Detroit Health Care Providers Sentenced For $29M Medicare Fraud
On April 21, 2015, the Department of Justice announced that three Detroit-based health care providers were ordered to collectively pay, as part of their sentences, more than $11 million in restitution for their roles in a $29 million Medicare fraud scheme. Following a 12-week trial in the Eastern District of Michigan, a federal jury in Detroit found the three defendants guilty of billing Medicare for health services that were not provided. The defendants received prison sentences ranging from 4 to 10 years based on falsely billing Medicare for various psychotherapy and home health services.
The three defendants – Felicar Williams, a former operator of a Detroit adult day care center, and Abdul Malik Al-Jumail and Jamella Al-Jumail, both former owners of Detroit-area home health care companies – were convicted on September 30, 2014. According to the evidence introduced at trial, Williams billed Medicare, through her adult day care center, for psychotherapy services that were not actually provided to patients. The evidence also established that, in some instances, Williams billed Medicare for services purportedly provided to patients who were already deceased. The evidence further demonstrated that Williams also sold the private medical information of her patients to Abdul Malik Al-Jumail, who then used it to submit fraudulent claims to Medicare.
The conspiracy did not end there – Abdul Malik Al-Jumail also obtained patients by paying unlawful kickbacks to Williams and others, and caused claims to be submitted to Medicare for home health services, including physical therapy, that were never delivered. His daughter, Jamella Al-Jumail was also convicted of billing Medicare for home health services and physical therapy that was never actually provided to patients. Evidence introduced at trial also showed that, on the day her father was arrested, she instructed an employee to retrieve falsified patient medical records so that she could destroy them.
Williams was sentenced to five years in prison and ordered to pay $2.4 million in restitution, representing the amount paid by Medicare for his fraudulent claims. Adbul Malik Al-Jumail was sentenced to 10 years in prison and ordered to pay $8.4 million in restitution, while Jamella Al-Jumail was sentenced to 4 years in prison and ordered to pay $590,000 in restitution. The case was investigated by the FBI, HHS-OIG and the IRS, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.