Industry News

Detroit Area Physician Pleads Guilty to Health Care Fraud Conspiracy in $19 Million Medicare Fraud Scheme.

The Department of Justice (DOJ) recently reported that a Michigan physician pleaded guilty to one count of conspiracy to commit health care fraud before a U.S. District Judge of the Eastern District of Michigan.  Abdul Haq, 72, of Ypsilanti, Michigan pleaded guilty for his role in a $19 million Medicare fraud scheme.  Haq admitted to conspiring with three Detroit area providers and the owner of the Tri-County Network to prescribe medically unnecessary controlled substances to Medicare beneficiaries, many of whom were already addicted to narcotics.  Further, Haq admitted to requiring beneficiaries to undergo unnecessary medical services in furtherance of the conspiracy.  Sentencing is scheduled for May of 2018.  The DOJ Criminal Division’s Fraud Section is prosecuting the case.  The Fraud Section leads the Medicare Fraud Strike Force (MFSF), which is a partnership between the U.S. Attorney’s Offices, the Federal Bureau of Investigation (FBI) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG).  The Internal Revenue Service Criminal Investigation Division was also involved in the investigation.

Key highlights surrounding the fraud scheme include the following:

  • To evade Michigan laws prohibiting non-physicians from owning medical clinics, Haq served as the straw owner of numerous pain clinics that were owned or controlled by Mashiyat Rashid, owner of the Tri-County Network.
  • As a straw owner, Haq submitted false and fraudulent enrollment materials to Medicare without the disclosure of Rashid’s ownership interest in those clinics.
  • Haq admitted to prescribing medically unnecessary controlled substances such as Oxycodone, Hydracodone and Opana to Medicare beneficiaries.
  • Haq admitted that Rashid and others directed Haq and other physicians to require Medicare beneficiaries to undergo unnecessary facet joint injections if they wished to obtain prescriptions for the controlled substances;
  • Haq admitted that he and other physicians made medically unnecessary referrals to specific third party home health agencies, laboratories, and diagnostic providers, in furtherance of the conspiracy.
  • Haq admitted that, in total, he submitted or caused the submission of approximately $19 million in false and fraudulent claims to Medicare.

Since its inception in 2007, the Medicare Fraud Strike Force (MFSF) has collectively charged over 3,500 defendants who have falsely billed Medicare for over $12.5 billion.

The DOJ News article is available at:

https://www.justice.gov/opa/pr/doctor-pleads-guilty-health-care-fraud-conspiracy-role-19-million-detroit-area-medicare-fraud.