Leader of $29.1 Million Medicare Fraud Scheme Pleads Guilty in Detroit
|U.S. Department of Justice May 03, 2013|
WASHINGTON—The mastermind of a $29.1 million Medicare fraud scheme involving approximately 30 purported medical clinics pleaded guilty today in Detroit for his role in the scheme.
The guilty plea was announced by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley III 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 Special Agent in Charge Erick Martinez of the Internal Revenue Service Criminal Investigation (IRS-CI) Detroit Field Office.
Sachin Sharma, 37, of Detroit, pleaded guilty before U.S. District Judge Denise P. Hood in the Eastern District of Michigan to one count of conspiracy to commit health care fraud and one count of tax evasion.
According to court documents, Sharma oversaw and directed operations of a broad network of home health, psychotherapy, and other purported medical clinics in and around Detroit, including Reliance Home Care LLC, First Choice Home Health Care Services, Inc., and Haven Adult Day Care Center LLC. Working with co-conspirators, Sharma created and/or operated these companies for the purpose of billing Medicare for home health and psychotherapy services that Sharma knew were not provided. Court documents show that Sharma paid kickbacks to patient recruiters in order to obtain the information of Medicare beneficiaries, which he then used at these companies to bill Medicare for services that were not medically necessary and/or were not provided to these beneficiaries.
Court documents show that Sharma trained others on techniques to defraud Medicare and to conceal the fraud and directed employees to fabricate and alter medical documents to give the false impression that home health and psychotherapy services were provided when, in fact, they were not.
Sharma admitted that from 2007 through 2011, he received substantial proceeds of the fraud from these companies, but failed to report these proceeds on his individual federal income tax returns. Sharma admitted that he filed no individual income tax returns from 2007 through 2011.
Court documents allege that between 2007 and 2012, Sharma caused these companies to submit approximately $29,171,017 in claims to Medicare for services that were not medically necessary and/or not provided.
At sentencing, scheduled for August 8, 2013, Sharma faces a maximum penalty of 10 years in prison and a $250,000 fine.
Sachin Sharma’s co-defendants, Dana Sharma, Beverly Cooper, and Clarence Cooper, each previously pleaded guilty to one count of conspiracy to commit health care fraud for their roles in the scheme. Co-defendants Abdul Malik al-Jumail, aka Tony; Felicar Williams; and Jamella al-Jumail are scheduled for trial on June 10, 2013. Co-defendant Firas Alky remains a fugitive. Defendants are presumed innocent unless and until proven guilty at trial.
This case is being prosecuted by Trial Attorney William G. Kanellis and Deputy Chief Gejaa Gobena of the Criminal Division’s Fraud Section, with assistance from the Department of Justice Tax Division. It was investigated by the FBI, HHS-OIG, and IRS-CI, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is 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.