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Three Michigan Pharmacists Charged in Scheme to Defraud $9.2 Million from Insurers

tbel-abuseridze-eBW1nlFdZFw-unsplash-300x200A grand jury in Detroit has returned an indictment charging three Michigan residents for their alleged involvement in a scheme to defraud insurance companies by billing them for medication that was never dispensed.

Wansa Nabih Makki, 42, of Dearborn; her brother, Mahmoud Makki, 37, of Dearborn; and her husband Hossam Tanana, 54, of Dearborn, were each charged with multiple health care fraud and money laundering offenses. The first defendant was additionally charged with making a false statement to the Internal Revenue Service after she falsely claimed to be a pharmacist in her tax returns. It is unclear if any of the defendants have acquired legal counsel.

The indictment alleges that the first defendant owned and operated two pharmacies between 2010 and 2018: LifeCare of Michigan in Farmington Hills and LifeCare Pharmacy in Livonia. Both pharmacies were “closed door,” meaning they were not open to the public and only filled prescriptions for individuals affiliated with various healthcare facilities.

The three defendants are accused of taking part in a conspiracy to bill Medicaid, Medicare, and Blue Cross Shield of Michigan for approximately $9.2 million dollars worth of medications that were never dispensed.

The defendants allegedly submitted claims for over 500 medications for people who had died prior to the claimed date of delivery. The scheme was reportedly discovered by Medicare because of a huge deficit between the pharmacies’ recorded inventories and the claims they submitted for reimbursement.

The proceeds of the alleged scheme were purportedly laundered by the trio by overpaying consulting and delivery companies owned by the second defendant and her husband. In April 2012, the husband allegedly incorporated a pharmacy consulting company. Between that date and December 2013, the company received over $400,000 for consulting services from LifeCare Pharmacy. The pharmacy also paid over $1 million to a delivery service owened by the second defendant from December 2013 to January 2015, according to the indictment.

Over the course of the investigation, the Federal Bureau of Investigation (FBI) seized several assets belonging to the defendants, including: over $2 million in liquid assets from bank accounts controlled by the defendants, gold coins valued at over $3,000, a Tiffany’s diamond ring valued at $60,000, six gold bars valued at $8,000, and 27 designer handbags valued at an estimated $78,000. The U.S. Attorney’s Office will additionally seek the forfeiture of a 5,700 square-foot residence in Dearborn and the proceeds from the sale of a Waterford lake house purchased by the male defendant.

Health care fraud and money laundering are serious charges. If convicted on money laundering charges, the defendants face up to 20 years in prison. If convicted on the health care fraud charges, the defendants face an additional 10 years in prison and a maximum fine of $250,000. The court would also be required to impose forfeiture and restitution judgments if there is a conviction.

As the federal government tightens regulation and increases scrutiny of healthcare industry transactions and operations, businesses in the industry must have good legal representation to help them understand all of their legal requirements, and help them prevent and resolve fraud issues.

South Florida Fraud Defense Attorney

Are you accused of committing fraud in South Florida? Contact Brian Silber, P.A. to set up a free initial consultation with one of South Florida’s most experienced fraud defense attorneys.

Source: 10.1.20 Pharmacy owner and pharmacist charged in scheme to defraud insurance providers.pdf

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