Shams Gets 8-25 Years: $7M Medicaid Heist

NEW YORK – Imran Shams, 66, of California, is headed back to prison, this time for eight and one third to twenty-five years, after being sentenced for a brazen scheme to steal $7 million from New York’s Medicaid system. The sentencing, handed down by Judge Michele Rodney of the New York County Supreme Court, adds to the 13 years Shams is already serving on federal convictions related to similar healthcare fraud schemes.

Attorney General Letitia James didn’t mince words, stating, “When criminal organizations abuse our health care system, the most vulnerable patients suffer.” James’ office exposed how Shams, already banned from billing Medicaid due to a prior fraud conviction, secretly owned Multi-Specialty, a clinic built on deception. The operation lured Medicaid recipients with kickbacks of $20 to $50 to undergo unnecessary – and often fabricated – medical evaluations and tests. The clinic staffed untrained individuals posing as healthcare professionals to legitimize the scam.

The scheme wasn’t just about bogus tests. Shams allegedly received millions in kickbacks for referring patients, regardless of medical need, to diagnostic testing companies owned by Tea Kaganovich and Ramazi Mitaishvili, both of Brooklyn. These referrals ensured a steady stream of fraudulent claims submitted to Medicaid and Medicaid-funded Managed Care Organizations (MCOs). Paying recipients to accept Medicaid-funded services is a clear violation of both state and federal law, and Shams exploited that vulnerability.

This sentencing marks the end of a multi-year investigation and prosecution. Kaganovich and Mitaishvili previously received sentences of one and a half to four and a half years in state prison in November 2023 on charges of Grand Larceny in the First Degree. Radiologist Bernard Bentley of East Hampton also faced consequences, receiving three years of probation for his role in fraudulently billing Medicaid over $8 million for the same sham diagnostic tests. The pair were also prosecuted in federal court and ordered to pay over $18 million in restitution to the New York Medicaid Fraud Restitution Fund.

Authorities anticipate more than $7 million in assets seized from Kaganovich and Mitaishvili during the federal investigation will be returned to New York. The Attorney General’s office extended gratitude to the New York State Office of the Medicaid Inspector General (OMIG) and the U.S. Department of Justice Medicare Strike Force for their collaborative efforts in dismantling this predatory operation. Shams’ sentence will run concurrent with his existing federal prison term.

This case underscores the ongoing threat of healthcare fraud and the Attorney General’s commitment to protecting taxpayer dollars and ensuring vulnerable New Yorkers receive the care they deserve. The Grimy Times will continue to follow any asset recovery efforts and monitor for similar schemes targeting the Medicaid system.