WASHINGTON D.C.
Sixteen Michigan and Ohio-area defendants, including 12 physicians, have been sentenced to prison for a $250 million health care fraud scheme, officials stated.
This included the exploitation of patients suffering from addiction and the illegal distribution of over 6.6 million doses of medically unnecessary opioids.
Five physicians were convicted in two separate trials, while 18 other defendants pleaded guilty. Seven defendants await sentencing.
“It is unconscionable that doctors and health care professionals would violate their oath to do no harm and exploit vulnerable patients struggling with addiction,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “These are not just crimes of greed, these are crimes that make this country’s opioid crisis even worse – and that is why the department will continue to relentlessly pursue these cases.”
“Patients look to physicians and medical professionals for their expertise and knowledge, trusting that they will do what is best to take care of them,” said Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division. “In this circumstance, these medical professionals provided prescription drugs to those with no medical need.”
Adding, “it is unacceptable that in this nation’s current opioid crisis, physicians and medical professionals are exploiting the well-being of their patients for profit.”
According to court documents and evidence presented at trial, the scheme involved doctors refusing to provide patients with opioids unless they agreed to unnecessary back injections.
Perpetrated through a multi-state network of pain clinics from 2007 to 2018, the evidence established that the clinics were pill mills frequented by patients suffering from addiction, as well as drug dealers, who sought to obtain high-dosage prescription drugs like oxycodone.
The doctors working at the clinics agreed to work only a few hours a week to “stay under the radar” of the Drug Enforcement Administration (DEA), yet were among the highest prescribers of oxycodone in the State of Michigan, according to officials.
To obtain prescriptions, the evidence showed that the patients had to submit to expensive, unnecessary, and sometimes painful back injections, known as facet joint injections.
The injections were selected because they were among the highest reimbursing procedures, rather than based on medical need.
Trial testimony indicated that, in some instances, patients experienced more pain from the shots than from the pain they had purportedly come to have treated, and that some patients developed adverse conditions, including open holes in their backs.
Patients largely acquiesced to these unnecessary procedures because of their addiction or desire to obtain pills to be resold on the street by drug dealers.
The evidence further established that the defendant physicians repeatedly performed these unnecessary injections on patients over several years and were paid more for facet joint injections than any other medical clinic in the United States.
The evidence further established that the proceeds of the fraud were used to fuel lavish lifestyles.
Francisco Patino, a doctor and part-owner of the clinics, bought jewelry, cars and vacations, as well as paid Ultimate Fighting Championship and other mixed martial arts fighters to promote his specialized diet program.
Mashiyat Rashid, Patino’s business partner and part-owner of the clinics, purchased private jet flights, courtside tickets to the NBA Finals and expensive real estate. Other physicians involved in the scheme purchased luxury cars, gold bars, and indoor basketball courts and swimming pools.
Over $16 million in fraud proceeds was forfeited by the United States from the defendants.
The physicians sentenced by the court include:
- Spilios Pappas, M.D., 63, of Lucas County, Ohio, convicted at trial in 2020 for conspiracy to commit health care fraud and wire fraud, and health care fraud, was sentenced on March 9, to nine years in prison and ordered to pay $32,287,758 in restitution.
- Tariq Omar, M.D., 63, of Oakland County, Michigan, convicted at trial in 2020 for conspiracy to commit health care fraud and wire fraud, and health care fraud, was sentenced on March 9, to eight years in prison and ordered to pay $24,243,603 in restitution.
- Joseph Betro, D.O., 60, of Oakland County, Michigan, convicted at trial in 2020 for conspiracy to commit health care fraud and wire fraud, and health care fraud, was sentenced in February 2022 to nine years in prison and ordered to pay $27,417,516 in restitution.
- Mohammed Zahoor, M.D., 53, of Oakland County, Michigan, convicted at trial in 2020 for conspiracy to commit health care fraud and wire fraud, and health care fraud, was sentenced in February 2022 to eight years in prison and ordered to pay $36,645,577 in restitution.
- Zahid Sheikh, M.D., 62, of Macomb County, Michigan, was sentenced to 70 months in prison, and ordered to pay $2,088,797 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud.
- Abdul Haq, M.D., 76, of Ypsilanti, Michigan, was sentenced to four years in prison, and ordered to pay $6,927,046.12 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud.
- Steven Adamczyk, M.D., 47, of Bloomfield Hills, Michigan, was sentenced to 42 months in prison, and ordered to pay $1,237,570.97 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud.
- David Weaver, M.D., 67, of Canton, Michigan, was sentenced to three years in prison, and ordered to pay $229,500 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud.
- Glenn Saperstein, M.D., 58, of Commerce Township, Michigan, was sentenced to 20 months in prison, and ordered to pay $2,722,760.95 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud.
- Manish Bolina, M.D., 43, of Canton, Michigan, was sentenced to 20 months in prison, and ordered to pay $310,936.95 in restitution in connection with his guilty plea to one count of false statements.
- Hussein Saad, M.D., 42, of Dearborn, Michigan, was sentenced to 10 months in prison, and ordered to pay $415,207.54 in restitution in connection with his guilty plea to one count of false statements.
- David Yangouyian, M.D., 58, of Farmington Hills, Michigan, was sentenced to six months in prison, and ordered to pay $35,480.98 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud.
Other defendants sentenced by the court include:
- Mashiyat Rashid was sentenced in March 2021 to 15 years in prison and ordered to pay over $51 million in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud and wire fraud, and one count of money laundering.
- Yousef Almatrahi, 34, of Romulus, Michigan, the owner of a home health agency, was sentenced to three years in prison and ordered to pay $1,359,512.69 in restitution in connection with his guilty plea to one count of conspiracy to commit health care fraud in connection with his payment of illegal kickbacks for the referral of patients from the clinics for medically unnecessary home health services.
- Hina Qazi, 39, of Rochester Hills, Michigan, the owner of a home health agency, was sentenced to 18 months in prison and ordered to pay $827,713 in restitution in connection with her guilty plea to one count of conspiracy to commit health care fraud in connection with her payment of illegal kickbacks for the referral of patients from the clinics for medically unnecessary home health services.
- Joshua Burns, 43, of Detroit, Michigan, was sentenced to one-day in prison and ordered to pay $144,00 in restitution in connection with his guilty plea to one count of conspiracy to defraud the United States and pay and receive illegal kickbacks and bribes in connection with Patino’s referral of urine drug testing and sponsorship of MMA fighters.
The following defendants are scheduled to be sentenced on future dates:
- Francisco Patino, M.D., is scheduled to be sentenced on his conviction after a one-month trial in 2021 on one count of conspiracy to commit health care fraud and wire fraud, two counts of health care fraud, one count of conspiracy to defraud the United States and pay and receive health care kickbacks, one count of conspiracy to commit money laundering, and one count of money laundering.
- Yasser Mozeb, 39, of Hamtramck, Michigan, the office manager of the Tri-County clinics, is scheduled to be sentenced in connection with his guilty plea to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and pay and receive illegal kickbacks and bribes.
- Kashif Rasool, M.D., 46, of Troy, Michigan, is scheduled to be sentenced in connection with his guilty plea to one count of conspiracy to commit health care fraud.
- Tariq Siddiqi, 44, of Sterling Heights, Michigan, is scheduled to be sentenced in connection with his guilty plea to one count of conspiracy to commit health care fraud in connection with his payment of illegal kickbacks for the referral of patients from the clinics for medically unnecessary home health services.
- Tasadaq Ali Ahmad, 54, of Canton, Michigan, the owner of a home health agency, is scheduled to be sentenced in connection with his guilty plea to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and pay and receive kickbacks.
- Stephanie Borgula, 41, of Livonia, Michigan, a licensed physical therapist, is scheduled to be sentenced in connection with her guilty plea to one count of conspiracy to commit health care fraud.
- Meiuttenun Brown, M.D., 51, of Toledo, Ohio, is scheduled to be sentenced in connection with her guilty plea to one count of conspiracy to commit health care fraud.
The FBI, HHS-OIG and IRS-CI investigated the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program.
Since March 2007, this Program, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion, officials stated.
In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.
More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.