Daily Court Reporter - News National health care fraud takedown includes two Ohio companies and owners charged with false billing
National health care fraud takedown includes two Ohio companies and owners charged with false billing
(Columbus) A federal grand jury has returned separate indictments charging two central Ohio health care companies and the people who own them with health care fraud. One company allegedly billed government insurance programs for unnecessary medical procedures and the other is accused of billing government insurance programs for pain and scar creams that recipients said they never requested or wanted.
The two Ohio cases are part of a nationwide health care fraud takedown announced today by Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D.
Benjamin C. Glassman, United States Attorney for the Southern District of Ohio; Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services; Office of Inspector General – Chicago Region; the Medicaid Fraud Control Unit in Ohio Attorney General Mike DeWine’s Office; Angela Byers, Special Agent in Charge, Federal Bureau of Investigation Cincinnati; Timothy J. Plancon, Special Agent in Charge, Drug Enforcement Administration (DEA); and Steven W. Schierholt, Executive Director of the Ohio Board of Pharmacy announced the indictments today as part of a nationwide crackdown on fraudulent health care providers.
One indictment alleges that Salim Dahdah who owns and operates the Ohio Institute of Cardiac Care (OICC) in Springfield, and his wife Cindy Dahdah who owns Accubil, a company that handles the billing for OICC, received more than $2 million from Medicare and Medicaid for medically unnecessary nuclear stress tests and medically unnecessary coronary interventions such as pacemaker insertion and stent procedures. The indictment charges them with conspiracy to commit health care fraud and health care fraud, crimes punishable by up to ten years in prison, and health care false statements a crime which carries a maximum sentence of five years in prison.
The grand jury also indicted Darrell Bryant and Gifty Kusi, a husband and wife who own and manage Health & Wellness Pharmacy in Dublin. Kusi and Dr. Jornel Rivera owned and operated Health & Wellness Medical Center, also in Dublin. The indictment alleges that they fraudulently received more than $3 million from the Ohio Department of Medicaid and Medicaid Managed Care Organizations (MCOs) through multiple schemes including billing for compound creams that were not provided or not requested by patients, billing for counseling services that were not provided or billing for group counseling sessions as individual counseling services. The indictment charges all three defendants with conspiracy to commit health care fraud and health care fraud.
“Health care fraud creates victims out of patients, providers, and taxpayers,” U.S. Attorney Glassman said. “It’s a crime that breaks the bonds of trust between doctor and patient, and between government and the people, just for the sake of personal greed.”
“The charges announced today should send a strong message to criminals that theft from vital health care programs will not be tolerated”, said SAC Pugh of HHS Office of Inspector General. “The OIG and our law enforcement partners will continue to be vigilant in our efforts to protect tax payer dollars that are intended to aid our most vulnerable citizens.”
“Both of these cases are egregious,” said Attorney General DeWine. “In the OICC case, the investigation found that patients underwent dangerous and completely unnecessary medical procedures, and in the Health and Wellness Pharmacy case, the investigation found that people who legitimately needed drug treatment and counseling weren’t getting it – even though the company charged for it. In the midst of the opioid epidemic in Ohio, it is critical that healthcare providers are rendering services that are meant to help Ohioans struggling with addiction.”
“Some of the charges described include medically unnecessary procedures performed which could cause patient harm. This is the most egregious form of health care fraud”, said SAC Byers of the FBI, adding that “Health care fraud contributes to rising health care costs for everyone.”
Today’s nationwide enforcement action is the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
U.S. Attorney Glassman commended the investigation of this case by the HHS-OIG, Ohio Attorney General Mike DeWine’s Medicaid Fraud Control Unit and IRS Criminal Investigation, as well as Assistant United States Attorney Kenneth Affeldt and Special Assistant United States Attorney Maritsa Flaherty, who are representing the United States in this case.
An indictment merely contains allegations, and the defendant is presumed innocent unless proven guilty in a court of law.
Date Published: July 27, 2017