Detroit, Michigan - A Michigan home health agency owner was sentenced to 84 months in prison today for his role in an $8.3 million scheme to defraud Medicare.
Assistant Attorney General Brian A. Benczowski of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge Timothy R. Slater of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.
Zahir Shah, 49, of West Bloomfield, Michigan, was sentenced by U.S. District Judge Avern Cohn of the Eastern District of Michigan, who also ordered Shah to pay $ 8,339,790.28 in restitution. In May 2018, Shah pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to pay and receive health care kickbacks.
As part of his guilty plea, Shah admitted that he submitted false certifications to enroll and stay enrolled as a Medicare provider. Shah further admitted that he paid illegal kickbacks to recruiters in exchange for Medicare beneficiary referrals and billed Medicare for claims procured through these illegal kickbacks. Additionally, according to evidence presented, Shah conspired with others to submit claims to Medicare for home health services that were medically unnecessary and not eligible for Medicare reimbursement. The court ordered that Shah repay as restitution the total amount that his home health agencies received from the Medicare program from 2007 to 2017, which was over $8.3 million.
The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. Trial Attorneys Rebecca Yuan and Howard Locker of the Fraud Section prosecuted the case. Assistant U.S. Attorney Philip Ross of the Eastern District of Michigan handled the asset forfeiture proceedings.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.