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Michigan doctor convicted in $18.3M Medicare fraud scheme

A Detroit federal jury has convicted Farmington Hills, Mich. physician Jose Castro-Ramirez on 13 counts in connection with his role in an $18.3 million Medicare fraud scheme.

Evidence at trial showed that beginning in late 2003, Castro-Ramirez conspired with Suresh Chand to defraud the Medicare program. Chand owned and controlled several companies in Warren, Mich., including Continental Rehab Services, Inc., and Pacific Management Services, Inc., which claimed to provide physical and occupational therapy services to Medicare beneficiaries.

Castro-Ramirez, Chand and others paid cash kickbacks and other inducements to Medicare beneficiaries in exchange for their Medicare numbers and signatures on documents that falsely indicated they had received therapy services.

According to federal investigators, licensed physical and occupational therapists were paid to sign fictitious "progress notes" and other documents that appeared to reflect that services had been provided to the beneficiaries.

Between January 2003 and June 2007, Chand and others submitted claims to the Medicare program totaling $18,379,300 for supposed physical and occupational therapy services. Medicare paid $8,562,688 on those claims. There were also $1.4 million in claims to the Medicare program for "home visits" allegedly provided to beneficiaries. Medicare paid approximately $929,000 on those claims.

Castro-Ramirez faces a maximum penalty of 10 years in prison and a $250,000 fine on healthcare fraud conspiracy and substantive healthcare fraud counts.

Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 500 individuals who collectively have falsely billed the Medicare program for more than $1 billion.

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