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May 26, 2008
AMBULANCE SERVICE OWNERS CONVICTED OF CONSPIRACY TO COMMIT HEALTH CARE FRAUD
(HOUSTON, Texas) – After a five-week trial, two brothers and co-owners of a Houston area ambulance service, have been convicted of conspiring to commit health care fraud, United States Attorney Don DeGabrielle announced today.
Mazen Abdallah, 28, and his brother, Wesam Abdallah, 32, were convicted today by a jury’s verdict of conspiracy to commit health care fraud in a scheme in which Medicare and Medicaid were billed for non-emergency ambulance transport of dialysis patients to and from dialysis treatment. Wesam Abdallah was also found guilty of four counts of health care fraud and one count of the federal anti-kickback statue.
During a five-week trial before U.S. District Judge Lee H. Rosenthal, the jury heard testimony from more than 40 witnesses, including patients, family members of patients, doctors, medics, Medicare and Medicaid officials and others. Two other defendants, Ayad Fallah and Murad Almasri, who pleaded guilty to the conspiracy charge prior to trial, also testified against the Abdallah brothers.
Trial testimony established that the Abdallah brothers and another unindicted person owned and operated Americare Ambulance Service, a Medicare and Medicaid provider, and were primarily engaged in transporting non-emergency dialysis patients. They bought the company in 2006 from Fallah and their cousins, defendants Raed Elmasri and Murad Almasri. Dialysis patients who suffer from end stage renal disease generally need dialysis treatment three times a week. The average reimbursement rate for a trip to and from dialysis, with mileage, is approximately $400-$500. Patients must have a prescription to receive the ambulance transport.
Evidence at trial showed the Abdallahs illegally paid a nursing home administrator to refer dialysis patients to Americare for dialysis transport. Evidence also showed that two nursing home doctors were tricked into signing transport prescriptions for several dialysis patients who were never treated at the nursing home, even though it was represented to the doctors that the patients were being treated there. The doctors testified they did not know who these patients were, and a nursing home clerk added that these specific patients were never even admitted to the facility. Evidence at trial further showed the Abdallahs illegally paid some patients or their family members in order to induce patient ridership with Americare. In addition, the FBI recorded Wesam Abdallah on videotape offering an illegal bribe to a patient to use Americare for dialysis transport. The Abdallahs were paid more than $1 million in Medicare and Medicaid funds for claims filed for these fraudulent ambulance transports.
The jury acquitted the brothers of two other substantive health care fraud counts. Mazen Abdallah was also acquitted of spending illegal proceeds. Wesam Abdallah was acquitted of one anti-kickback count.
Each of the Abdallah brothers face imprisonment of not more than five years and a maximum $250,000 fine for their conspiracy to commit health care fraud conviction. Wesam Abdallah faces a maximum of 10 years imprisonment and a $250,000 fine for each of the substantive health care fraud convictions and a maximum of five years imprisonment for the anti-kickback statute conviction. Each count of conviction also carries a maximum $250,000 fine and up to a three-year-term of supervised release. Sentencing is set for Sept. 23, 2008. Both men have been permitted to remain free on bond pending their sentencing hearing.
Raed Elmasri, also charged in this case, remains a fugitive. A warrant for his arrest remains outstanding. Elmasri is presumed innocent unless convicted through due process of law.
This case was the result of the investigative efforts of the FBI, the Texas Attorney General’s Medicaid Fraud Control Unit in Houston, U.S. Health & Human Services Office of the Inspector General-Office of Investigations, Internal Revenue Service Criminal Investigations, Immigration and Customs Enforcement and the U.S. Attorney’s Office. Special Assistant U.S. Attorney Suzanne Bradley and Assistant U.S. Attorney Al Balboni tried the case.
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