients referred by Walid Jamil and Jalal Jamil for medically unnecessary home services, resulting in billing Medicare for services that were never actually provided to the patients and for services that were not medically necessary.
The Justice Department went on to say that, “As part of this scheme, the defendants billed Medicare over $11.5 million in fraudulent claims for which they were paid nearly $4 million, which they misappropriated for their personal benefit. Malas is also alleged to have laundered the misappropriated funds by conducting illegal financial transactions.”
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Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division said, “At the FBI, we swear an oath to protect the American people. Fraudsters look to orchestrate their schemes at the cost of our health care systems, patients and taxpayers. The FBI and our law enforcement partners remains dedicated to investigating and bringing to justice those who seek to exploit our U.S. healthcare system at the expense of its patients.”
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