Michigan Physician Pleads Guilty to Role in $3.6 Million Medicare Fraud Scheme

WASHINGTON—A Detroit-area medical doctor who referred Medicare beneficiaries for home health services in exchange for illegal cash kickbacks as part of a $3.6 million home health care fraud scheme has plead guilty for his role in the scheme. Kutub Mesiwala, 64, of Bloomfield Hills, Michigan, pleaded guilty before U.S. District Judge George Caram Steeh of the Eastern District of Michigan to one count of conspiracy to commit health care fraud. A sentencing hearing is set for Oct. 5, 2015. According to admissions in his plea agreement, Mesiwala referred patients to Detroit-area home health agency Advance Home Health Care Services Inc. (Advance) and other home health care agencies in exchange for cash kickbacks. Advance’s owner, Amer Ehsan, pleaded guilty on July 24, 2014, to fraudulently billing Medicare for $3.6 million in home health services that were not medically necessary or not provided through Advance. Ehsan is awaiting sentencing. Mesiwala admitted that Medicare paid a total of $770,668.31 to Advance and $118,375.81 to other home health care companies for fraudulent claims based on his referrals. This case is being investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.