Former Chief Operating Officer of MetroHealth Hospital System sentenced to more than 15 years in prison for his role in a conspiracy to defraud the hospital and others through a series of bribes and kickbacks

The former Chief Operating Officer of MetroHealth Hospital System was sentenced to more than 15 years in federal prison for his role in a conspiracy to defraud the hospital and others through a series of bribes and kickbacks totaling hundreds of thousands of dollars related to the hospital’s dental program.

Edward R. Hills, 58, of Aurora, was sentenced to 188 months in prison. Restitution will be determined at a later date.

A jury previously found Hills, Sari Alqsous, 34, of Cleveland, Yazan B. Al-Madani, 34, of Westlake, and Tariq Sayegh, 38, of Cleveland, guilty of criminal charges following a trial last year. The other three defendants are scheduled to be sentenced later this month.

“Dr. Hills violated the trust of taxpayers and the leadership of a hospital dedicated to serving the least among us,” U.S. Attorney Justin Herdman said. “Dr. Hills earned this prison sentence by putting his greed above all else, soliciting and taking cash, rent payments, plane tickets, an expensive briefcase and other items as bribes.”

"Mr. Hills will now serve his deserved sentence for defrauding our healthcare system,” FBI Special Agent in Charge Eric B. Smith said. "The investigation and subsequent prosecution of Hills and his associates revealed these individuals had engaged in a pervasive pattern of fraud, betraying the MetroHealth Hospital System, its employees, and our community.  The collective efforts of law enforcement and MetroHealth officials led to the disruption of this destructive illegal deceit. "

“Misusing their position of trust for their own personal gain and obstructing justice by telling witnesses to not to cooperate with law enforcement is what ultimately lead to the downfall of these defendants,” said William Cheung, Acting Special Agent in Charge, IRS Criminal Investigation, Cincinnati Field Office. “The success of this case is a direct result of the excellent partnership amongst IRS Criminal Investigation, the U.S. Attorney’s Office, FBI, the Ohio Bureau of Criminal Investigation, and the Ohio Office of the Inspector General.”

“These four criminals hit Ohio’s taxpayers and healthcare system right in the teeth,” said Ohio Attorney General Dave Yost. “With today’s sentence, justice struck back. I’m pleased our Bureau of Criminal Investigation could assist our law enforcement partners who investigated and prosecuted this case.”

Hills worked in various capacities at MetroHealth, including as Chief Operating Officer and Director of MetroHealth Dental. He also served as interim President and Chief Executive Officer from December 2012 through July 2013. Alqsous, Al-Madani and Sayegh are dentists who worked for MetroHealth.

According to court documents, testimony and documents presented at trial:

Hills, Alqsous and Al-Madani engaged in a racketeering conspiracy from 2008 through 2016 involving a series of elaborate bribery conspiracies, witness tampering and other crimes. These bribes include Hills soliciting cash, checks, a $3,879 Louis Vuitton briefcase, a 55-inch television, airline flights and use of a downtown apartment from Alqsous, Al-Madani and others. In return, Hills took official actions on their behalf, including allowing them to work at their private dental businesses during regular business hours while receiving a full-time salary from MetroHealth.

Alqsous, Al-Madani and others gave cash, checks and other things of value to Hills beginning in 2009. Evidence included text messages and meetings, often at expensive restaurants, which resulted in cash being deposited into Hills’ bank accounts.

Alqsous sent a text message to Al-Madani and another person in 2013 that stated: “With 22^nd of October approaching we ll be celebrating Dr hills bday earlier this year…1000 dollars each is the gift from the 3 sons their father.” Later that day, $3,000 was deposited into Hills’ bank account.

In 2012, Alqsous rented and lived in an apartment at the Perry Payne apartment building in downtown Cleveland. When he bought a residence, Hills instructed Alqsous to continue paying rent and other bills at the Perry Payne building, even though Alqsous would no longer be living there. Hills used the Perry Payne apartment to house an associate and for his own personal use in 2013 and 2014 while Alqsous, acting on Hills’ orders, continued to pay rent and other bills.

Hills instructed Alqsous to purchase furniture for the apartment for Hills’ personal use. Alqsous sent Hills a text in 2013 stating: “I bought your bedroom yesterday…there is mirrors everywhere…You will like it.”

Hills became interim President and CEO of the MetroHealth Hospital System in December 2012. Around that time, he told Alqsous, Al-Madani and others that he wanted a specific Louis Vuitton briefcase because his predecessor had a similar briefcase.

Alqsous texted a photo of the briefcase to Hills and wrote: “The guys are also very excited about their raise haha.” Hills responded with: “Thanks I’m so excited to have my bag to start my new job as #1.” Later that day, Alqsous, Al-Madani and others purchased the briefcase for $3,879 from Saks Fifth Avenue in Beachwood and later presented it to Hills.

As director of MetroHealth Dental, Hills was responsible for determining monthly bonuses for dentists who produced receipts in excess of their monthly salary and benefits. Dentists typically received a monthly bonus totaling 25 percent of the monies they generated for excess receipts.

Between 2010 and 2014, Hills regularly upwardly adjusted the bonuses of Alqsous, Al-Madani and others, by a total of approximately $92,829.

Hills also allowed Alqsous, Al-Madani and others to retain full-time salaries and benefits at MetroHealth without requiring them to work full-time hours, thus allowing them to operate private dental clinics. Hills, acting at the request of Alqsous and Al-Madani, provided MetroHealth dental residents to practice at those private clinics during regular business hours. Neither Alqsous nor Al-Madani paid wages or salaries to the resident dentists.

Additionally, Alqsous, Al-Madani and Sayegh solicited and accepted bribes totaling tens of thousands of dollars from prospective candidates to the MetroHealth Dental residency program.

In a typical year, the MetroHealth Dental residency accepted four to six candidates for the residency program from a pool of 40 to 60 applicants. Alqsous, Sayegh and Al-Madani each had the authority to influence the selection of dental residents, and Hills had final decisional authority over who was selected for the residency program.

Alqsous and Sayegh often identified and selected candidates who were from Jordan or trained at a Jordanian dental school, telling them they would have to pay a “donation” to MetroHealth to be considered. Alqsous and Sayegh directed the candidates to pay the “donation” directly to them, and in some cases, told the candidates a portion of the money would go to Hills.

Alqsous, Sayegh and Al-Madani solicited at least $75,000 in bribes from resident dentist candidate between 2008 and 2014.

In another conspiracy, Al-Madani and Alqsous paid bribes to Hills in exchange for him taking actions to refer Medicaid recipients to private dental clinics owned by Al-Madani and Alqsous instead of MetroHealth. All three took steps to conceal this activity by claiming kickback checks totaling $17,600 written to Hills were for “consultation fees” or “professional fees”.

Hills, Alqsous and Al-Madani also conspired to obstruct justice, instructing people not to cooperate with law enforcement after becoming aware of the federal investigation in 2014.

Hills also made false statements on tax returns, failing to claim approximately $165,751 in unreported income stemming from bribes, kickbacks and other things of value between 2011 and 2013.

This case was prosecuted by Assistant U.S. Attorneys Om Kakani, Michael L. Collyer and James Lewis following an investigation by the FBI, IRS-CI, Ohio Bureau of Criminal Investigation and the Ohio Office of the Inspector General.