8 Charged In $68M Home Care, Adult Day Fraud Scheme

An indictment was unsealed on Wednesday in Brooklyn, New York, charging eight defendants with allegedly scheming to defraud Medicaid of approximately $68 million. This was done through the operation of two social adult day care organizations and a home care financial intermediary that paid kickbacks and bribes for services not provided.

According to court documents, Zakia Khan and Ahsan Ijaz owned two Brooklyn-based social adult day care organizations, Happy Family Social Adult Day Care Center Inc. and Family Social Adult Day Care Center Inc., and a financial intermediary called Responsible Care Staffing Inc.

These organizations were involved in the New York Medicaid Consumer Directed Personal Assistance Services Program (CDPAP), which allows family members of Medicaid recipients to receive payment for helping the recipients with daily activities.

Starting around October 2017, marketers Elaine Antao, Omneah Hamdi and Manal Wasef reportedly directed Medicaid recipients to Happy Family, Family Social or Responsible Care in exchange for kickbacks and bribes. In return, the marketers allegedly paid kickbacks and bribes to Medicaid recipients for social adult day care and CDPAP services that the organizations billed to Medicaid – services they either did not provide or services that were influenced by those kickbacks and bribes.

Ansir Abassi, Ansir Zaib and Amran Hashmi purportedly managed Happy Family and Family Social along with the marketers. To carry out the kickback scheme, Khan, Antao, Ijaz, Abassi and Hamdi allegedly used business entities to launder the fraud proceeds and generate cash to pay kickbacks and bribes. Seema Memon, an employee of Happy Family who was previously charged by complaint on July 1, was also indicted.

“As alleged in the indictment, these defendants orchestrated a years-long scheme to defraud Medicaid of tens of millions of dollars for social adult day care and home care services that they did not provide,” Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division, said in a statement. “The defendants allegedly paid cash bribes and kickbacks to recruiters and Medicaid recipients as part of a scheme to enrich themselves at the expense of vital programs for senior citizens. The charges make clear that the Criminal Division will not tolerate schemes that brazenly steal from federal health care programs.”

Khan has been charged with several offenses, including conspiracy to commit health care fraud, three counts of health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, paying health care kickbacks, conspiracy to commit money laundering, and money laundering. If found guilty, she could face a maximum penalty of 20 years in prison for each count of conspiracy to commit money laundering and money laundering, ten years in prison for each count of conspiracy to commit health care fraud, health care fraud, and paying health care kickbacks, and five years in prison for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Abassi, Antao, Hamdi and Ijaz face charges of conspiracy to commit health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, conspiracy to commit money laundering and money laundering. If found guilty, they could be sentenced to a maximum of 20 years for each count of conspiracy to commit money laundering and money laundering, ten years for conspiracy to commit health care fraud, and five years for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Hashmi is facing charges of conspiracy to commit health care fraud, three counts of health care fraud, conspiracy to defraud the United States, and paying and receiving health care kickbacks. If found guilty, he could be sentenced to a maximum of ten years for each count of conspiracy to commit health care fraud, health care fraud, and paying health care kickbacks, as well as five years for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Memon is charged with conspiracy to commit health care fraud, conspiracy to defraud the United States, and paying and receiving health care kickbacks. If convicted, she faces a maximum penalty of ten years for each count of conspiracy to commit health care fraud and paying health care kickbacks and five years for conspiracy to defraud the United States and pay and receive health care kickbacks.

Wasef faces charges of conspiracy to commit health care fraud, conspiracy to defraud the United States, and conspiracy to pay and receive health care kickbacks. If found guilty, she could face a maximum penalty of ten years for conspiracy to commit health care fraud and five years for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Since March 2007, the Health Care Fraud Strike program, consisting of nine strike forces operating in 27 federal districts, has prosecuted over 5,400 defendants who have overbilled federal health care programs and private insurers by over $27 billion.

“The crimes outlined in this indictment took advantage of a network that offers essential health care and other services to those in need,” Interim Commissioner Thomas G. Donlon of the New York City Police Department (NYPD) said in a statement. “Let it be clear: anyone who attempts to profit by defrauding the system will face consequences, as these schemes drain already limited resources and deprive beneficiaries of crucial funds. I commend our NYPD investigators and federal law enforcement partners for their continued collaboration.”