National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims

Press Release

Six Defendants Charged in the Eastern District of Michigan

DETROIT - Today, United States Attorney Dawn N. Ison announced criminal charges against six defendants in connection with alleged schemes to defraud Medicare. The charges filed in federal court in Detroit are part of the Justice Department's 2024 National Health Care Fraud Enforcement Action.

"It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable," said Attorney General Merrick B. Garland. "The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits."

"Medicare is an essential safety net for seniors and individuals with disabilities. The Department of Justice and my office are committed to investigating and prosecuting those who steal taxpayer funds intended to protect vulnerable members of our community," said United States Attorney Dawn N. Ison.

"We will not tolerate fraud that preys on patients who need and deserve high quality health care," said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). "The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today's action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being."

The charges announced today by U.S. Attorney Ison are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 147 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.5 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the government, in connection with the enforcement action, seized over $150 million in cash, luxury vehicles, gold, and other assets.

The Eastern District of Michigan, in particular, worked with the Department's Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation.

The following individuals have been charged in the Eastern District of Michigan:

• Ibrahim Sammour, 63, and Bashier Sammour, 28, of Wayne County, Michigan, were charged by indictment with conspiracy to pay illegal kickbacks, Ibrahim Sammour was additionally charged with conspiracy to commit health care fraud and health care fraud, and Bashier Sammour was additionally charged with making false statements relating to health care matters, all in connection with an alleged scheme to fraudulently obtain over $2 million from Medicare. According to charging documents, the Sammours operated Individualized Home Health Care, P.C., through which they submitted false and fraudulent claims to Medicare for home health care services that were medically unnecessary, not provided as represented, or not rendered. Five others were also charged by information-two registered nurses, two group home owners, and a licensed practical nurse-for their involvement in the charged conspiracies. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Jeff Crapko of the Midwest Strike Force.

• Yvette Hardy, 60, of Wayne County, Michigan, was charged by information with health care fraud in connection with an alleged scheme to fraudulently obtain over $3.4 million in Medicare funds. According to the information, Hardy, who owned and operated Pebble Brook Care Agency LLC, caused the submission of false and fraudulent claims to Medicare for psychotherapy services that were not provided as represented or not rendered at all. The case is being prosecuted by Trial Attorney Shankar Ramamurthy of the Midwest Strike Force.

• Ruby Scott, 53, of Oakland County, Michigan, was charged by indictment with a conspiracy to defraud the United States and to pay illegal health care kickbacks, as well as with paying illegal health care kickbacks, in connection with an alleged scheme to fraudulently obtain over $2.2 million in Medicare funds. According to the indictment, Scott, who owned and operated Delta Home Health Care LLC, caused the submission of claims to Medicare for home health care services obtained through the payment of illegal kickbacks to patient recruiters in violation of the Anti-Kickback Statute. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Kelly Warner of the Midwest Strike Force.

• Dr. Vijil Rahulan, 52, of Hyderabad, India, was charged by indictment with conspiracy to commit heath care fraud and health care fraud, in connection with an alleged scheme to fraudulently obtain over $82 million in Medicare funds. As alleged in the indictment, Rahulan caused the submission of false and fraudulent claims for DME and genetic testing that were medically unnecessary or otherwise ineligible for reimbursement through Medicare because they were not the product of a doctor-patient relationship and examination. The indictment further alleges that the defendant's fraudulent conduct resulted in over $28.7 million being paid by Medicare. The case is being prosecuted by Trial Attorneys Kelly Warner and Andres Almendarez of the Midwest Strike Force.

• Amro Sharafeldin, 40, of Michigan, was charged by criminal complaint with a scheme to violate the Anti-Kickback Statute and illegally purchase Medicare beneficiary information, in connection with Sharafeldin's operation of Prestige Specialty Pharmacy ("Prestige") in Sterling Heights, Michigan. As alleged in the complaint, Sharafeldin, through Prestige, agreed to pay kickbacks and bribes to illegally acquire Medicare beneficiary information, which he and others then used in February and March 2023 to bill Medicare more than $1 million for OTC COVID-19 tests, regardless of whether the Medicare beneficiary requested the test kits. The case is being prosecuted by Assistant U.S. Attorney Andrew Lievense of the U.S. Attorney's office for the Eastern District of Michigan.

A complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Descriptions of each case involved in today's enforcement action are available on the Department's website here.

Updated June 27, 2024