MI: Pharmacist, Physician, and Pharmacy Technician Charged in Health Care Fraud Scheme

Healthcare Facility Rx Drug Diversion – Healthcare Fraud

Three individuals, including a pharmacist, doctor, and pharmacy technician, were charged in an Indictment for their alleged roles in a more than $7 million health care fraud scheme involving the diversion of expensive “specialty” prescription drugs, United States Attorney Dawn N. Ison announced.

Joining in the announcement were Devin J. Kowalski, Acting Special Agent in Charge, Federal Bureau of Investigation (FBI), Special Agent in Charge Mario Pinto, Health and Human Services, Office of Inspector General (HHS-OIG), Special Agent in Charge Angie M. Salazar, Homeland Security Investigations (HSI), and Special Agent in Charge Orville Green, Drug Enforcement Administration.

Charged in the Indictment are:

•          Samer N. Youssef, age 56, of Troy, Michigan and Indian Rocks Beach, Florida.

•          Dr. Daoud Faraj, age 52, of Dearborn, Michigan; and

•          Houda Bazzi, age 34, of Dearborn, Michigan and Indian Rocks Beach, Florida.

The charges against Youssef, Dr. Faraj, and Bazzi include one count of health care fraud conspiracy and 15 counts of health care fraud, aiding and abetting. Youssef is also charged with 12 counts of money laundering.

According to the Indictment, beginning in 2016, and continuing through 2021, Youssef, a licensed pharmacist, worked with other people to identify expensive “specialty” drugs that he could re-sell. “Specialty” drugs are prescription medications that treat less common conditions, or have other unique features, and prescriptions for the drugs are usually filled by specialty pharmacies, not regular retail pharmacies, via the mail or courier. Some of the specialty drugs identified in the indictment were meant to treat cystic fibrosis and relapsing forms of multiple sclerosis.

Youssef worked with physicians in Southeast Michigan, including Dr. Faraj, to write medically unnecessary prescriptions for the specialty drugs Youssef wanted. Dr. Faraj wrote the medically unnecessary prescriptions in the names of “patients” who were individuals Youssef, Bazzi, or Dr. Faraj knew, including Medicare beneficiaries, and in the names of Youssef and Bazzi themselves, who were covered by Blue Care Network.

These defendants arranged for the medically unnecessary drugs to be shipped to addresses in southeast Michigan which were under their control.    Youssef, Dr. Faraj, and Bazzi caused Medicare and Blue Care Network to be billed for the medically unnecessary specialty medications.  Medicare and Blue Care Network then paid for the specialty medications, which Youssef, Bazzi, and others sold and shipped to domestic and foreign businesses at 100% profit.

“These licensed health care professionals are alleged to have defrauded Medicare and private insurers  of millions of dollars and lined their own pockets with funds meant to provide essential services to seniors and disabled individuals ,” said U.S. Attorney Ison. “My office is committed to prosecuting any medical professional who attempts to exploit taxpayer-funded programs or private insurers.”

“Medical professionals and others who submit fraudulent claims to Medicare, undermine the solvency of our valuable Federal health care programs,” said Mario M. Pinto, Special Agent in Charge with the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG).  “HHS-OIG is committed continuing to working with our law enforcement partners to ensure that those alleged of defrauding these programs are held accountable.”

“These defendants allegedly compromised the integrity of the healthcare systems by taking millions of dollars that should have gone to providing quality care to patients with true medical needs,” said Devin J. Kowalski, Acting Special Agent in Charge of the FBI’s Detroit Field Office. “The FBI and our law enforcement partners will not relent in our efforts to investigate and bring to justice anyone who engages in this type of criminal behavior.”

“HSI is committed to working with our partners to identify and investigate criminal activity that defrauds the American taxpayer,” said HSI Detroit Special Agent in Charge Angie M. Salazar. “This type of fraud hurts all members of our community but is especially dangerous to the elderly and those who rely on these programs for treatment of serious illnesses.”

An indictment is only a charge and is not evidence of guilt.  The burden is on the government to prove guilty beyond a reasonable doubt.

The case is being prosecuted by Assistant United States Attorney Andrew J. Lievense, and Assistant United States Attorney Jessica Nathan is handling related forfeiture matters. The investigation is being conducted jointly by the FBI, HHS-OIG, HSI, and the DEA.