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$40 Million Detroit-Area Medicare Fraud Scheme

Sep 26 | 2012  by

A Detroit-area doctor, Hicham Elhorr, has been charged in federal court for his alleged leading role in a $40 million Medicare fraud scheme.

Dr. Elhorr was the owner and operator of House Calls Physicians (HCP), a physician home visiting service. Elhorr allegedly submitted claims through HCP for physician home visits for patients that were never seen or visits conducted by doctors who were not licensed. The complaint further alleges that Elhorr submitted claims to Medicare when he was out of the country, when beneficiaries were hospitalized, or even when the beneficiary was dead.

Additionally, Elhorr is charged with accepting kickbacks from home health agencies in exchange for referring patients to those agencies.  According to court documents, HCP has billed Medicare for approximately $9.2 million since January 2008.  In that same time period, the company has allegedly referred Medicare beneficiaries for home health services that resulted in approximately $30.8 million of reimbursements from Medicare.

Of course, these charges mean that Dr. Elhorr is suspected of committing these crimes but is considered innocent until proven guilty beyond a reasonable doubt in a court of law. Medicare and Medicaid fraud are serious offenses that are harshly prosecuted and carry severe penalties and jail time.  Having quality legal advice is imperative when defending against such allegations.

The experienced fraud team at Fausone Bohn, LLP – Mark Mandell and Tariq Hafeez – can provide a top-notch legal defense for those involved in a government investigation or prosecution.  The team can also provide counsel for “whistleblowers” looking to expose the fraud of their employers (or ex-employers).  Whistleblowers may be eligible to receive money from a settlement or verdict and this knowledgeable team has the expertise to obtain these positive results.

To learn more about this topic, please visit the Department of Justice website.