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Michigan Man Faces 10 Years for $13.8M Medicare Fraud Scheme
Nabeel Shaikh, a 30-year-old resident of Wixom, Mich., has pleaded guilty to one count of conspiracy to commit health care fraud, announced the government today.
According to information contained in plea documents, Shaikh purported to be a physical therapy assistant with a limited license who provided physical therapy services to homebound Medicare beneficiaries. In fact, Shaikh had a forged physical therapy assistant’s degree and no medical license.
Beginning in approximately January 2009, Shaikh was paid to falsify medical documentation for two home health agencies, known as Physicians Choice Home Health Care LLC and Quantum Home Care Inc., each of which billed and received payments from Medicare for home health care services that were never rendered.
Shaikh paid kickbacks and bribes to Medicare beneficiaries in order to obtain the beneficiaries’ Medicare information, which was then used to bill Medicare for home health services that were never provided. Shaikh created evaluations, therapy revisit notes and other medical documentation memorializing purported physical therapy for patients he did not see or treat.
From approximately January 2009 through September 2011, Medicare paid approximately $900,430 to Physicians Choice and Quantum for fraudulent physical therapy claims based on falsified files and notes signed by Shaikh.
Overall, between approximately July 2008 and September 2011, Physicians Choice, Quantum and two other fraudulent home health care agencies involved in the conspiracy, known as First Care Home Health Care LLC and Moonlite Home Care Inc., were paid approximately $13.8 million in fraudulent home health claims by the Medicare program for services that were medically unnecessary and/or never rendered.
Shaikh faces a maximum penalty of 10 years in prison and a $250,000 fine at sentencing. The case was prosecuted by Trial Attorney Catherine K. Dick of the Criminal Division’s Fraud Section, with assistance from Trial Attorney Niall M. O’Donnell. It was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
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Key Facts
- State: Michigan
- Category: Fraud & Financial Crimes|White Collar Crime
- Source: DOJ Press Release ↗
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