Two brothers have been convicted of Medicare, Medicaid, and Private Insurer Fraud related to prescription medication claims.
Raad Kouza, a pharmacist, and Ramis Kouzza collectively caused Medicare, Medicaid, and Blue Cross Blue Shield of Michigan to lose over $15 million.
Two brothers charged for pharmacy claims corruption of over $15 million
Information disclosed as part of the investigation and court proceedings showed the two men based in Michigan billed Medicaid and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated in Michigan.
As a result of their attempts to defraud these vital healthcare cornerstones of the American public, they have now been convicted of conspiracy to commit healthcare fraud and wire fraud. In addition to their joint behavior leading to the conviction, Raad Kouza was also convicted of one count of healthcare fraud.
The Kouza brothers face a maximum penalty of 20 years in prison on the conspiracy count, and Raad Kouza faces a maximum penalty of 10 years on the healthcare fraud count.
The Federal Bureau of Investigations Detroit Field Office and the Department of Health and Human Services Office of Inspector General (HHS-OIG) investigated the case. The Criminal Division’s Fraud Section is prosecuting the brother’s fraud attempts in collaboration with the Health Care Fraud Strike Force Program’s findings.
Currently, the Health Care Fraud Strike Force Program is comprised of nine strike forces operating in 27 federal districts. It has charged more than 5,400 defendants who collectively billed federal health care programs and private insurers more than $27 billion.
News of the conviction was delivered as part of a collaborative effort by Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division; Special Agent in Charge Cheyvoryea Gibson of the FBI Detroit Field Office; and Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG).
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