Washington – A Detroit-area doctor has been charged and arrested in connection with a $40 million Medicare fraud scheme involving physician home visits and home health services, announced the Department of Health and Human Services (HHS), the FBI and the HHS-Office of Inspector General (OIG).
Dr. Hicham Elhorr, 45, allegedly masterminded a scheme involving the submission of fraudulent claims submitted to Medicare for services that were medically unnecessary and/or never provided through House Calls Physicians (HCP), a physician home visiting service he owned and operated.
According to a criminal complaint unsealed today in U.S. District Court in Detroit, Elhorr submitted claims through HCP for physician home visits for patients who were never seen and for visits conducted by doctors who were not licensed.
The complaint alleges Elhorr submitted claims to Medicare for physician home visits purportedly rendered when he was out of the country, when beneficiaries were hospitalized or when the beneficiary was dead.
Elhorr is also alleged to have referred Medicare beneficiaries for medically unnecessary home health services, as well as accepted kickbacks from home health agencies in exchange for writing these referrals.
Since January 2008, HCP has billed Medicare for approximately $9.2 million. In the same time period, HCP has allegedly referred Medicare beneficiaries for home health services that have resulted in approximately $30.8 million of reimbursements from Medicare.
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Key Facts
- State: Michigan
- Category: Fraud & Financial Crimes|White Collar Crime
- Source: DOJ Press Release ↗
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