Four people in metro Detroit have been indicted in a more than $9 million healthcare fraud scheme that involved money laundering and racking up claims for dead patients, according to federal officials, adding to a growing pile of healthcare fraud cases in the region.
An indictment unsealed Tuesday says a pharmacy owner and pharmacist billed insurers for medications that were never dispensed. The defendants billed insurance companies for delivering over 500 medications to people who had died prior to the claimed date of delivery, officials said Tuesday in a news release.
Wansa Makki, 41, who owned LifeCare Pharmacy in Livonia and LifeCare of Michigan in Farmington Hills, along with pharmacist Mohamad Makki, 41, billed nearly $9.2 million to insurers, including Medicare, Medicaid and Blue Cross Blue Shield of Michigan, the officials said.
The scheme was flagged by Medicare due to a "huge deficit" between each pharmacy's inventories and the claims that each pharmacy submitted, the release said.
Proceeds from the fraud scheme were laundered through consulting and delivery companies operated by Wansa's husband, Hossam Tanana, 53, and her brother Mahmoud Makki, 36.
Tanana's consulting company garnered more than $400,000 from the LifeCare Pharmacy between April 2012 and December 2013. The pharmacy also paid more than $1 million to a delivery service opened by Mahmoud Makki over a 14-month stretch starting in December 2013, the release says.
In the past as a licensed pharmacist, Tanana was convicted for diverting drugs like oxycodone, hydrocodone (Vicodin) and alprazolam (Xanax), and was released from custody in April 2012.
The money-laundering charges are part of related criminal complaints that were unsealed at the same time, the release says.
If convicted of a health care fraud charge, the defendants face a maximum sentence of imprisonment of ten years, and a maximum fine of $250,000. In addition to any sentence imposed for health care fraud, the defendants face a mandatory and consecutive two-year sentence if convicted of aggravated identity theft.
The case was investigated by the U.S. Department of Health and Human Services, the Federal Bureau of Investigation, and the Michigan Department of Health and Human Services' Office of Inspector General. It is being prosecuted by Assistant U.S. Attorneys John Engstrom, Philip Ross and Shankar Ramamurthy.
"4 in metro Detroit charged in alleged $9.2 million health care fraud scheme" originally appeared in Crain's Detroit Business.