Business Owner Convicted of $1.9M Medicare, Medicaid, and Private Insurer Fraud Scheme

DETROIT - A business owner from Dearborn Heights pleaded guilty today to conspiring to commit health care fraud, which resulted in $1.9 million in loss to Medicare, Medicaid, and Blue Cross Blue Shield of Michigan, announced United States Attorney Jerome F. Gorgon, Jr.

Gorgon was joined in the announcement by Mario M. Pinto, Special Agent in Charge at the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Jennifer Runyan, Special Agent in Charge, Federal Bureau of Investigation, Detroit Field Office.

Pleading guilty was Rabih Hamdan, 41, of Dearborn Heights, Michigan.

At the plea hearing, Hamdan admitted to creating and operating a scheme to submit false and fraudulent claims for prescription drugs that were medically unnecessary or not actually dispensed. In many instances, his pharmacy lacked the inventory to dispense these drugs but billed the health care insurers as though they had been dispensed. In these instances, the medications were never ordered by a physician. Hamdan used the fraud proceeds for his personal use and to benefit others. In total, Hamdan and his coconspirators submitted false and fraudulent claims totaling at least $1.9 million over a five-year period.

Sentencing before United States District Judge Matthew F. Leitman will be set after a presentence report is prepared. Hamdan faces a possible maximum sentence of 10 years in prison, a fine of up to $250,000, and up to three years of supervised release following any term of imprisonment.

The case was investigated by the Department of Health and Human Services - Office of the Inspector General (HHS-OIG) and the Federal Bureau of Investigation (FBI). The case is being prosecuted by Assistant United States Attorney Jason Dorval Norwood.