Tampa-Area Resident Charged in Nationwide Medicare Fraud Strike Force Takedown

WASHINGTON—The Departments of Justice and Health and Human Services and the Florida Department of Law Enforcement announce today that a Tampa-area pharmacist was charged for illegal diversion of controlled substances. In an indictment unsealed today, Emmanuel Mekowulu (56, Tampa) was charged with conspiring to distribute controlled substances, primarily Oxycodone, not for a legitimate medical purpose, and outside the usual course of professional practice. Mekowulu was arrested earlier today by members of the Tampa Bay Medicare Fraud Strike Force. He faces a maximum penalty of 20 years in federal prison. The indictment also notifies Mekowulu that the United States intends to forfeit his Florida Department of Health Pharmacist License; the DEA Registration and Florida Department of Health Pharmacy License for Felky Rx, LLC, which are alleged to be property used to commit or to facilitate the commission of the offense. The United States is also seeking a money judgment in the amount of $121,350, representing the amount of proceeds that Mekowulu obtained as a result of the conduct charged in the indictment. Assistant United States Attorney Kathy J.M. Peluso is prosecuting the case.

In addition to the arrest of Mekowulu, agents of the Tampa Bay Strike Force also executed search warrants at four businesses in the Tampa Bay area today. These law enforcement efforts in Tampa are part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities. The national effort is linked to charges against 107 individuals for their alleged participation in schemes to collectively submit more than $452 million in fraudulent claims to Medicare.

“Any time false claims are submitted for payment, our nation’s health insurance programs and beneficiaries suffer,” said Christopher Dennis, Special Agent in Charge of the federal Health and Human Services Department, Office of Inspector General’s region covering Florida. Today’s arrest brings a successful conclusion to a lengthy health care fraud/prescription drug diversion investigation involving exceptional partnerships between federal, state, and local law enforcement.”

“Individuals involved in health care fraud activities steal vital resources from those citizens who truly need them. The FBI and our local law enforcement partners continue to increase our investigative efforts and rely on the public’s support in combating this crime problem,” said Special Agent in Charge Steven E. Ibison, FBI Tampa Field Office.

“FDLE is committed to ending the illegal distribution of prescription drugs,” said Commissioner Gerald Bailey. “We will continue to work with our law enforcement partners to investigate and arrest those who represent a danger to Florida.”

Last week two arrests were made as a result of investigations generated by the Tampa Bay Strike Force. Luis Duluc (51, formerly of Weston, Florida), and Margarita Grishkoff (57, Charlotte, North Carolina) were charged with health care fraud-related violations. According to the 30-count indictment, Duluc and Grishkoff utilized multiple physical therapy clinics to fraudulently bill Medicare for services not rendered to any Medicare beneficiaries. During the time frame of the conspiracy, through their holding company, Duluc and Grishkoff allegedly purchased three physical therapy clinics in the Middle District of Florida. These clinics were used by Duluc and Grishkoff to fraudulently bill Medicare. The indictment alleges that, as a result of the health care fraud scheme, Medicare paid out approximately $8,152,262.14 for services not rendered. Assistant United States Attorney Simon Gaugush is prosecuting the case.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The results of today’s nationwide takedown were announced earlier today by Attorney General Eric Holder, HHS Secretary Kathleen Sebelius, Assistant Attorney General Lanny A. Breuer, FBI Deputy Director Sean Joyce, HHS Deputy Inspector General Gary Cantrell, and Deputy Administrator for Program Integrity of the Centers for Medicare and Medicaid Services (CMS) Dr. Peter Budetti.

An indictment is merely a charge and defendants are presumed innocent until proven guilty.

To learn more about HEAT, go to: www.stopmedicarefraud.gov.

Doctor Charged with Conspiring to Distribute Controlled Substances

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; Pam Bondi, Florida Attorney General, Medicaid Fraud Control Unit (MFCU), West Palm Beach Bureau; William J. Maddalena, Acting Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Office of Investigations; John F. Khin, Special Agent in Charge, Defense Criminal Investigative Service (DCIS); and the Greater Palm Beach Health Care Fraud Task Force, announced the arrest of Dr. Selwyn Carrington, a 57-year-old physician living in Miami, Florida.

The criminal complaint charges the defendant, Dr. Carrington with conspiring to dispense and distribute and to cause the dispensing and distribution of controlled substances through medical clinics in Hallandale and West Palm Beach, Florida, in violation of Title 21, United States Code, Sections 846 and 841(a)(1). If convicted, Dr. Carrington faces a maximum statutory sentence of 20 years. Selwyn Carrington is a licensed physician in the State of Florida. Carrington’s primary practice is at

1613 North Hiatus Road, Pembroke Pines, Florida

.

According to the complaint and corresponding affidavit, Dr. Carrington served as the medical director of Primary Care Primary Care Practitioners, a family medical practice owned by two advanced registered nurse practitioners (ARNPs). Primary care practitioners operates clinics in Hallandale and West Palm Beach, Florida.

According to court documents, the investigation revealed that Dr. Carrington did not treat or evaluate any clients at the clinics and he was not at the clinics during their normal business hours. The investigation revealed that, in exchange for $5,000 per month, Dr. Carrington went to the clinics approximately once per week to sign progress notes for patients that had been previously seen by the ARNPs and to pre-sign blank prescriptions so that the ARNPs and other employees, who have no medical licenses, could illegally prescribe controlled substances to their clients. According to the charging documents, Percocet, Oxycodone, and Xanax were all illegally prescribed in this manner.

An analysis of the payments made by Florida Medicaid for the time period from March 2005 through January 2011 indicated that over 300,000 pills containing controlled substances were dispensed to Primary Care Practitioner’s clients due to the prescriptions pre-signed by Dr. Carrington. The Florida Medicaid Program paid for these pills. The 300,000 pill total includes 150,000 pills containing Schedule II control substances. Schedule II controlled substances, such as Oxycodone, have a high level of abuse or misuse and so their use is severely restricted in the United States.

Mr. Ferrer commended the investigative efforts of the MFCU, the FBI, HHS OIG, DCIS, and the Greater Palm Beach Health Care Fraud Task Force. The case is being prosecuted by Assistant U.S. Attorney Stephanie Evans.

Connersville Woman Sentenced for Medicaid Fraud

INDIANAPOLIS—Joseph H. Hogsett, United States Attorney, announced today that Andrea R. Williams, 23, Connersville, Ind., was sentenced to two years’ probation today by U.S. District Judge William T. Lawrence, for health care fraud following a six month investigation by the Department of Health and Human Services, Office of Inspector General, Federal Bureau of Investigation and Indiana Attorney General Greg Zoeller’s Medicaid Fraud Control Unit.

From January 2008, and continuing through May 20, 2010, Andrea Williams, the billing manager of Handy Van Medical Transportation (HVM), used her position at the company to carry out a scheme to defraud the Indiana Medicaid Program.

HVM is a company operating in the Connersville, Ind., area which transports Indiana Medicaid beneficiaries to medical appointments. Williams, as the billing manager, submitted claims for payment to Indiana Medicaid falsely indicating that HVM was providing all of its services to wheelchair bound patients, thereby causing Indiana Medicaid to pay at higher rate. Williams further represented that most patients required an additional attendant to help transport these patients which was also false.

Law enforcement executed a search warrant at the premises of HVM on May 20, 2010. During this search, Williams confessed to the above scheme. As a result of her actions, Indiana Medicaid lost $102.012.02.

"The detection of fraud in Medicare and Medicaid is the priority of the Office of Inspector General." said Lamont Pugh III, Special Agent in Charge of the Chicago Region for the U.S. Department of Health and Human Services, Office of Inspector General. "Working with our federal and state partners we will continue to defend the interests of patients and taxpayers and hold those who attack these programs accountable."

"Medicaid fraud is an offense against all taxpayers. When a wheelchair van provider fraudulently over-bills Medicaid for their own selfish ends, it diverts Medicaid dollars that are needed elsewhere to pay for other patients. The Indiana Attorney General's Office and Indiana Medicaid Fraud Control Unit work collaboratively with our federal counterparts to detect over-billing and to hold accountable the fraudsters to reimburse the public treasury," Indiana Attorney General Greg Zoeller said.

According to Assistant U.S. Attorney Bradley P. Shepard, who prosecuted the case for the government, Judge Lawrence ordered Williams to make restitution in the amount of $102.012.02.

Houston Doctor Sentenced to 41 Months in Prison for Role in Medicare Fraud Scheme

Medical Equipment Company Manager and Delivery Driver Also Sentenced to Prison for Roles in Fraud Scheme

WASHINGTON – Houston-area residents Dr. Howard Grant, Obisike Nwankwo and John Lachman were sentenced today to 41 months in prison, 21 months in prison, and 26 months in prison, respectively, for their roles in a multi-million dollar durable medical equipment (DME) Medicare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced today.

In addition to the prison terms, U.S. District Court Judge Nancy Atlas in the Southern District of Texas sentenced Grant, Nwankwo and Lachman each to three years of supervised release. Grant was ordered to pay $121,742 in restitution jointly and severally with co-defendants.  Nwankwo was ordered to pay $29,052 in restitution jointly and severally with co-defendants. Lachman was ordered to pay $1.14 million in restitution jointly and severally with co-defendants. 

Grant and Nwankwo were both convicted by a federal jury after a two-week trial in the Southern District of Texas in May and June 2010. Grant was convicted of two counts of health care fraud and one count of conspiracy to commit health care fraud and Nwankwo was convicted of one count of conspiracy to commit health care fraud .  Lachman pleaded guilty prior to the trial to one count of conspiracy to commit health care fraud.

Evidence at trial established that Onward Medical Supply, a Houston-area DME company, billed Medicare for fraudulent DME, including power wheelchairs and orthotic devices, beginning in 2003 and continuing until late 2009.  In addition to the three co-conspirators sentenced today, one additional individual was convicted at trial, and seven individuals have pleaded guilty for their participation in various parts of Onward’s Medicare fraud scheme, including Onward’s owner, Doris Vinitski.

According to evidence presented at trial, Vinitski worked with Medicare biller and co-defendant John Nasky Okonkwo and others in late 2008 and early 2009 to submit fraudulent claims to Medicare identifying Dr. Howard Grant as the prescribing physician for the DME.  The claims were submitted in several groups in November 2008.  Evidence presented at trial showed that Grant learned about the fraudulent prescriptions prior to Onward’s submission of the claims to Medicare.  Evidence at trial also showed that, upon learning of the prescriptions, Grant asked Vinitski for $10,000 in exchange for allowing the fraud scheme to continue.  Okonkwo agreed to plead guilty for his participation in the scheme. Following the verdict, U.S. District Court Judge Nancy Atlas ordered Grant to surrender his medical license and his Drug Enforcement Administration (DEA) number and to stop all billing to Medicare and Medicaid.

Evidence at trial established that Nwankwo acted as a delivery driver for Onward and several other DME companies and that he delivered DME such as power wheelchairs and orthotics for Onward to beneficiaries who did not want or need the equipment.  One beneficiary testified at trial that when Nwankwo tried to deliver a power wheelchair to her, she told him to get off her front step or she would call the police.

Lachman managed the Onward fraud scheme in the early years, until the end of 2006. During that time, he created fraudulent patient files, managed payments of kickbacks to recruiters and delivery drivers, and operated the day-to-day business of Onward.

The sentences were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney José Angel Moreno of the Southern District of Texas; Richard C. Powers, Special Agent-in-Charge of the FBI’s Houston office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of the HHS Office of Inspector General (OIG), Office of Investigations; and Texas Attorney General Greg Abbott on behalf of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).

The cases were prosecuted by Trial Attorneys Jennifer L. Saulino, O. Benton Curtis III and Nicola J. Mrazek of the Criminal Division’s Fraud Section. The cases were investigated by the FBI, HHS-OIG and MFCU.

The cases were brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section. Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 850 individuals who collectively have falsely billed the Medicare program for more than $2.1 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

Medicare Fraud

Clinic Manager and Patient Recruiter Plead Guilty to Roles in $2 Million Medicare Fraud Scheme Beneficiaries Paid to Fake Symptoms to Justify Medicare Billing


WASHINGTON—Detroit-area residents Carlos Grana and Dwight Armstrong pleaded guilty today to engaging in a fraudulent medical testing scheme, announced the Departments of Justice and Health and Human Services (HHS).

Grana, 36, and Armstrong, 32, each pleaded guilty today to one count of conspiracy to commit health care fraud before U.S. District Court Judge Lawrence P. Zatkoff in the Eastern District of Michigan. At sentencing, scheduled for July 13, 2010, each defendant faces a maximum penalty of 10 years in prison and a $250,000 fine. Grana and Armstrong were indicted in December 2009, along with Price Marshall, who pleaded guilty on Feb. 23, 2010, for his role in the scheme.

According to the plea documents, Grana managed the day-to-day operations of Careplus LLC, a medical clinic in Livonia, Mich. Grana admitted he that while he managed Careplus, he paid patient recruiters for Medicare beneficiary referrals. According to court documents, the recruiters were expected to find and transport Medicare beneficiaries to Careplus. Grana admitted he paid the recruiters between $100 and $150 per patient referral, and instructed the recruiters to pay the patients $50 from that amount. According to court documents, nearly all of the patients treated at Careplus were secured through the payment of kickbacks.

Grana also admitted that in exchange for the payments, he and his co-conspirators expected the Medicare beneficiaries who received kickbacks to subject themselves to a medical examination and to medically unnecessary tests. Grana told the recruiters to instruct the patients to feign certain symptoms when they arrived at Careplus, which ultimately led to the patients’ medical records containing information about false symptoms. The falsified records then helped Careplus deceive Medicare about the legitimacy and medical necessity of the tests it performed. Between approximately February 2008 and October 2009, Grana and his co-conspirators at Careplus submitted approximately $2.2 million in claims to the Medicare program for unnecessary medical and testing services that were procured through the payment of kickbacks. Medicare paid approximately $2 million of those claims.

According to the plea documents, Armstrong was one of the patient recruiters for Careplus. Armstrong admitted that beginning in approximately June 2008 he began recruiting patients for the owners and/or operators of Careplus and that he paid kickbacks to the Medicare beneficiaries he recruited and later transported to Careplus using money provided by the owners/operators. Armstrong admitted he kept part of the funds he received as a kickback for referring the Medicare beneficiaries he recruited. According to court documents, the owners and operators of Careplus typically paid $100-$150 per patient Armstrong recruited, with Armstrong retaining $50-$75 of that amount as a kickback for the referral.

Armstrong admitted he instructed the beneficiaries he recruited, based on instructions from the owners and operators of Careplus, to claim they had certain symptoms to trigger medically unnecessary tests. The patients Armstrong recruited generated approximately 12 percent of the total amount fraudulently billed by Careplus to the Medicare program, or approximately $342,000 in claims. Medicare paid approximately $250,000 on those claims.

Today’s result was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

The case was prosecuted by Senior Trial Attorney John K. Neal and Trial Attorney Gejaa T. Gobena of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 500 individuals who collectively have falsely billed the Medicare program for approximately $1.1 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: http://www.stopmedicarefraud.gov/.

Medicare Fraud

Palmetto Physician Pleads Guilty to Illegal Prescription Drug and Medicare Fraud Conspiracies


March 19, 2010 - TAMPA, FL—United States Attorney A. Brian Albritton announces that Dr. Jeffrey Friedlander (age 50, of Palmetto) today pleaded guilty to conspiring to distribute and dispense numerous controlled substances--Oxycodone, Morphine, Hydrocodone, and Alprazolam--and also to conspiring to defraud Medicare. Friedlander faces a maximum penalty of twenty years in federal prison for the drug conspiracy and ten years for the fraud conspiracy.

According to the plea agreement, Friedlander was licensed to practice Internal Medicine, Neurology, Pain Management, and Vascular and Interventional Radiology in Florida. He practiced primarily out of a medical business known as "Neurology and Pain Center" (NPC), with clinics in Tampa, Sarasota, Lakeland, St. Petersburg, Jacksonville, and Orlando. Friedlander also was a participating physician in Medicare. He submitted claims for reimbursement for his services under Medicare Part B and wrote prescriptions for controlled substances for Medicare patients that were filled under Medicare Part D.

While operating the NPC, Freidlander allowed unauthorized and non-medical employees to prescribe controlled substances to patients by using blank prescription forms that he pre-signed. Prescriptions were issued without conducting adequate physical

exams, making proper diagnoses, or considering alternative treatment options, and often

with the knowledge that the patients receiving the controlled substances were misusing or abusing them, asking for drugs to support their own addictions, or sharing or giving the controlled substances away to others. Undercover detectives with the Hillsborough County Sheriff's Office were able to obtain prescriptions for controlled substances at NPC clinics on numerous occasions in 2008 and 2009 with little or no contact with Friedlander, no meaningful physical examination, no verification of their medical complaints, no diagnostic tests, no discussion of alternate treatment methods, no assessment of risk of abuse, no referrals for physical therapy or other alternative treatments, and no discussion of a treatment plan. Often, the detectives simply asked for particular types of drugs and were given prescriptions for those drugs, with no medical basis and even after making clear that they had shared or intended to share the drugs with others.

The plea agreement also states that, between 2005 and March 2009, Friedlander submitted false claims to Medicare for performing Paravertebral Facet Joint Block Injections, when such injections had not been performed or had been performed improperly, and when some of the injections had been performed by unlicensed nonmedical persons outside Friedlander's supervision. Friedlander also submitted false claims to Medicare for office visits coded at the highest degree of complication and requiring detailed involvement by the treating physician, when, in reality, unlicensed, non-medical persons had performed limited office visits outside of Friedlander's supervision. Friedlander entered false information in patient files to support the false Medicare claims.

As part of the plea agreement, Friedlander has agreed to forfeit all assets and properties obtained and utilized during the conspiracies, including but not limited to his

DEA Controlled Substance Registrations, his Florida Medical License, and a money judgment in the amount of $317,047.13--the gross proceeds traceable to Friedlander's Medicare Fraud conspiracy.

This case was investigated by the United States Department of Health & Human Services, Office of Inspector General; the United States Marshals Service; the Federal Bureau of Investigation; the Florida Department of Law Enforcement; the Florida Department of Health; the Florida Office of the Attorney General Medicaid Fraud Control Unit; the Florida Division of Fraud; and the Hillsborough County Sheriff’s Office.

It is being prosecuted by Assistant United States Attorneys Kathy J.M. Peluso and Josie Thomas.

Medicare Fraud

Detroit-Area Doctor Convicted in Medicare Fraud Scheme


March 12, 2010 - WASHINGTON—Farmington Hills, Mich., physician Jose Castro-Ramirez was convicted today by a Detroit federal jury on all 13 charged counts in connection with his role in an $18.3 million Medicare fraud scheme, announced Assistant Attorney General Lanny Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; 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.

After a three-week trial, the jury convicted Castro-Ramirez of one count of conspiracy to commit health care fraud, 11 substantive counts of health care fraud, and one count of conspiracy to launder the proceeds of the fraudulent scheme.

Evidence at trial established that beginning in late 2003, the defendant, a physician licensed in the state of Michigan, entered into an agreement with co-conspirator Suresh Chand to defraud the Medicare program. Chand owned and controlled several companies operating in Warren, Mich., including Continental Rehab Services Inc. (CRS) and Pacific Management Services Inc. (PM), which purported to provide physical and occupational therapy services to Medicare beneficiaries. In reality, as the evidence showed, Chand and his associates at CRS and PM created fictitious therapy files, appearing to document physical and occupational therapy services provided to Medicare beneficiaries, when in fact no such services had taken place. The fictitious services reflected in the files were billed to Medicare through sham Medicare providers controlled by Chand and his co-conspirators.

Evidence introduced at trial established that in order to create the fictitious files, Chand and his co-conspirators paid cash kickbacks and other inducements to Medicare beneficiaries, in exchange for the beneficiaries’ Medicare numbers and signatures on documents falsely indicating that they had received therapy services. Evidence also showed that Chand paid licensed physical and occupational therapists to sign fictitious “progress notes” and other documents that appeared to reflect that physical and occupational therapy services had been provided to the beneficiaries, when in fact they had not. Castro-Ramirez signed therapy prescriptions and other documents in the files falsely indicating that he had evaluated the Medicare beneficiaries and certified the need for physical and occupational therapy services. In fact, the evidence at trial established that Castro-Ramirez had not overseen any treatment provided to the patients and was fully aware that his signatures were part of a fraudulent scheme. According to evidence presented at trial, in many instances Castro-Ramirez had never seen the beneficiaries.

One of the inducements that Chand and his co-conspirators used to recruit Medicare beneficiaries into the scheme was the provision of prescriptions for controlled substances and other drugs, including Vicodin and Xanax. Evidence presented at trial showed that Chand provided Castro-Ramirez with lists of the controlled substances or drugs the beneficiaries preferred, and that Castro-Ramirez wrote prescriptions for the substances without ever seeing the patients. The evidence established that between January 2003 and March 2007, Castro-Ramirez wrote thousands of prescriptions for a variety of drugs for patients that he had never seen. The evidence also showed that Castro-Ramirez was fully aware that the purpose of the prescriptions was to induce beneficiaries into the scheme.

Evidence introduced at trial demonstrated that Castro-Ramirez profited from his participation in the scheme in several ways. Castro-Ramirez’s largest source of fraudulent proceeds came from his own billings to Medicare for “home visits” that he purportedly made to Medicare beneficiaries whom Chand recruited into the scheme. In fact, Castro-Ramirez never conducted “home visits” with the vast majority of these patients, and never discussed or ordered therapy services for the few he did see. The evidence showed that Chand and other co-conspirators also distributed proceeds of the fraud directly to Castro-Ramirez on occasion, and did so through transactions designed to disguise the nature, source, ownership, control and location of the tainted funds. The evidence showed that Castro-Ramirez knew that the cash and checks he received from Chand were structured so as to conceal the fact that they were proceeds of Medicare fraud.

Between approximately January 2003 and June 2007, Chand and his co-conspirators submitted claims to the Medicare program totaling $18,379,300 for physical and occupational therapy services that were supposedly ordered and supervised by Castro-Ramirez, but were in fact never rendered. Medicare paid $8,562,688 on those claims. In addition, Castro-Ramirez submitted approximately $1.4 million in claims to the Medicare program for “home visits” supposedly provided to beneficiaries recruited into the scheme by Chand and his co-conspirators. Medicare paid approximately $929,000 on those claims.

Chand pleaded guilty on Sept. 28, 2009, before U.S. District Judge Sean F. Cox to one count of conspiracy to commit health care fraud and one count of conspiracy to launder money.

At sentencing, scheduled for June 29, 2010, Castro-Ramirez faces a maximum penalty of 10 years in prison and a $250,000 fine on the health care fraud conspiracy and substantive health care fraud counts. He faces a maximum penalty of 20 years in prison and a $250,000 fine on the money laundering conspiracy count.

The case was prosecuted by Senior Trial Attorney John K. Neal of the Criminal Division’s Fraud Section and Special Assistant U.S. Attorney Thomas W. Beimers of the U.S. Attorney’s Office for the Eastern District of Michigan. The case was investigated by the FBI and HHS-OIG. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 500 individuals who collectively have falsely billed the Medicare program for more than $1 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.