March 18, 2025 | JacobiJournal.com — A Medicare fraud scheme carried out by four pharmacy owners led to over $13 million in losses, targeting Medicare, Medicaid, and Blue Cross Blue Shield of Michigan. The defendants orchestrated fraudulent billing practices at five pharmacies across Michigan and Ohio, including Eastside Pharmacy, Harper Drugs, Wayne Campus Pharmacy, Heartland Pharmacy, and Heartland Pharmacy 2. Following a federal jury conviction on Sept. 5, 2024, each pharmacist received a prison sentence corresponding to their role in the scheme.
Sentences Handed Down
- Raef Hamaed (Maricopa County, Arizona) – Sentenced to 10 years in prison on Jan. 8.
- Tarek Fakhuri (Windsor, Ontario, Canada) – Sentenced to seven years in prison on Jan. 13.
- Ali Abdelrazzaq (Macomb County, Michigan) – Sentenced to two years in prison on Jan. 15.
- Kindy Ghussin (Greene County, Ohio) – Sentenced to five years and five months in prison.
Fraudulent Billing Scheme
Four Pharmacists Sentenced: Court documents and evidence presented at trial revealed that the pharmacists billed Medicare, Medicaid, and Blue Cross Blue Shield of Michigan for medications they never dispensed. The fraudulent activities occurred at these pharmacies:
- Michigan: Eastside Pharmacy, Harper Drugs, and Wayne Campus Pharmacy.
- Ohio: Heartland Pharmacy and Heartland Pharmacy 2.
The defendants used these pharmacies to orchestrate the scheme, resulting in millions of dollars in fraudulent claims. Following their conviction by a federal jury on Sept. 5, 2024, each pharmacist was sentenced for their specific roles in the conspiracy.
Law Enforcement’s Response
Supervisory Official Antoinette T. Bacon of the Justice Department’s Criminal Division, Special Agent in Charge Cheyvoryea Gibson of the FBI Detroit Field Office, and Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG) led the investigation.
“The defendants exploited public health systems to line their pockets,” said Antoinette T. Bacon. “These sentences should send a strong message that such criminal behavior will not be tolerated.”
Ongoing Efforts to Combat Fraud
The FBI Detroit Field Office and HHS-OIG conducted a thorough investigation into the Medicare fraud scheme, meticulously gathering evidence and coordinating across state and federal agencies. Trial Attorneys Claire Sobczak Pacelli, Kelly M. Warner, and S. Babu Kaza of the Criminal Division’s Fraud Section successfully prosecuted the case, demonstrating the government’s commitment to holding individuals accountable for orchestrating such fraudulent activities. Their efforts highlight the ongoing vigilance required to detect, investigate, and dismantle complex Medicare fraud schemes that exploit public healthcare systems.
Report Suspected Fraud
If you suspect fraudulent activity, report it to HHS-OIG or your local law enforcement agency.
Source: U.S. Department of Justice
FAQs: Medicare Fraud Scheme
What is a Medicare fraud scheme?
A Medicare fraud scheme involves intentionally submitting false claims to Medicare for reimbursement, often for services or items not provided, resulting in financial losses to the program.
How can I report suspected Medicare fraud?
Suspected Medicare fraud can be reported to the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) through their hotline or website.
What are the penalties for Medicare fraud?
Penalties for Medicare fraud can include substantial fines, restitution, and prison sentences, depending on the severity and scope of the fraudulent activity.
How does Medicare fraud impact healthcare costs?
Medicare fraud increases healthcare costs by diverting funds from legitimate services, leading to higher premiums and reduced resources for beneficiaries.
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