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Major National Health Care Fraud Takedown Unveils Local Defendants

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Conceptual image representing health care fraud with a gavel and medical bills.

News Summary

In a historic health care fraud operation, over 300 individuals, including 11 from Oakland, Macomb, and Wayne counties, have been charged. The operation revealed a staggering loss of over $14.6 billion due to fraudulent activities and illegal drug diversion schemes. Notable cases involve local nursing facilities and individuals linked to significant fraudulent claims filed against Medicare and Medicaid. This extensive enforcement effort underscores the federal government’s commitment to tackling health care fraud and safeguarding taxpayer resources.

Oakland, Michigan – Major National Health Care Fraud Takedown Unveils Local Defendants

More than 300 individuals, including 11 from Oakland, Macomb, and Wayne counties, have been charged in a sweeping national health care fraud operation conducted by federal authorities. This unprecedented crackdown resulted in 324 defendants accused of engaging in fraudulent activities and illegal drug diversion schemes, which contributed to intended losses exceeding $14.6 billion.

The takedown, referred to as the “Health Care Fraud Takedown,” has far-reaching implications, particularly in the Michigan area. Among the serious claims, reported losses include the illegal diversion of over 15 million pills of controlled substances. As part of the operation, the U.S. Department of Justice announced the seizure of more than $245 million in cash, luxury cars, and various assets linked to the accused.

U.S. Attorney General Pamela Bondi emphasized that this operation sends a firm message to those involved in exploiting vulnerable individuals and taxpayers in the health care sector. The focus of the investigations highlights the urgent need for integrity and accountability within health care services.

Local nursing facilities have also faced scrutiny. Six nursing homes in the Detroit area, including Villa Financial Services LLC and Villa Olympia Investment LLC, recently resolved federal allegations by agreeing to pay $4.5 million. These facilities were accused of breaching the False Claims Act by failing to provide adequate services to their residents. The homes in question include The Ambassador in Detroit, Father Murray in Center Line, Imperial in Dearborn Heights, Regency in Taylor, St. Joseph’s in Detroit, and Westland on Warren Road.

To enhance the standard of care, these nursing homes will enter into a five-year Corporate Integrity Agreement and will be monitored by an independent quality supervisor.

The individual cases of those charged reveal the extent of the fraudulent activities. Among them is Usman Ahmad (66) of Lake Orion, who faces charges related to the illegal distribution of prescription drugs tied to fictitious patients. Others, such as Wahid Makki (62) and Zainab Makki (62) of Dearborn Heights, agreed to pay $1.5 million after submitting false claims to Medicare and Medicaid. Doctor Mohammed Al-Shihabi (55) is indicted for a $1.9 million fraudulent home health care scheme, while Doctor Priti Bhardwaj (55) faces similar charges in a separate case involving $1.8 million in fraudulent claims.

Furthermore, Ali Naserdean (32) from Dearborn allegedly billed Medicare $6 million for unnecessary medications through his pharmacy. The operation also encompasses charges against Paul Eric Lyons (41) and Tiffany Nicole Childs (35), who submitted $1.4 million in false claims for dental services that were never rendered.

This substantial operation extends beyond Michigan as well. In total, 13 individuals from Indiana, five from Kentucky, and nine from Illinois are included among the defendants. The investigation revealed that 74 defendants were charged with the illegal diversion of over 15 million pills of prescription opioids. In addition, 49 defendants face charges totaling $1.17 billion for fraudulent Medicare claims linked to telemedicine and genetic testing fraud. Another 170 defendants are implicated in various schemes, generating over $1.84 billion in fraudulent claims against Medicare, Medicaid, and private insurers.

This vast and coordinated enforcement effort highlights the federal government’s commitment to addressing and dismantling health care fraud and ensuring that resources are properly allocated for legitimate patient needs. The details revealed in this operation serve as a critical reminder of the systemic issues that continue to challenge the health care industry nationwide.

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