23 Michigan residents charged for ‘astonishing abuse of our health care system’
LANSING, Mich. (WILX) - Twenty-three Michigan residents are being charged for more than $61.5 million in alleged kickbacks, bribes and Medicare billing fraud, according to U.S. Department of Justice court documents unsealed this week.
According to court documents, Walid Jamil, 62, and Jalal Jamil, 69, both of Oakland County, owned and operated several home health agencies in the Detroit metropolitan area. They allegedly used “straw owners” – including family members and other associates – and submitted approximately $50 million in fraudulent home health care claims to Medicare.
According to the justice department, Walid and Jalal Jamil allegedly paid bribes to other to recruit patients who did not need home health care, did not qualify for home health care under Medicare rules, and in many instances were not actually provided the care for which Medicare was billed.
Walid and Jalal Jamil allegedly entered into quid pro quo relationships with physician clinics to receive the necessary information to fraudulently bill Medicare. Based on their fraudulent claims, Walid and Jalal Jamil received more than $43 million from Medicare, according to court documents.
A registered nurse employed by the Jamil home health agencies is alleged to have fraudulently billed Medicare for home health services he never provided and falsely certified patients as “homebound”, according to the justice department.
According to court documents, physicians and a licensed nurse practitioner, were allegedly employed providing medically unnecessary services to Medicare beneficiaries or submitted claims to Medicare for medical services that were not provided including 60-minute complex patient visits and B-12 and Toradol injections.
Malas also allegedly demanded that physicians order the highest-reimbursing urine drug test for patients, which was medically unnecessary, but for which Malas allegedly received a referral fee from the laboratory that processed the samples. As a result of the illegal kickbacks, one lab submitted approximately $2.8 million in fraudulent claims to Medicare and was paid more than $730,000, according to court documents.
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