Friday, September 28, 2018

Detroit Doctor Sentenced to more than 11 Years in Prison for $8.9 Million Health Care Fraud Scheme


A Detroit-area doctor was sentenced to 135 months in prison today for her role in a scheme involving approximately $8.9 million in fraudulent Medicare claims for home health care and other physician services that were procured through the payment of kickbacks, were not medically necessary, were not actually provided or, in some instances, were provided by the defendant, who was not a licensed physician during the relevant time period.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.

Millicent Traylor, M.D., 47, of Detroit, Michigan, was sentenced by U.S. District Judge Robert Cleland of the Eastern District of Michigan.  Traylor was convicted in May 2018 of one count of conspiracy to commit health care fraud, one count of conspiracy to pay and receive healthcare kickbacks, and five counts of health care fraud following a four-day trial.  Traylor’s co-defendant, Muhammad Qazi, 48, of Oakland Township, Michigan, was sentenced to serve 42 months in prison on Aug. 27, her co-defendant Christina Kimbrough, M.D., 39, of Canton, Michigan, was sentenced to serve 27 months in prison on Sept. 26, and her other co-defendant, Jacklyn Price, 34, of Shelby, Michigan, awaits sentencing.  Qazi, Price, and Kimbrough each pleaded guilty to one count of conspiracy to commit health care fraud. 

According to evidence presented at trial, from 2011 to 2016, Traylor and her co-conspirators engaged in a scheme to defraud Medicare of approximately $8.9 million through fraudulent home health and physician claims.  The evidence showed that Traylor, who was unlicensed at the time, acted as a physician for these companies, providing services that were not medically necessary and that were billed to Medicare as if they were provided by a licensed physician.  The evidence further showed that Traylor conspired to cause Medicare to be billed for services that were not rendered.  To make it appear that these services were medically necessary and actually provided, Traylor and her co-conspirators falsified medical records and signed false documents.  Additionally, the evidence at trial showed that Traylor and her co-conspirators paid and received kickbacks in exchange for referring Medicare beneficiaries to serve as patients at the clinics.  The trial evidence also revealed that Traylor fraudulently signed the names of licensed physicians on prescriptions for opioid medications, such as oxycodone, as a means of inducing patient participation in the scheme.

The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision by the Criminal Division’s Fraud Section and U.S. Attorney’s Office for Eastern District of Michigan.  Trial Attorneys Stephen Cincotta and Steve Scott of the Criminal Division’s Fraud Section are prosecuting the case.

The Criminal Division’s Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in 12 cities across the country, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.

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