Looting the kuffar, it’s a family affair.
LIVONIA, Mich. – Two men have been charged in connection with a Livonia pharmacy scheme in which $48 million worth of health care claims were made for patients after their dates of death, according to court records.
Hossam Tanana, 53, of Dearborn, and Mahmoud Makki 36, of Dearborn, are accused of conspiracy to launder monetary instruments after an investigation into LifeCare Pharmacy in Livonia, officials said.
According to court documents, Wansa Nabih Makki, 41, of Dearborn, who is Mahmoud Makki’s sister and Tanana’s wife, maintained national provider identifiers for pharmacies she owned and managed in order to submit claims to Medicare, Medicaid and Blue Cross Blue Shield.
Wansa Makki and Mohamad Ali Makki, 43, of Dearborn Heights, are accused of making claims for expensive medications that weren’t purchased or given to patients.
There were 371 claims submitted to Medicare and Medicaid between January 2010 and January 2016 for patients after their dates of death, according to authorities. LifeCare Pharmacy was reimbursed for all of the claims, officials said.
An additional 147 claims were made between July 2015 and July 2018 for medications purportedly dispensed to patients after their dates of death, court records show.
When an audit was conducted in 2016, Mohamad Makki tried to hide the scheme by creating false invoices, officials said.
The audit found Medicare and Medicaid had paid the pharmacy about $8,596,291.80 between Jan. 6, 2010, and Feb. 14, 2016, and about $616,164.15 between Dec. 1, 2015, and Jan. 22, 2018, for medications that were reported to have been dispensed, but for which the pharmacy didn’t have enough inventory.
Wansa Makki is accused of causing the transfer for about $1.1 million in health care fraud proceeds by signing 66 checks from a LifeCare Pharmacy account to a delivery company owned and operated by Mahmoud Makki.
FBI agents also traced funds from LifeCare accounts to accounts controlled by Tanana and Mahmoud Makki, authorities said.
From Jan. 1, 2013, to July 2018, who Bank of America accounts linked to LifeCare received more than $48 million in deposits from pharmacy benefit managers, such as CUVS Caremark, Express Scripts and Optum Rx, or other payers, according to court records.
Wansa Makki received at least $4,421,300 in a personal bank account from the pharmacy accounts, officials said. She also received funds indirectly from the pharmacy after they flowed through other business entities, officials said.
Tanana is a licensed pharmacist who was sentenced to 36 months in federal prison after a 2010 conviction for diverting controlled substances such as oxycodone, Vicodin and Xanax, court records show.
LifeCare Pharmacy paid Metro Detroit Delivery Services $1,089,000 between Dec. 20, 2013, and Dec. 26, 2015, according to bank records. MDDS paid Tanana $47,500 between May 1, 2015, and Oct. 29, 2015, records show.
LifeCare Pharmacy began paying Tanana shortly after he was released from federal prison on April 2, 2012, officials said.
From page 8 of the full criminal complaint, at the link above:
“The total funds paid by federally funded health care programs for these periods was $70,061,381. As described above, at least $9.8 million worth of these funds paid by Medicare, Medicaid, and BSBSM were fraudulent claims based on drug inventory shortage.”
An indictment unsealed Tuesday says a pharmacy owner and pharmacist billed insurers for medications that were never dispensed. The defendants billed insurance companies for delivering over 500 medications to people who had died prior to the claimed date of delivery, officials said Tuesday in a news release.
Wansa Makki, 41, who owned LifeCare Pharmacy in Livonia and LifeCare of Michigan in Farmington Hills, along with pharmacist Mohamad Makki, 41, billed nearly $9.2 million to insurers, including Medicare, Medicaid and Blue Cross Blue Shield of Michigan, the officials said.
In the past as a licensed pharmacist, Tanana was convicted for diverting drugs like oxycodone, hydrocodone (Vicodin) and alprazolam (Xanax), and was released from custody in April 2012.
The money-laundering charges are part of related criminal complaints that were unsealed at the same time, the release says.
If convicted of a health care fraud charge, the defendants face a maximum sentence of imprisonment of ten years, and a maximum fine of $250,000. In addition to any sentence imposed for health care fraud, the defendants face a mandatory and consecutive two-year sentence if convicted of aggravated identity theft.
For readers not familiar with Livonia, Michigan, peruse these posts.