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Carlos Grana, Health Care Fraud, Michigan 2010

A Detroit-area clinic operator has been sentenced to 56 months in prison for his role in a conspiracy to defraud the Medicare program, federal authorities announced today.

Carlos Grana, 36, a Miami resident, was sentenced by U.S. District Judge Lawrence P. Zatkoff in the Eastern District of Michigan to three years of supervised release following his prison term and was ordered to pay $2 million in restitution.

According to the plea documents, Grana managed the day-to-day operations of Careplus LLC, a medical clinic in Livonia, Mich. Grana admitted that while he managed Careplus, he paid patient recruiters for Medicare beneficiary referrals.

Grana pleaded guilty in April 2010 to one count of conspiracy to commit health care fraud.

The scheme, which ran from February 2008 to October 2009, involved Grana and his co-conspirators submitting approximately $2.2 million in claims to the Medicare program for unnecessary medical and testing services that were procured through the payment of kickbacks.

Medicare paid approximately $2 million of those claims, resulting in a total loss of $2 million to the Medicare program.

The case was prosecuted by Assistant Chief John K. Neal, Trial Attorney Gejaa T. Gobena and Special Trial Attorney Stephanie M. Hays of the Criminal Division’s Fraud Section.

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