PHYSICAL THERAPY COMPANY CO-OWNER SENTENCED TO 48 MONTHS FOR MEDICARE FRAUD

FROM:  U.S. DEPARTMENT OF JUSTICE
Thursday, May 17, 2012
Co-Owner of Detroit-Area Physical Therapy Company Sentenced to 48 Months for Medicare Fraud Scheme
The co-owner of a Detroit-area physical therapy company was sentenced today to 48 months in prison for her leading role in a more than $1.9 million Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Fatima Hassan, 44, was sentenced by U.S. District Judge Avern Cohn in the Eastern District of Michigan.   In addition to her prison term, Hassan was sentenced to three years of supervised release and ordered to pay $ 855,484 in restitution.    

Hassan pleaded guilty on Sept. 15, 2011, to one count of conspiracy to commit health care fraud.   According to the plea documents, i n 2005, Hassan incorporated a company known as Jos Campau Physical Therapy, which she owned with a co-defendant.   Jos Campau Physical Therapy did not have a Medicare provider number and was not entitled to bill Medicare for therapy services.

According to court documents, Hassan paid kickbacks to recruiters who obtained Medicare beneficiary information and signatures needed to create fictitious physical and occupational therapy files.   The Medicare beneficiaries pre-signed forms and visit sheets that were later falsified to indicate that they received therapy services that were never provided.

Hassan and the co-owner of Jos Campau Physical Therapy hired and paid an occupational therapist and an uncertified occupational therapy assistant to falsify medical files.   The occupational therapist created patient evaluation forms for beneficiaries whom she had never met, seen or evaluated.   The uncertified therapy assistant fabricated and signed patient notes for occupational therapy visits.   The uncertified therapy assistant did not provide the services reflected in the fictitious patient notes.   Additionally, Hassan’s co-owner, a physical therapist, falsified patient evaluation forms and fictitious patient notes for physical therapy services that were never rendered.

Hassan and the co-owner of Jos Campau Physical Therapy sold the fictitious physical and occupational therapy files to multiple fraudulent therapy companies that had obtained Medicare provider numbers.   Those companies billed the fictitious files created by Jos Campau Physical Therapy to Medicare and paid kickbacks to Jos Campau Physical Therapy based on these billings.   Hassan and her co-owner split the profits from the sale of the falsified files.

Hassan admitted that, between approximately June 2005 and May 2007, she and her co-conspirators at Jos Campau Physical Therapy submitted or caused the submission of approximately $1.9 million in fraudulent claims to the Medicare program for physical and occupational therapy services that were never rendered.

Hassan’s co-owner, Victor Jayasundera, pleaded guilty on Jan. 18, 2012, for his role in the scheme and is scheduled to be sentenced on May 31, 2012.

Tariq Mahmud, the owner of a Medicare provider company that bought and billed Jos Campau Physical Therapy ’s fake files, was convicted at trial on Feb. 2, 2012, for his role in the scheme and is scheduled to be sentenced on June 11, 2012.

Today’s sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

This case was prosecuted by Trial Attorney Catherine K. Dick and Assistant Chief Benjamin D. Singer of the Criminal Division’s Fraud Section, with assistance from Trial Attorney Niall M. O’Donnell.    It was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.  

HIM DISCRIMINATION COMPLAINTS SETTLED WITH HEALTH CARE PROVIDERS

FROM:  U.S. DEPARTMENT OF JUSTICE
Friday, May 11, 2012
Health Care Providers Settle with Justice Department Over Complaints of HIV Discrimination

The Justice Department announced that it has reached two settlements today resolving claims that health care providers refused to serve people with HIV in violation of the Americans with Disabilities Act (ADA).

The first complaint was filed by a man with HIV who went to the Mercy Medical Group Midtown Clinic in Sacramento, Calif.   After meeting with the patient and examining him, a podiatrist at the clinic informed the patient of his treatment options.   Although surgery was one of the treatment options, the podiatrist incorrectly told the patient that he could not perform the surgery because of a risk that he would contract HIV from the patient during surgery.   The United States determined that the podiatrist’s actions violated the ADA by denying the patient the full and equal enjoyment of the services offered at the clinic on the basis of his disability.

The second complaint was filed by a man with HIV who went to the Knoxville Chiropractic Clinic North in Knoxville, Tenn., for chiropractic treatment following an automobile accident.   After examining him, the doctor determined that the patient required 24 subsequent appointments to treat his injuries.   On his third visit to the clinic, however, the receptionist informed him that the doctor would not see him because they could not treat people “like him.”   The United States determined that Knoxville Chiropractic Centers had a blanket policy of refusing treatment to persons with HIV in violation of the ADA.

“It is critical that people with disabilities, including HIV, not be denied equal access to goods and services, especially to health care services.   The Civil Rights Division takes discrimination based on unfounded fears and stereotypes about HIV very seriously,” said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division.   “We applaud Mercy Medical Group and CHW Medical Foundation, as well as Knoxville Chiropractic Centers, for working cooperatively with the Justice Department to resolve these matters quickly and fairly.”

The settlement agreements require the entities to develop and implement a non-discrimination policy and to train staff on the requirements of the ADA.   In addition, Mercy Medical Group and CHW Medical Foundation are required to pay $60,000 to the complainant and $25,000 as a civil penalty, and Knoxville Chiropractic Centers is required to pay $10,000 as a civil penalty.

The ADA requires public accommodations, like doctors’ offices, medical clinics, hospitals and other health care providers, to provide individuals with disabilities, including people with HIV, equal access to goods, services, privileges, accommodations, facilities, advantages and accommodations.

The Department of Justice provides a webpage specifically dedicated to information about the ADA and HIV at www.ada.gov/aids.   Those interested in finding out more about these settlements or the obligations of public accommodations under the ADA may call the Justice Department’s toll-free ADA information line at 800-514-0301 or 800-514-0383 (TDD), or access its ADA website at www.ada.gov.  ADA complaints may be filed by email toada.complaint@usdoj.gov.