By ZEINAB NAJM
Times-Herald Newspapers
HEIGHTS — Pharmacist Mohamed Gomaa, 28, of Dearborn Heights has been charged with four counts of mail fraud for his role in alleged Medicare fraud schemes totaling $144.8 million in Michigan alone.
Gomaa also owns MedlifeRx Pharmacy in Auburn Hills and was formally charged in a Sept. 26 federal indictment.
“Charges stem from Gomaa’s alleged role in a $3.48 million scheme that dispensed expensive and medically unnecessary medications, using forged or fraudulent prescriptions, and sent them by mail to Medicare, Medicaid, BCBS and other private insurance beneficiaries who did not want or need them,” a Department of Justice press release said. “Gomaa then allegedly billed Medicare and the other various insurance programs and insurers for the high-cost drugs.”
Trial attorney Patrick Suter of the Fraud Section is prosecuting the case following an investigation by the FBI and U.S. Department of Health and Human Services Office of Inspector General.
“I applaud the actions taken by our law enforcement partners to seek out and hold accountable those who choose to defraud our health care programs,” Eastern District of Michigan U.S. Attorney Matthew Schneider said. “These charges should send a strong message to health care professionals that theft from these vital programs will be met with serious consequences.”
In total, 53 people were charged in relation to a $250 million healthcare fraud scam in Michigan, Illinois and Minnesota. Charges were filed against 20 people in the Eastern District of Michigan, another 12 people in Northern District of Illinois for their alleged involvement in Medicare fraud schemes resulting in over $103 million in illegitimate billings, and, 21 people have been charged in Minnesota with defrauding Medicaid for almost $3 million.
Cases in all three states involved multiple doctors, pharmacists or licensed medical professionals.
“The charges announced today aggressively target schemes billing Medicare, Medicaid and private insurance companies for medically unnecessary procedures, medical procedures that were never provided and prescription medications that often were never purchased and/or distributed to beneficiaries,” the DOJ press release said.
The enforcement actions announced on Sept. 27 were led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force partners, a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG, according to the press release.
“Health care fraud robs taxpaying Americans and corrupts the relationship between doctors and patients,” Justice Department Criminal Division Assistant Attorney General Brian Benczkowski said. “Today’s actions in the Midwest are further proof of the department’s steadfast commitment to investigating and prosecuting those who put their personal greed above the public good.”
“The abuse of our healthcare programs affects all taxpayers, who foot the bill to make coverage available,” FBI Detroit Field Office Special Agent in Charge Steven D’Antuono said. “These offenders stole American taxpayers’ hard-earned money to line their own pockets. We thank our federal and state partners for their collaborative efforts to stop this systemic fraud.”
(Zeinab Najm can be reached at [email protected])