September 30, 2014

Detroit-Area Doctor and Three Others Indicted for Their Alleged Roles in $7 Million Health Care Fraud

WASHINGTON—Four defendants, including a Detroit-area physician, were charged in a superseding indictment with a $7 million health care fraud conspiracy. Fifteen defendants have now been charged in this case, including seven who have pleaded guilty for their conduct.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul Abbate 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 (HHS-OIG) Chicago Regional Office made the announcement.

The eight-count superseding indictment, unsealed today, charges defendants Dr. Kutub Mesiwala, 63, of Bloomfield Hills, Michigan, Jaweed Mohammed, 34, of Orland Park, Illinois, Mohammad Zubair Khan, 27, of West Bloomfield, Michigan, and Tousif Khan, 42, of Ypsilanti, Michigan, in connection with Medicare fraud involving unnecessary home health care and therapy services.

According to allegations in the indictment, Advance Home Health Care Services Inc. (Advance Home Health) and Perfect Home Health Care LLP (Perfect Home Health) purported to provide home health care and physical therapy services to eligible Medicare beneficiaries in the Detroit metropolitan area.

Dr. Mesiwala allegedly received kickbacks to refer Medicare beneficiaries to Advance Home Health and to falsely certify that the beneficiaries required home health care. Patient recruiters and office staff, including Tousif Khan, allegedly paid cash kickbacks to Medicare beneficiaries in exchange for their signing blank physical therapy records. Jaweed Mohammed, Mohammed Zubair Khan, and other co-conspirators then allegedly used those pre-signed blank physical therapy records to fabricate patient records for Advance Home Health and Perfect Home Health. Those records were used to support claims to Medicare when, in fact, no services were rendered.

The superseding indictment charges all four defendants with conspiracy to commit health care fraud, and charges Dr. Mesiwala and Tousif Khan with conspiracy to pay or receive health care kickbacks. It also charges Mohammad Zubair Khan, Jaweed Mohammed, and Tousif Khan with destruction of documents with the intent to obstruct the investigation. Additionally, Dr. Mesiwala was charged with two counts of health care fraud in relation to claims for reimbursement submitted to Medicare for visiting physician services that he purportedly rendered to patients in their Michigan homes while he was allegedly out of the country.

Between February 2009 and November 2013, Medicare paid Advance Home Health and Perfect Home Health more than $7 million as a result of these allegedly false and fraudulent claims. Fifteen defendants have been charged with participating in the health care fraud and kickback conspiracies, and seven of those defendants have entered guilty pleas. One of those defendants, Dr. Adelina Herrero, was sentenced by U.S. District Judge Paul D. Borman of the Eastern District of Michigan on Aug. 18, 2014, to three years in prison and ordered to pay $1,321,372 in restitution.

An indictment is merely an allegation, and the defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. This case is being prosecuted by Trial Attorneys Patrick J. Hurford and Katharine A. Wagner and Special Trial Attorney Katie R. Fink of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare & 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 Team (HEAT), go to: