Fatima Hassan, a 44 year old Nigerian woman who was also the co-owner of a Detroit-area physical therapy company has been sentenced to 48 months in prison for her leading role in a more than $1.9 million Medicare fraud scheme, the Department of Justice, the FBI, and the Department of Health and Human Services (HHS) announced at the weekend.
Fatima Hassan who was sentenced by U.S. District Judge Avern Cohn in the Eastern District of Michigan was also sentenced to three years of supervised release and ordered to pay $855,484 in restitution in addition to her prison term.
The accused person pleaded guilty on September 15, 2011 to one count of conspiracy to commit health care fraud.
?According to the plea documents, in 2005, Hassan incorporated a company known as Jos Campau Physical Therapy, which she owned with a co-defendant. Jos Campau Physical Therapy did not have a Medicare provider number and was not entitled to bill Medicare for therapy services.
?According to court documents, Hassan paid kickbacks to recruiters who obtained Medicare beneficiary information and signatures needed to create fictitious physical and occupational therapy files. The Medicare beneficiaries pre-signed forms and visit sheets that were later falsified to indicate that they received therapy services that were never provided.
The accused and the co-owner of Jos Campau Physical Therapy hired and paid an occupational therapist and an uncertified occupational therapy assistant to falsify medical files. The occupational therapist created patient evaluation forms for beneficiaries whom she had never met, seen, or evaluated.
The uncertified therapy assistant fabricated and signed patient notes for occupational therapy visits. The uncertified therapy assistant did not provide the services reflected in the fictitious patient notes. Additionally, Hassan’s co-owner, a physical therapist, falsified patient evaluation forms and fictitious patient notes for physical therapy services that were never rendered.
Hassan and the co-owner of Jos Campau Physical Therapy sold the fictitious physical and occupational therapy files to multiple fraudulent therapy companies that had obtained Medicare provider numbers. Those companies billed the fictitious files created by Jos Campau Physical Therapy to Medicare and paid kickbacks to Jos Campau Physical Therapy based on these billings. Hassan and her co-owner split the profits from the sale of the falsified files.
?She admitted that, between approximately June 2005 and May 2007, she and her co-conspirators at Jos Campau Physical Therapy submitted or caused the submission of approximately $1.9 million in fraudulent claims to the Medicare program for physical and occupational therapy services that were never rendered.
Hassan’s co-owner, Victor Jayasundera, pleaded guilty on January 18, 2012 for his role in the scheme and is scheduled to be sentenced?on May 31, 2012.
Tariq Mahmud, the owner of a Medicare provider company that bought and billed Jos Campau Physical Therapy’s fake files, was convicted at trial on February 2, 2012 for his role in the scheme and is scheduled to be sentenced?on June 11, 2012.
The sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.
?This case was prosecuted by Trial Attorney Catherine K. Dick and Assistant Chief Benjamin D. Singer of the Criminal Division’s Fraud Section, with assistance from Trial Attorney Niall M. O’Donnell. It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,330 individuals who collectively have falsely billed the Medicare program for more than $4 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.