CEO Sentenced to Prison in $150 Million Health Care Fraud, Opioid Distribution, and Money Laundering Scheme

The chief executive officer of a Michigan and Ohio-based group of pain clinics and other medical providers was sentenced today to 15 years in prison for developing and approving a corporate policy to administer unnecessary back injections to patients in exchange for prescriptions of over 6.6 million doses of medically unnecessary opioids.

Mashiyat Rashid, 40, of West Bloomfield, Michigan, was the CEO of the Tri-County Wellness Group of medical providers in Michigan and Ohio. In addition to the prison sentence, Rashid was also ordered to pay over $51 million in restitution to Medicare, 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.

Rashid pleaded guilty in 2018 to one count of conspiracy to commit health care fraud and wire fraud, and one count of money laundering. Twenty-one other defendants, including 12 physicians, have been convicted thus far, including four physicians who were convicted after a one-month trial in 2020. Rashid is the second defendant to be sentenced.

According to court documents, from 2008 to 2016, Rashid was the CEO of the Tri-County Wellness Group, where the clinics had a policy to offer patients, some of whom were suffering from legitimate pain and others of whom were drug dealers or opioid addicts, prescriptions of Oxycodone 30 mg, but forced the patients to submit to unnecessary back injections in exchange for the prescriptions.

Testimony at the trial established that in some instances the patients experienced more pain from the shots than from the pain they had purportedly come to have treated; that audible screams from patients were observed throughout the clinics; and that some patients developed adverse conditions, including open holes in their back. Patients, including patients who were addicted to opioids, who told the doctors that they did not want, need, or benefit from the injections, were denied medication by the defendants and their co-conspirators until they agreed to submit to the expensive and unnecessary injections. The evidence further established that the defendants repeatedly performed these unnecessary injections on patients, as Tri-County was paid more for facet joint injections than any other medical clinic in the United States.

The evidence at trial showed that the Tri-County clinics valued making money over patient care. The Tri-County clinics intentionally targeted the Medicare program and recruited patients from homeless shelters and soup kitchens. Evidence at trial indicated that Rashid only hired physicians who were willing to disregard patient care in the pursuit of money. Rashid incentivized the physicians to follow the Tri-County protocol of offering opioid prescriptions and administering unnecessary injections by offering to split the Medicare reimbursements for these lucrative procedures. The specific injections used had nothing to do with the medical needs of the patients but were instead selected to be administered because they were the highest-paying injection procedures. A former Tri-County employee testified at the trial of Rashid’s co-defendants that the practices at the clinic were “barbaric.”

Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division; Acting U.S. Attorney Saima Shafiq Mohsin of the Eastern District of Michigan; Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services’ Office of Inspector General’s (HHS-OIG’s) Chicago Region; Special Agent in Charge Timothy Waters of the FBI’s Detroit Field Office; and Special Agent in Charge Sarah Kull of IRS Criminal Investigation (IRS-CI) Detroit made the announcement.

HHS-OIG, FBI, and IRS-CI conducted the investigation. Assistant Chief Jacob Foster of the National Rapid Response Strike Force and Trial Attorney Tom Tynan of the Criminal Division’s Fraud Section prosecuted the case.

The Fraud Section leads the Health Care Fraud Strike Force. Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Source: CEO Sentenced to Prison in $150 Million Health Care Fraud, Opioid Distribution, and Money Laundering Scheme / U.S. Department of Justice

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