August 20, 2014

Michigan Home Health Agency Owner Pleads Guilty to Participating in $22 Million Medicare Fraud Scheme

WASHINGTON—A greater Detroit-area owner of three home health agencies pleaded guilty today for his role in a $22 million home health care fraud scheme.

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, 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 and Acting Special Agent in Charge Jarod Koopman of the Internal Revenue Service—Criminal Investigation (IRS-CI) made the announcement.

According to information contained in plea documents, Muhammad Aamir, 43, of Bloomfield Hills, Michigan, admitted that, beginning in 2008 and continuing through January 2013, he conspired with others to bill Medicare for home health care services that were not actually rendered, not medically necessary, and procured through paying illegal kickbacks.

Aamir admitted that he and his conspirators at three home health agencies—Prestige Home Health Services Inc. and Platinum Home Health Services Inc., both located in Troy, Michigan, and Empirical Home Health Care Inc., located in Farmington Hills, Michigan—paid kickbacks to patient recruiters to obtain identifying information of Medicare beneficiaries and then fraudulently billed Medicare. Aamir and others fabricated and falsified medical documents reflecting or supporting purported physical therapy and other services—including home health certifications and plans of care, therapy notes, evaluations, recertifications, discharges and other records—making it appear that the services had been provided and were medically necessary, when in fact they were not. The three home health care agencies then billed Medicare for those services.

Aamir admitted that he submitted or caused the submission of false claims to Medicare, which in turn caused Medicare to pay approximately $15,118,254. According to court records, the conspiracy resulted in the submission of fraudulent claims that caused Medicare to pay more than $22 million.

Aamir pleaded guilty before U.S. District Judge Bernard A. Friedman in the Eastern District of Michigan to one count of conspiracy to commit health care fraud and one count of filing a false or fraudulent tax statement. Sentencing has been scheduled for Jan. 13, 2015.

This case was investigated by the FBI, HHS-OIG, and IRS-CI 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 Niall M. O’Donnell and James McDonald 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 1,900 defendants who have collectively billed the Medicare program for more than $6 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.

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