The operator of a Dallas physician house call practice was arrested in connection with the largest health care fraud enforcement action in the Department of Justice's (DOJ) history.
Nehaj Rizvi, of Carrolton, was arrested on a federal complaint charging her with health care fraud scheme. The announcement was made by U.S. Attorney Erin Nealy Cox of the Northern District of Texas.
The physician house call practice, Life Spring Housecall Physicians, Inc., generated hundreds of fraudulent home health orders and certifications for multiple home health agencies in the DFW area, according to documents filed in the case. Life Spring is operated by Rizvi and owned by her husband, Mohsin Raza.
Rizvi used a physician's signature stamp to sign home health orders and home health certifications for patients that the physician had never seen and who were not qualified for home health care, according to the DOJ.
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Far from being home-bound, many of the practice's patients were reportedly able to drive and carry out normal functions of ever day life. Authorities say more than 100 home health agencies obtained physicians orders and certifications from Life Spring, which enabled the agencies to claim their parents were home-bound and gave the appearance that their services were justified.
Life Spring's allegedly false documents led to home health agencies billing Medicare approximately $2.5 million in fraudulent claims.
"The charges announced today in Dallas are an example of the outstanding investigative work by this district's Healthcare Fraud Strike Force that has been in operation since 2011," stated U.S. Attorney Nealy Cox. "Home health care fraud continues to plague the DFW area. This office will continue to aggressively investigate and prosecute anyone trying to defraud Medicare and other public health care programs."
"This take down is a warning to fraudsters that their crimes will be uncovered," said C.J. Porter, Special Agent in Charge of the Dallas Regional Office of the Department of Health and Human Services, Office of Inspector General (HHS-OIG). "Along with our law enforcement partners, we will work to ensure that criminals who orchestrate these schemes are brought to justice."
A federal criminal complaint is a written statement of the essential facts of the offense charged, and must be made under oath before a magistrate judge. A defendant is entitled to the presumption of innocence until proven guilty. The U.S. Attorney's office has 30 days to present the matter to a grand jury for indictment.
The maximum statutory penalty for the health care fraud offense charged against Rizvi is 10 years in federal prison and a $250,000 fine. The investigation is being conducted by Special Agents with HHS. Assistant U.S. Attorney Douglas Brasher is in charge of the prosecution.
Rizvi's arrest is part of the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, announced today by Attorney General Jeff Sessions and HHS Secretary Alex M. Azar III.
These enforcement actions involves 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $2 billion in false billings to Medicare, Medicaid, TRICARE (a health insurance program for members and veterans of the armed forces and their families), and private insurance companies. Of those charged, over 162 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics.
In addition, HHS announced today that from July 2017 to the present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal health care programs, which includes 587 providers excluded for conduct related to opioid diversion and abuse.
"Health care fraud is a betrayal of vulnerable patients, and often it is theft from the taxpayer," said Attorney General Sessions. "Today the Department of Justice is announcing the largest health care fraud enforcement action in American history. This is the most fraud, the most defendants, and the most doctors ever charged in a single operation-and we have evidence that our ongoing work has stopped or prevented billions of dollars' worth of fraud."
"Every dollar recovered in this year's operation represents not just a taxpayer's hard-earned money-it's a dollar that can go toward providing health care for Americans in need," said HHS Secretary Azar.
"This year's Takedown Day is a significant accomplishment for the American people, and every public servant involved should be proud of their work."
Additional documents related to this announcement are available online.