Health Care Fraud Division part of largest ever nationwide takedown

Michigan Attorney General Bill Schuette last Thursday announced that his Health Care Fraud Division has charged three individuals with Medicaid Fraud, in coordination with the U.S. Department of Justice. All three investigations were part of the nation’s largest ever Healthcare Fraud Takedown. Other state Attorneys General offices from around the country, as well as the FBI, DEA and IRS, all participated in this initiative.

“Medicaid fraud is a serious issue across the country,” said Schuette. “Most individuals rely on the specialized knowledge of medical professionals to take care of their medical needs, asking for their expert help in good faith and trusting them to both help them and uphold the law. Unfortunately, there are individuals whose greed overshadows patient care, and it is important those individuals are found, stopped, and held accountable for their crime.”

Schuette filed the following charges on July 11 against defendants Roumayah and Dickey, and on July 12 against defendant Denard, in the 54B District Court in Ingham County:

• Dr. Najah Roumayah, 71 of West Bloomfield:

One count of Medicaid Fraud-False Claim, a felony punishable by imprisonment of up to 4 years or $50,000 or both.
Schuette’s Health Care Fraud Division used a technique called “data-mining” that uncovered the alleged fraud. The Health Care Fraud Division’s investigation revealed that from 2012-2016, Dr. Roumayah allegedly billed Medicaid for dental services not performed. Dr. Roumayah’s dental practice is located in Berkley, Michigan. At this point, Roumayah’s dental license is still current.
Roumayah was arraigned on Tuesday, July 11, in 54B District Court and released on a personal recognizance bond.

• Dr. David Dickey, 67 of Camden:

One count of Medicaid Fraud-False Claim, a felony punishable by imprisonment of up to 4 years or $50,000 or both.
Schuette’s Health Care Fraud Division used a technique called “data-mining” that uncovered the alleged fraud. From 2012-2015, Dr. Dickey allegedly billed Medicaid for dental services not performed. Dr. Dickey’s dental practice was located in Camden, Michigan. Dickey’s dental license has since lapsed.
Dickey was arraigned on Tuesday, July 11, in 54B District Court and released on a personal recognizance bond.

• Marie Denard, 31 of Macomb:

Twenty-five counts of Medicaid Fraud-False Claim, a felony punishable by imprisonment of up to 4 years or $50,000 or both.
One count of False Pretenses, a felony punishable by imprisonment of up to 5 years or a fine of $10,000 or both.
This case was referred to the Health Care Fraud Division by the Michigan Department of Health and Human Services Office of Inspector General (OIG). Denard was the owner and operator of Going Forward Transport (GFT), who was allegedly paid over $10,000 of Michigan Children’s Special Health Services (CSHCS) that were allegedly never provided to two Medicaid beneficiaries. Additionally, Denard allegedly submitted false claims for payment that were never paid because the scheme was detected.
Denard was arraigned on Wednesday, July 12, in 54B District Court and released on a $1,000 personal recognizance bond.

National Health Care Fraud Takedown

Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced last Thursday the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving over 412 charged defendants across 41 federal districts, including over 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving over $1.3 billion in false billings. Of those charged, last Thursday’s action also involved charges against over 120 defendants, including doctors, for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in last Thursday’s arrests.  In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to 295 providers, including doctors, nurses and pharmacists.

Schuette’s Health Care Fraud Division

The Attorney General Health Care Fraud Division exists to identify, prosecute, and prevent fraudulent activity by doctors, dentists, pharmacists, and other health care providers participating in the Medicaid program. Taxpayer dollars provide health care to indigent patients and other recipients. It is vital that these dollars be effectively spent to help those in need.  Fraud affects everyone including the recipients of care, the taxpayers who pay for it, and the overwhelming majority of providers who conscientiously provide quality care.  Anyone aware of fraud in the Medicaid program is encouraged to report it to Attorney General Schuette’s Health Care Fraud Division by calling 800-24-ABUSE.

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