Forty-Four Individuals Indicted in Health Care Fraud and Drug Distribution Scheme
Seven Doctors, Four Pharmacists, Three Home Health Agency Owners Among Those Indicted
|U.S. Attorney’s Office March 20, 2013|
Forty-four individuals have been charged in a health care fraud and drug distribution scheme, U.S. Attorney Barbara L. McQuade announced today.
McQuade was joined in the announcement by Special Agent in Charge Robert L. Corso of the Drug Enforcement Administration; Special Agent in Charge Robert D. Foley, III of the Federal Bureau of Investigation; Acting Special Agent in Charge Gilbert Salinas of the Bureau of Alcohol, Tobacco, Firearms, and Explosives; Lamont Pugh, Special Agent in Charge of the Inspector General of the Department of Health and Human Services; Acting Special Agent in Charge William Hayes of U.S. Immigration and Customs Enforcement’s Homeland Security Investigations; Special Agent in Charge Erick Martinez of the Internal Revenue Service, Criminal Investigation; Detroit Police Chief Chester Logan; and Portsmouth, Ohio Police Chief Robert Ware, II.
The 13-count superseding indictment charges 44 new defendants with a drug conspiracy involving prescription drug controlled substances such as Oxycontin, Opana, Vicodin, and other drugs. Health care fraud charges were filed against 32 of the defendants, while three defendants were charged with money laundering and three defendants were charged with being felons in possession of firearms.
The superseding indictment alleges that Sardar Ashrafkhan, Deepak Kumar, John Check, and David Vezzossi, owners of home health agencies, would provide kickbacks, bribes, and other illegal benefits to physicians to induce them to write prescriptions for patients with Medicare, Medicaid, and private insurance. Patients were recruited into the scheme by patient recruiters or “marketers,” who would pay kickbacks and bribes to patients in exchange for the patients’ permitting the pharmacies and physicians to bill their insurance for medications and services that were medically unnecessary and/or never provided. During this conspiracy, prescriptions were presented to the Sav-Max (pharmacist Ahab Elmadhoun), Sav-Mart (pharmacist Waleed Yaghmour), Atrium (pharmacist Krina Patel and manager Sanjay Patel), or Caremax (pharmacist Jayshriben Gandhi and manager Guarang Gandhi) Pharmacies for filling. The medical professionals and health care agency owners would then bill the relevant insurers for services supposedly provided to the patients, without regard to the medical necessity of those prescriptions and services. Some of the pharmacists would bill insurers, including Medicare, Medicaid, and private insurers, for dispensing the medications, despite the fact that the medications were medically unnecessary and, in many cases, never provided. Other times, the pharmacists accepted cash from the recruiters for filling and dispensing medications.
The indictment further alleges a conspiracy to distribute controlled substances by the health care owners, physicians, pharmacies, and recruiters to facilitate the submission of false claims to Medicare, Medicaid, and private insurers. The home health care owners paid physicians associated with the scheme kickbacks in exchange for prescriptions for controlled substances for their patients which were filled at the respective pharmacies. The controlled substances involved included the Schedule II drug oxycodone (Oxycontin), the Schedule III drug hydrocodone (Vicodin, Lortab) the Schedule IV drug alprazolam (Xanax), and the Schedule V drug cough syrup with codeine.
The indictment further alleges illegal money laundering by pharmacists Waleed Yaghmour and Ahab Elmadhoun, and also by home health agency owner Sardar Ashrafkhan, a.k.a. “Dr. Khan.” The indictment further alleges individual charges of felon in possession of a firearm against marketers Toney Taylor and Troy Ivory and home health agency owner John Stephen Check.
The 44 new defendants named in the 13-count indictment are
- pharmacist Krina Patel, 35, of Shelby Township
- office manager Sanjay Patel, 39, of Shelby Township
- Jayshriben Gandhi, 43, of Canton
- office manager Guarang Gandhi, 39, of Canton
- pharmacist Ahab Elmadhoun, 40, of Canton
- pharmacist Waleed Yaghmour, 46, of Dearborn
- physician Adelfo Pamatmat, 67, of Farmington Hills
- physician John Geralt, 84, of Beverly Hills
- physician Malik Dababneh, 53, of Oxford
- physician Paul Kelly, 76, of Bath
- physician Ravi Iyer, 42, of Novi
- physician Muhammad Ahmed, 65, of Ypsilanti
- physician assistant Timothy Spencer, 64, of Inkster
- Wayne State Medical School graduate Javar Myatt-Jones, a.k.a. “Dr. Jones,” 33, of Chicago
- foreign medical student Faraj Ghabag, 33, of Oregon, Ohio
- home health agency owners Sardar Ashrafkhan, a.k.a. “Dr. Khan,” 55, of Warren
- home health agency owner Deepak Kumar, 45, of Washington Township
- his assistant Mohammad Mian, 44, of Oak Park
- home health agency owner John Stephen Check, 53, of Dearborn Heights
- business partner co-owner David Vezzossi, 52, of West Bloomfield
- marketer Frederick Till Jackson Sr., a.k.a. “Big Fred,” 52, of Detroit
- marketer Tiffany Walker, a.k.a. “Mary Reed,” 45, of Detroit
- Sierra Walker, a.k.a. “Tosha,” 25, of Detroit
- marketer Toney Taylor, 44, of Detroit
- marketer Jimmy Foster, 35, of Detroit
- marketer James Blake, 32, of Sterling Heights
- marketer Troy Ivory, 47, of Warren
- marketer Jackie Renee Ivory, 32, of Ecorse
- marketer Eric Hester, 40, of Ionia
- marketer Felicia Jackson, 27, of Eastpointe
- marketer Ayesha McCray, 30, of Detroit
- marketer Jamall Gibson, 30, of Eastpointe
- couriers Alfornia Johnson, a.k.a. “Con,” a.k.a “Alex,” a.k.a. “ShiCon,” 34, of Detroit
- Phillip Burnett, a.k.a. “Frank,” a.k.a “Frank Burns,” 33, of Detroit
- Ronnie Moses, a.k.a. “Red,” 23, of Detroit
- Corey Williams, a.k.a. “CoCo,” 44, of Detroit
- William Ashley Smith, a.k.a. “Cash,” of Portsmouth, Ohio
- Robert Scott Dials, 25, of Portsmouth, Ohio
- Cherish Lewis, 26, of Whe! elersburg, Ohio
- distributors Willie David Jackson, a.k.a. “Lil’ Dave,” 24, of Eastpointe
- Lance Hatten, 29, of Columbus, Ohio
- Josh Barnes, 33, of Wheelersburg, Ohio
- Nathan Reed, a.k.a. “Reed,” 31, of Portsmouth, Ohio
- electronic transfer nominee Garland Holman, 30, of Detroit
“The merger of health care fraud and drug trafficking is a disturbing trend that is not only robbing taxpayers but also fueling addictions to prescription drugs,” McQuade said. “Prescription drug abuse has become a national epidemic, with more Americans dying from overdoses than from gunshot wounds.”
Robert L. Corso, Special Agent in Charge of DEA’s Detroit Field Division stated, “Confronting the illegal diversion and abuse of controlled pharmaceuticals is a top priority of DEA and our law enforcement partners. The indictment alleges that this drug distribution organization includes members of the medical profession who abused their positions of trust and endangered the lives of countless people for pure profit. This was done by illegally distributing opiate painkillers and other controlled prescription medications throughout southeast Michigan and stretching to the southern reaches of Ohio. This investigation makes it clear that the DEA and our partners in law enforcement will continue to investigate and bring to justice those individuals that are responsible for the illegal distribution of prescription medicines.”
FBI Special Agent in Charge Foley stated, “These arrests are the result of countless hours of hard work by the FBI and its law enforcement partners. We remain dedicated to pursuing and prosecuting any individuals who illegally exploit the health care system for their own personal gains.”
Acting ATF Special Agent in Charge Gil Salinas stated, “The combined law enforcement intelligence and resources were crucial in addressing this criminal element and in making our communities safer. ATF continues to pursue the those who continually endanger our communities. I commend the outstanding collaboration of our Violent Crime Task Force and our local, state, and federal law enforcement partners in undertaking this sweeping investigation.”
Special Agent in Charge Erick Martinez, Internal Revenue Service Criminal Investigation added that these crimes committed by doctors and pharmacists were worse than many typical schemes: “These illegal activities are done primarily to make money, and once the money is in the hands of the suspects, it’s hard for them to deny their involvement.”
“The public rightfully expects that doctors will uphold professional standards rather than exploit patients for personal gain,” said Lamont Pugh, III, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General’s region including Michigan. “Working closely with our law enforcement partners, we will investigate and bring to justice those who harm the Medicare program and taxpayers by fraudulently submitting claims related to illegal diversion and/or distribution of addictive drugs.”
Detroit Police Chief Logan stated, “The investigation of this case exemplifies the strong teamwork between the men and women of the Detroit Police Department and our state and federal law enforcement partners, along with members of the Portsmouth, Ohio Police Department. Having the United States Attorney’s Office prosecute this criminal case will be sending a strong message to those who choose to break the law. Together, we will make a difference.”
Police Chief Robert Ware stated, “Portsmouth is along a corridor of U.S. Route 23, better known as the drug pipeline. The flow of drugs from Detroit to Portsmouth and to neighboring cities such as Huntington, West Virginia, has changed lives and communities forever. Behind the scenes are some very dedicated, hardworking officers, deputies, state troopers, federal agents and prosecutors working together to bring justice to those poisoning our communities. What you have before you today is the culmination of some of those joint efforts to curb the flow of illegal drugs into our neighborhoods.”
Of the 10 defendants charged in the earlier indictment, all have been convicted by pleas over the last year. Those defendants included Detroit and Ohio residents. Several have been sentenced already and others are due to be sentenced in the near future.
The investigation in this case was handled by the Drug Enforcement Administration; the Federal Bureau of Investigation; the Bureau of Alcohol, Tobacco, Firearms, and Explosives; Detroit Police Department; Portsmouth, Ohio Police Department; Scioto County Sheriff’s Office; the Internal Revenue Service Criminal Investigation; the U.S. Immigration and Custom’s Enforcement’s Department of Homeland Security Investigations; the Department of Health and Human Services Office of Inspector General; and the Detroit Violent Crimes Task Force and Michigan State Police. The case is being prosecuted by Assistant U.S. Attorneys Terrence R. Haugabook, Michael Martin, and Wayne F. Pratt. They will be assisted by Assistant U.S. Attorneys Jonathan Grey and Gjon Juncaj of the Forfeiture Section.
An indictment is only a charge and is not evidence of guilt. A defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.