Home health care owner sentenced for fraudulently billing Medicare

A Michigan home health care company owner was sentenced last Thursday to three years and five months in prison for his role in a health care fraud conspiracy that resulted in almost $7.9 million in false and fraudulent claims for home health care services paid by Medicare Part A.

According to court documents, Muhammad Zafar, 53, of Wayne County, owned and operated a home health care business in Michigan. Together with three doctors and two other home health care company owners, Zafar offered kickbacks, bribes, and other inducements to beneficiary recruiters in exchange for Medicare beneficiary information. Zafar and his co-conspirators used this information to bill Medicare for services that were medically unnecessary and not provided. Zafar pleaded guilty to submitting approximately $393,500 in claims to Medicare from his home health care company for services that were medically unnecessary, ineligible for Medicare reimbursement, and not provided as represented.

On the same day that Zafar appeared in court for his initial appearance on June 17, 2015, he violated his court-issued bond, crossed the international border into Canada, and shortly thereafter flew to Pakistan. Zafar remained an international fugitive for approximately seven and a half years before returning to the United States to face the charges against him.

On May 29, Zafar pleaded guilty to conspiracy to commit health care fraud and wire fraud.

Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division; Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG); and Special Agent in Charge Cheyvoryea Gibson of the FBI Detroit Field Office made the announcement.

HHS-OIG and the FBI Detroit Field Office investigated the case.

Trial Attorney Jeffrey A. Crapko of the Criminal Division’s Fraud Section prosecuted the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. Additional information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.

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