Four pharmacists who turned neighborhood drugstores in Michigan and Ohio into a $13 million billing machine just lost their shot at a do-over.
A federal appeals panel last Friday upheld prison sentences for the group, which prosecutors said spent years using five independently operated pharmacies to bill Medicare, Medicaid, and private insurers for prescriptions that were often never actually dispensed. The decision leaves in place multi-year prison terms and a joint restitution tab topping $13 million.
Appeals court affirms convictions
According to the Sixth Circuit opinion, the court affirmed convictions for Raef Hamaed, Kindy Ghussin, Ali Abdelrazzaq, and Tarek Fakhuri on charges of conspiracy to commit health care fraud and wire fraud. The panel found no reversible error and said the trial record backed up what the jury decided.
The opinion, filed last Friday following oral argument earlier this year, keeps intact the sentences the four received earlier this year. According to a Department of Justice release, Hamaed was sentenced to 120 months in prison, Fakhuri to 84 months, Ghussin to 65 months, and Abdelrazzaq to 24 months. Prosecutors said the differing terms reflected each pharmacist’s role across the five pharmacies, and noted the scheme hit Medicare, Medicaid, and Blue Cross Blue Shield of Michigan.
How the alleged billing scheme worked
The Sixth Circuit opinion lays out a straightforward but lucrative scheme. The pharmacists operated Eastside Pharmacy, Harper Drugs, and Wayne Campus Pharmacy in Detroit, along with two Heartland Pharmacy locations in Ohio. Insurers were repeatedly billed for prescriptions that, in many cases, were never picked up by patients…