Washington, D.C.–A health care CEO pleaded guilty Monday to a superseding indictment as part of an investigation into a $300 million health care fraud scheme that involved the distribution of over 6.6 million dosage units of controlled substances and the administration of medically unnecessary injections that resulted in patient harm, federal prosecutors said.
Mashiyat Rashid, 38, of West Bloomfield, Michigan, was the CEO of the Tri-County Wellness Group of medical providers in Michigan and Ohio, and pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud, and one count of money laundering. In connection with his plea agreement, Rashid agreed to the entry of a forfeiture money judgment in the amount of $51,396,917.70, as well as forfeiture to the United States of property traceable to proceeds of the health care fraud scheme, including over $11.5 million, commercial real estate, residential real estate, and a Detroit Pistons season ticket membership.
“The Department of Justice has made ending the opioid crisis a top priority and taken historic new steps to stop the spread of addiction,” said Attorney General Jeff Sessions. “That includes prosecuting important cases like this one. The defendant and physicians working for him allegedly flooded the streets with some 4.2 million unnecessary doses of drugs like oxycodone and required patients to undergo expensive and unnecessary back injections that might cause slight back pain in exchange for pills.”
Sessions said while people were suffering, Rashid lived in luxury funded by ‘ill-gotten gains.’ He said the guilty plea will reduce the supply of illegal drugs flowing into the communities.
“Opioid prescription abuse is clearly a cause of some of the addiction we are seeing today,” Sessions said. “Successful conclusions of important cases like this one will have a great impact. We are not through yet. There will be more cases like this. Ending opioid prescription abuse is achievable and we intend to end it.”
“Health care fraud diverts taxpayer dollars from Medicare and lines the pockets of dishonest health care providers,” said U.S. Attorney Matthew Schneider. “This case is particularly troubling in that Rashid, through his clinics, made Michigan’s opioid crisis even worse by prescribing over six million dosage of medically unnecessary opioids to individuals who were already suffering from opioid addiction.”
In connection with his guilty plea, Rashid stated that he was the CEO of Tri-County Wellness Group, and owned, controlled and operated numerous pain clinics, laboratories and other providers in Michigan and Ohio. As alleged in the superseding indictment, from 2008 until their arrest in 2017, Rashid and physicians working in Rashid’s clinics conspired to obtain patients by prescribing over 4.2 million dosage units of medically unnecessary controlled substances, including oxycodone, hydrocodone and oxymorphone, to Medicare beneficiaries, some of whom were addicted to narcotics. Some of these opioids were allegedly resold on the street.
As part of his plea, Rashid admitted that he conspired with physicians to require Medicare beneficiaries who wished to obtain controlled substances to submit to expensive, medically unnecessary, and painful injections. Rashid paid physicians based on the number of injections that Medicare paid for, regardless of the medical necessity of the injections. In turn, the physicians conducted these repetitive and unnecessary injections on patients in order to increase revenue for Rashid, themselves, and their co-conspirators. Rashid stated that the beneficiaries included vulnerable patients, including those addicted to opioids, who were willing to submit to unnecessary and painful injections in order to obtain pills.
When Medicare conducted a medical review of the injection claims, it determined that 100 percent of the claims were not eligible for Medicare reimbursement and summarily suspended the medical billing privileges of one of the pain clinics involved in the scheme. In order to conceal the continued billing of these fraudulent claims to Medicare, the guilty plea states, Rashid and others created new shell companies that they enrolled in Medicare to keep billing the same fraudulent claims, often changing only the name of the company on the door to the medical practice and/or inventing new suite numbers to conceal the continuation of the fraudulent practices at the same location.
Rashid also owned a diagnostic laboratory and caused physicians to order medically unnecessary urine drug testing from the laboratory. When Medicare conducted a medical review of claims submitted by the laboratory, it determined that 95 percent of the claims were not eligible for Medicare reimbursement. In order to conceal the continued billing of these fraudulent urine drug testing claims to Medicare, the guilty plea states, Rashid and others created a new corporate entity that they enrolled in Medicare so that physicians could keep ordering the same fraudulent urine drug testing claims through this new entity.
In addition, Rashid stated in his guilty plea that he paid illegal health care kickbacks to obtain patients and solicited illegal kickbacks and bribes for physicians to refer Medicare beneficiaries to specific third-party home health agencies, laboratories and diagnostic providers even though those referrals were medically unnecessary.
Further, Rashid pleaded guilty to committing money laundering in connection with a $6.6 million wire transfer on April 13, 2016. The superseding indictment alleges that Rashid transferred the proceeds derived from the conspiracy to live an extravagant lifestyle and spend millions of dollars on luxury clothes from retailers like Hermes, rare Richard Mille watches, and exotic automobiles such as a Lamborghini and Rolls Royce Ghost; a mansion and other real estate in the Detroit, Michigan area; and to sit courtside or in the first row of NBA basketball games, including the NBA Finals.
Rashid; Spilios Pappas, 61, of Monclova, Ohio; Joseph Betro, 57, of Novi, Michigan; Tariq Omar, 61, of West Bloomfield, Michigan; and Mohammed Zahoor, 51, also of Novi, were each charged in a superseding indictment with one count of conspiracy to commit health care fraud and wire fraud. Pappas, Betro, Omar, and Zahoor were each additionally charged with one count of healthcare fraud. All of the defendants were previously charged in an original indictment, along with Yasser Mozeb, 35, of Oakland County, Michigan and Abdul Haq, 72, of Ypsilanti, Michigan. Mozeb and Haq have pleaded guilty, along with 12 other defendants, including seven other physicians. The case is pending before U.S. District Judge Denise Page Hood of the Eastern District of Michigan. Trial has been scheduled to begin on Nov. 27 before Judge Hood.
Rashid’s sentencing is set for April 11.