A health care CEO pleaded guilty today to a superseding
indictment as part of an investigation into a $300 million health care fraud
scheme that involved the distribution of over 6.6 million dosage units of
controlled substances and the administration of medically unnecessary
injections that resulted in patient harm.
Attorney General Jeff Sessions, 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 Timothy R. Slater of the FBI’s Detroit Field Office, 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 Region and Special Agent in
Charge Manny Muriel of IRS Criminal Investigation (IRS-CI) Detroit made the
announcement.
Mashiyat Rashid, 38, of West Bloomfield, Michigan, was the
CEO of the Tri-County Wellness Group of medical providers in Michigan and Ohio,
and pleaded guilty to one count of conspiracy to commit health care fraud and
wire fraud, and one count of money laundering.
In connection with his plea agreement, Rashid agreed to the entry of a
forfeiture money judgment in the amount of $51,396,917.70, as well as
forfeiture to the United States of property traceable to proceeds of the health
care fraud scheme, including over $11.5 million, commercial real estate,
residential real estate, and a Detroit Pistons season ticket membership.
“The Department of Justice has made ending the opioid crisis
a top priority and taken historic new steps to stop the spread of addiction,”
said Attorney General Sessions. “That
includes prosecuting important cases like this one. The defendant and physicians working for him
allegedly flooded the streets with some 4.2 million unnecessary doses of drugs
like oxycodone and required patients to undergo expensive and unnecessary back
injections in exchange for pills. And
while people were suffering, this corporate executive lived in luxury funded by
ill-gotten gains. Today’s guilty plea helps
us bring the defendant to justice and reduce the supply of illegal drugs flowing
into our communities. And so I want to
thank our FBI agents, our partners with HHS and IRS Criminal Investigation and
everyone else who helped investigate and prosecute this case. Opioid
prescription abuse is clearly a cause of some of the addiction we are seeing
today. Successful conclusions of important cases like this one will have a
great impact. We are not through yet. There will be more cases like this.
Ending opioid prescription abuse is achievable and we intend to end it.”
“Health Care Fraud diverts taxpayer dollars from Medicare
and lines the pockets of dishonest health care providers,” said U.S. Attorney
Schneider. “This case is particularly
troubling in that Rashid, through his clinics, made Michigan’s opioid crisis
even worse by prescribing over six million dosages of medically unnecessary
opioids to individuals who were already suffering from opioid addiction.”
“Health care fraud schemes such as these threaten the vital
trust between a patient and his or her health care provider, undermine the
integrity of our health care system, and cost all Americans billions of
dollars,” said FBI Special Agent in Charge Slater. “Americans already struggling with health
care issues and rising premiums are further burdened with each dollar lost to
fraud. To those dishonest and unethical
physicians and healthcare providers who prioritize profits over their pledge to
provide honest services to those in need, the message should be clear: that the
collective resources of local, state and federal law enforcement will expose
these schemes and will bring you to justice.”
“Ensuring the appropriate prescribing and use of controlled
substances is essential to protecting the health and safety of patients and the
Medicare program,” said HHS-OIG Special Agent in Charge Pugh. “Health care
professionals play a key role in combatting opioid misuse but some choose to
exploit patients and commit criminal acts in order to pursue financial gain and
when this happens the OIG and our law enforcement partners will be there to
hold them accountable.”
“Hippocratic Oaths and Laws are in place for a reason and in
this particular case, it’s about controlling medically unnecessary dosages and
administered injections,” said IRS-CI Special Agent in Charge Muriel. “Mashiyat Rashid and others allowed greed to drive
their moral compass, contributing to the growing opioid epidemic our nation is
facing. IRS-CI and its law enforcement
partners will painstakingly work, day in and day out, to catch these greedy
healthcare providers in efforts to keep dangerous prescriptions off the streets
of our communities.”
In connection with his guilty plea, Rashid stated that he
was the CEO of Tri-County Wellness Group, and owned, controlled and operated
numerous pain clinics, laboratories and other providers in Michigan and Ohio. As alleged in the superseding indictment,
from 2008 until their arrest in 2017, Rashid and physicians working in Rashid’s
clinics conspired to obtain patients by prescribing over 4.2 million dosage
units of medically unnecessary controlled substances, including oxycodone,
hydrocodone and oxymorphone, to Medicare beneficiaries, some of whom were
addicted to narcotics. Some of these
opioids were allegedly resold on the street.
As part of his plea, Rashid admitted that he conspired with
physicians to require Medicare beneficiaries who wished to obtain controlled
substances to submit to expensive, medically unnecessary, and painful
injections. Rashid paid physicians based
on the number of injections that Medicare paid for, regardless of the medical
necessity of the injections. In turn,
the physicians conducted these repetitive and unnecessary injections on
patients in order to increase revenue for Rashid, themselves, and their
co-conspirators. Rashid stated that the
beneficiaries included vulnerable patients, including those addicted to
opioids, who were willing to submit to unnecessary and painful injections in
order to obtain pills.
When Medicare conducted a medical review of the injection
claims, it determined that 100 percent of the claims were not eligible for
Medicare reimbursement and summarily suspended the medical billing privileges
of one of the pain clinics involved in the scheme. In order to conceal the continued billing of
these fraudulent claims to Medicare, the guilty plea states, Rashid and others
created new shell companies that they enrolled in Medicare to keep billing the
same fraudulent claims, often changing only the name of the company on the door
to the medical practice and/or inventing new suite numbers to conceal the
continuation of the fraudulent practices at the same location.
Rashid also owned a diagnostic laboratory and caused
physicians to order medically unnecessary urine drug testing from the
laboratory. When Medicare conducted a
medical review of claims submitted by the laboratory, it determined that 95
percent of the claims were not eligible for Medicare reimbursement. In order to conceal the continued billing of
these fraudulent urine drug testing claims to Medicare, the guilty plea states,
Rashid and others created a new corporate entity that they enrolled in Medicare
so that physicians could keep ordering the same fraudulent urine drug testing
claims through this new entity.
In addition, Rashid stated in his guilty plea that he paid
illegal health care kickbacks to obtain patients and solicited illegal
kickbacks and bribes for physicians to refer Medicare beneficiaries to specific
third-party home health agencies, laboratories and diagnostic providers even
though those referrals were medically unnecessary.
Further, Rashid pleaded guilty to committing money
laundering in connection with a $6.6 million wire transfer on April 13,
2016. The superseding indictment alleges
that Rashid transferred the proceeds derived from the conspiracy to live an
extravagant lifestyle and spend millions of dollars on luxury clothes from
retailers like Hermes, rare Richard Mille watches, and exotic automobiles such
as a Lamborghini and Rolls Royce Ghost; a mansion and other real estate in the
Detroit, Michigan area; and to sit courtside or in the first row of NBA
basketball games, including the NBA Finals.
Rashid; Spilios Pappas, 61, of Monclova, Ohio; Joseph Betro,
57, of Novi, Michigan; Tariq Omar, 61, of West Bloomfield, Michigan; and
Mohammed Zahoor, 51, also of Novi, were each charged in a superseding
indictment with one count of conspiracy to commit health care fraud and wire
fraud. Pappas, Betro, Omar, and Zahoor
were each additionally charged with one count of health care fraud. All of the defendants were previously charged
in an original indictment, along with Yasser Mozeb, 35, of Oakland County,
Michigan and Abdul Haq, 72, of Ypsilanti, Michigan. Mozeb and Haq have pleaded guilty, along with
12 other defendants, including seven other physicians. The case is pending before U.S. District
Judge Denise Page Hood of the Eastern District of Michigan. Trial has been scheduled to begin on Nov. 27
before Judge Hood. Rashid’s sentencing
is set for April 11.
An indictment is merely an allegation and all defendants are
presumed innocent until proven guilty beyond a reasonable doubt in a court of
law.
This case was investigated by the FBI, HHS-OIG and
IRS-CI. Trial Attorney Jacob Foster of
the Criminal Division’s Fraud Section is prosecuting the case. The financial investigation into Rashid’s
assets was conducted by a partnership between the FBI, IRS, U.S. Marshals
Service, Department of Justice’s Health Care Fraud Unit, and the U.S.
Attorney’s Office’s Forfeiture and Financial Litigation Unit. The group
conducted an extensive pre-indictment investigation and continued to support
the prosecution through today’s guilty plea.
Assistant U.S. Attorney Shankar Ramamurthy and DOJ Trial Attorney Jacob
Foster led the financial investigation.
The Fraud Section leads the Medicare Fraud Strike Force,
which is part of a joint initiative 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 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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