Medicare fraud and brazenness seem to be pairing up with troubling frequency these days, as individuals determined to illegally enrich themselves at the taxpayers’ expense are coming up with increasingly blatant schemes. We learn about these fraudulent endeavors when the fraudsters are caught stealing, but unfortunately, as we have discussed in our blogs, many of the schemes have gone unpunished. But San Francisco qui tam lawsuit attorney Gregory J. Brod would point to one scheme in particular in Detroit that was recently uncovered and prosecuted for being one of the more brazen cases of Medicare fraud.
According to the FBI’s Detroit Division, a case was unsealed in U.S. District Court in the Eastern District of Michigan on October 8 to which Usman Butt pleaded guilty for his role in a $22 million conspiracy to defraud Medicare. The plea of Butt, a former owner and manager of two metro Detroit home health care agencies, followed that of his former business partner and co-conspirator, Muhammad Aamir, who had already pleaded guilty on August 20.
In the plea documents, Butt admitted to conspiring with others to bill Medicare for home health services that were not actually provided, nor were medically necessary and that were procured through the payment of illegal kickbacks. Through the scheme, which ran from 2008 through January 2013, false claims were submitted to Medicare that resulted in the program paying out approximately $12,607,262. Butt specifically admitted that the nursing care services provided by his companies, Prestige Home Health Services in Troy, Mich., and Royal Home Health Care Inc, of Clawson and Troy, Mich., were neither medically necessary nor even needed.
What made the Butt scheme particularly brazen was the fact that he also admitted to having helped a co-conspirator to file a false corporate tax return for Prestige in which the illegal kickbacks were deducted as “business expenses.” That ploy saved Prestige at least $321,485 in taxes that were due for 2009.
Sentencing for Butt has been scheduled for Jan. 13, 2015. His case, investigated by the FBI, Health and Human Services Office of the Inspector General and IRS, represents another success story for the federal government’s Medicare Strike Force, which, since its inception in 2007, has charged nearly 2,000 defendants with more than $6 billion in collective fraud against Medicare.
While the case against Butt and other successful cases that the Medicare Fraud Strike Force has pursued have been encouraging developments in the fight against Medicare fraud, conservative estimates of the value of schemes that may slip by the government’s watch every year have been pegged at $100 billion per year, and more generous estimates place the total much higher at upward of $300 billion every year.
In the ongoing fight to recoup the losses to the U.S. Treasury and tamp down the criminal activity that has contributed to increased Medicare premiums for the millions of honest enrollees, it often takes a brave whistleblower to step forward with vital information so that the wrongdoers can be prosecuted. Typically, a whistleblower, whose role is protected by the federal False Claims Act, can contact an experienced attorney who can in turn launch a qui tam lawsuit on the government’s behalf. Should the lawsuit prove successful, the government will award the whistleblower a share of the proceeds. If you have key information regarding a scheme to defraud Medicare or any other government program, please contact the Brod Law Firm for a free consultation.
-James Ambroff-Tahan contributed to this article.
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