IRS - Internal Revenue Service

06/27/2024 | Press release | Distributed by Public on 06/28/2024 13:07

U.S. Attorney Breon Peace announces 11 arrests in national health care fraud enforcement action

Guilty plea and sentencing of two defendants in $4 million Medicare fraud also announced

Date: June 27, 2024

Contact:[email protected]

Today, United States Attorney Breon Peace announced criminal charges against nine defendants in connection with alleged schemes to defraud Medicare and Medicaid.

Merrick B. Garland, United States Attorney General; Breon Peace, United States Attorney for the Eastern District of New York; Nicole M. Argentieri, Principal Deputy Assistant Attorney General and head of the Justice Department's Criminal Division; Thomas M. Fattorusso, Special Agent-in-Charge, Internal Revenue Service Criminal Investigation, New York, (IRS-CI); James Smith, Assistant Director-in-Charge, Federal Bureau of Investigation; Ivan J. Arvelo, Special Agent-in-Charge, Homeland Security Investigations, New York (HSI); Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG); and Raymond A. Tierney, Suffolk County District Attorney, announced the arrests and charges.

"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," stated Attorney General 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."

"These defendants have been charged with treating the Medicare and Medicaid programs like cash registers they could use to ring up withdrawals from the public treasury straight into their pockets," stated United States Attorney Peace. "The enforcement actions announced today demonstrate my Office's resolve to prosecute those who exploit our health care benefits programs for personal gain."

Mr. Peace expressed his appreciation to the U.S. Drug Enforcement Administration, the New York City Police Department and the New York City Human Resources Administration, for their work on the cases.

"Health care fraud affects every American," stated Principal Deputy Assistant Attorney General Argentieri. "It siphons off hard-earned tax dollars meant to provide care for the vulnerable and disabled. In doing so, it also raises the cost of care for all patients. Even worse, as the prosecutions we announce today underscore, health care fraud can harm patients and fuel addiction. The Criminal Division is committed to rooting out health care fraud, wherever it may be found, no matter who commits it. And we are using more tools than ever before to uncover misconduct and hold wrongdoers to account, whether they are executives in corner offices or doctors who violate their oaths."

"Health care providers are rightly expected to treat their patients with honesty and integrity, often in the most vulnerable times," stated IRS-CI Special Agent-in-Charge Fattorusso. "The defendants in this case are accused of or have been convicted of betraying this sacred trust strictly for their own greed and financial gain. Today's actions should serve to restore integrity in the system and put those who engage in these fraudulent acts on notice that law enforcement will not turn a blind eye."

"These nine defendants allegedly submitted bills for services not provided collecting millions in reimbursements from Medicare and Medicaid programs. This is yet another unfortunate example of individuals abusing government services intended to help patients in need. These actions are representative of the FBI's nationwide efforts to bring justice to criminals who attempt to manipulate healthcare programs for personal benefits," stated FBI Assistant Director-in-Charge Smith.

"As alleged, the defendants abused their positions and power to exploit vulnerabilities in the Medicare and Medicaid systems to the tune of $7.1 million in illicit funds. Through the American Medical Utilization Management Corporation (AMC), these purported medical providers are accused of flouting vital narcotics regulations and healthcare practices despite the incalculable risks to the public," said HSI New York Special Agent in Charge Ivan J. Arvelo. "HSI New York, through the New York OCEDTF Strike Force and in coordination with our law enforcement partners, is committed to disrupting the illegal distribution of prescription drugs by utilizing its broad statutory authorities to bring to an end the plague of overprescribed pharmaceuticals."

"We will not tolerate fraud that preys on patients who need and deserve high quality health care," stated HHS-OIG Inspector General Grimm. "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."

"My Office remains committed to stand and work with our federal partners in combatting crime and keeping our citizens safe," stated Suffolk County District Attorney Tierney. "Those who seek to illegally profit off the backs of hardworking U.S. taxpayers will be found out and brought to justice. The defrauding of our citizens will not be tolerated."

U.S. v. Feng Jiang

On June 26, 2024, Feng Jiang was charged by indictment with conspiracy to commit health care fraud, conspiracy to defraud the United States and pay health care kickbacks, conspiracy to commit money laundering and money laundering in connection with an alleged $24 million scheme involving multiple New York pharmacies. As alleged in the indictment, Jiang and his co-conspirators paid kickbacks in the form of supermarket gift certificates and cash to Medicare beneficiaries and Medicaid recipients who filled medically unnecessary prescriptions at Elmcare Pharmacy Inc. and NY Elm Pharmacy Inc. The indictment further alleges that Jiang and others wrote checks to various "trading companies" to obtain cash that was distributed as profits amongst the pharmacies' owners and used to pay illegal kickbacks and bribes.

The case is being prosecuted by Trial Attorney Patrick J. Campbell of the Criminal Division, Fraud Section, Health Care Fraud Unit, Northeast Strike Force, which is based out of the Office's Business and Securities Fraud Section.

U.S. v. Joseph Tony Brown-Arkah and Evens Jean

On June 26, 2024, Joseph Tony Brown-Arkah and Evens Jean were charged by indictment in connection with an alleged $7.1 million health care fraud scheme and narcotics distribution. Brown-Arkah and Jean were charged with conspiracy to commit health care fraud, health care fraud, conspiracy to distribute narcotics and narcotics distribution, and Jean was also charged with false statements. As alleged in the indictment, Brown-Arkah, the owner of American Medical Utilization Management Corporation (AMC), a medical clinic in Brooklyn, along with Jean, a nurse practitioner, and others, engaged in an alleged scheme to bill Medicare and Medicaid fraudulently for services not provided or not provided as billed, and to prescribe narcotics pursuant to prescriptions that were not issued for a legitimate medical purpose by a provider acting in the usual course of professional practice. In particular, AMC was a purported provider of medicated addiction treatment and had a significant number of patients being treated with buprenorphine (Suboxone), a Schedule III narcotic. Many of these patients received prescriptions written by Jean, who lived in Florida and did not see or speak with the patients; instead, Jean issued the narcotics prescriptions based on information provided by individuals not entitled to prescribe buprenorphine, some of whom were not licensed medical professionals. As alleged in the indictment, Jean also made multiple false statements to law enforcement regarding his prescriptions of buprenorphine.

The case is being prosecuted by Trial Attorneys Miriam Glaser Dauermann of the Department's National Rapid Response Strike Force and Margaret Mortimer of the Criminal Division, Fraud Section, Health Care Fraud Unit, Northeast Strike Force, which is based out of the Office's Business and Securities Fraud Section.

For patients who are prescribed a controlled substance medication and have lost access to their healthcare provider, contact either of these virtual treatment providers for evaluation, prescription for medication to help manage opioid withdrawal (buprenorphine, as applicable), and referral to outpatient care:

Virtual Express Care (NYC Health and Hospitals) 631-397-2273; 24 hour/day, 7 days/week ExpressCare or MATTERS Medication for Addiction Treatment 765-M-A-T-T-E-R-S [765-628-8377] MATTERS Network.

Referrals to harm reduction services and drug treatment programs:

Call the OASAS (Office of Addiction Services and Supports) 24/7 HOPEline 877-8HOPENY or text HOPENY (467369).

U.S. v. Albert Muratov

Albert Muratov pleaded guilty on June 11, 2024 to health care fraud in connection with a scheme to defraud Medicare by billing for undispensed cancer medication. Muratov, who operated Ave M Pharmacy in Brooklyn, New York, along with Artom Rafaelov and others, handled the pharmacy's finances and payments and, together with others, caused the submission of approximately 253 claims to Medicare for Targretin Gel 1%. Targretin is a prescription drug used to treat skin conditions caused by Cutaneous T-Cell Lymphoma, a rare skin cancer. The average wholesale price for a 60-gram tube of Targretin Gel 1% was over $34,000. From 2017 to 2021, the defendant and his co-conspirators, including Rafaelov, billed Medicare for Targretin that was medically unnecessary, not ordered by a professional, or that they did not dispense; as a result, Medicare paid Ave M Pharmacy more than $4 million.

The government's case is being handled by the Office's Business and Securities Fraud Section. Assistant U.S. Attorney John Vagelatos is in charge of the prosecution.

U.S. v. Artom Rafaelov

Artom Rafaelov pleaded guilty on September 28, 2022 to a criminal information charging him with health care fraud. Rafaelov owned and operated Ave M pharmacy in Brooklyn. Between approximately February 2017 and September 2021, Rafaelov and co-conspirator Albert Muratov defrauded Medicare by causing Ave M to submit fraudulent claims for Targretin Gel 1% (described above) that were neither purchased nor stocked by Ave M; and not medically necessary or not prescribed by the doctors that Ave M claimed had prescribed the medication. In March 2024, Rafaelov was sentenced by United States District Judge William F. Kuntz II to 37 months' imprisonment and ordered to pay $4.2 million in restitution to Medicare.

The government's case is being handled by the Office's Business and Securities Fraud Section. Assistant U.S. Attorney John Vagelatos is in charge of the prosecution.

U.S. v. Ahmed et al.

On June 11, 2024, Noman Ahmed, Adnan Arshad, Rehman Diwan, Jessica Hendrickson, Jose Marte, Mohammed Saleem, Faisal Shamsi and Waqas Shamsi were arrested on a eight-count indictment charging them with conspiracy to commit health care fraud, health care fraud, conspiracy to defraud the United States and pay health care kickbacks, paying health care kickbacks, and money laundering. The defendants owned, operated and were employees of several transportation companies. From approximately December 2020 to the present, the defendants paid illegal health care kickbacks to Medicaid beneficiaries so that those beneficiaries would order medical transportation services specifically from the defendants, which generally included transportation to addiction treatment centers for the beneficiaries' purportedly necessary methadone treatment.

The defendants generally did not provide the medical transportation services ordered by the Medicaid beneficiaries. In total, the defendants and their transportation companies - 668 MTK Taxi LLC, All-Star Taxi LLC, Apollo Transportation, Sunrise Taxi LLC, and Transportation Solution NY Corp. d/b/a A1 Transport - fraudulently billed Medicaid millions of dollars for these services throughout the course of the scheme. At least two claims were submitted to Medicaid for individuals who were deceased, and some claims were submitted for individuals who were hospitalized or incarcerated.

The government's case is being prosecuted by Assistant U.S. Attorney Adam Toporovsky of the Criminal Section of the Office's Long Island Division, and Special Assistant U.S. Attorney Jennifer Milito.

The charges in the indictments are allegations and the defendants are presumed innocent unless and until proven guilty.

The enforcement actions announced today by U.S. Attorney Peace are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings to government programs. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Department of Justice, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold and other assets.

The defendants

E.D.N.Y. Docket No. 24-CR-264

Feng Jiang (also known as "Jeff")
Oakland Gardens, Queens

E.D.N.Y. Docket No. 24-CR-263

Joseph Tony Brown-Arkah
Brooklyn, New York

Evens Jean
Cape Coral, Florida

E.D.N.Y. Docket No. 24-CR-164 (WFK)

Albert Muratov
Forest Hills, Queens

E.D.N.Y. Docket No. 22-CR-368 (WFK)

Artom Rafaelov
Fresh Meadows, Queens

E.D.N.Y. Docket No. 24-CR-231 (JMA)

Noman Ahmed
Port Jefferson Station, New York

Adnan Arshad (also known as "Eddie")
Mount Sinai, New York

Rehman Diwan
Hicksville, New York

Jessica Hendrickson
Patchogue, New York

Jose Marte
Bronx, New York

Mohammed Saleem
Dix Hills, New York

Faisal Shamsi (also known as "Jimmy")
Massapequa, New York

Waqas Shamsi (also known as "Ricky")
Massapequa, New York