West Bloomfield Man Pleads Guilty to Health Care Fraud

A West Bloomfield physical therapist assistant – who was also an owner of a home health agency and a patient recruiter – pleaded guilty Wednesday for his role in a $22 million home health care fraud scheme.

According to a U.S. Department of Justice press release, Syed Shah, 51, pleaded guilty before U.S. District Judge Bernard A. Friedman in the Eastern District of Michigan to one count of conspiracy to commit health care fraud. Shah faces a maximum penalty of 10 years in prison.

According to the press release, Shah admitted that between 2008 and 2012, he conspired with others to commit health care fraud by billing Medicare for home health care services that were not actually rendered and/or not medically necessary.

Shah admitted that he began working in approximately October 2008 for Prestige Home Health Services, Inc., a home health agency located in Troy. People at Prestige paid him kickbacks in exchange for his obtaining the information of Medicare beneficiaries, which they then used to improperly bill Medicare, the release indicated.

Shah and the people involved at Prestige then created fictitious files that appeared to document physical therapy services provided to Medicare beneficiaries. Shah admitted to knowing that the documents he falsified were used to support false claims billed to Medicare.

According to the release, Shah also acknowledged that around August 2009, he became one of the owners of Royal Home Health Care, Inc., a home health agency located in Troy. Royal billed Medicare for home health visits that never occurred and were not medically necessary.

The fraud cost Medicare a total of $5,925,843, the release indicated. According to the indictment, two additional home health agencies were involved in the alleged conspiracy. In total, the four home health agencies at the center of the indictment received more than $22 million from the Medicare program.

This case was investigated by the FBI, HHS-OIG and IRS Criminal Investigation, brought as part of the Medicare Fraud Strike Force, and supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. It is being prosecuted by Trial Attorney Niall M. O’Donnell of the Criminal Division’s Fraud Section. 

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:www.stopmedicarefraud.gov.