Detroit-Area Physical Therapist Pleads Guilty in Medicare Fraud Scheme

Source: United States Department of Justice Criminal Division

Troy, Mich., resident Syed Aziz pleaded guilty today in U.S. District Court in Detroit to participating in a conspiracy to defraud the Medicare program.

In his plea today, Aziz, a licensed physical therapist, admitted that he began working in approximately May 2005 as a contract therapist for a co-conspirator, Suresh Chand.  Chand owned and controlled several companies operating in the Detroit area that purported to provide physical and occupational therapy services to Medicare beneficiaries.  Aziz admitted that he, Chand, and others created fictitious therapy files appearing to document physical and occupational therapy services provided to Medicare beneficiaries, when in fact no such services were provided.  According to court documents, the fictitious services reflected in the files were billed to Medicare through sham Medicare providers controlled by co-conspirators. 

Chand admitted to paying cash kickbacks and other inducements to Medicare beneficiaries in exchange for the beneficiaries’ Medicare numbers and signatures on documents falsely indicating that they had received physical or occupational therapy.  Chand pleaded guilty on Sept. 28, 2009, in U.S. District Court in Detroit to one count of conspiracy to commit health care fraud and one count of conspiracy to launder money. Aziz admitted that he was one of the licensed physical or occupational therapists from whom Chand obtained signatures on fictitious “progress notes” and other documents falsely indicating that the therapists had provided services to the Medicare beneficiaries.

Aziz also admitted that during the course of the scheme, he signed approximately 400 fictitious physical therapy files, indicating that he had provided physical therapy services to Medicare beneficiaries, when in fact he had not. Aziz admitted that he was paid between $70 and $90 for each file he falsified. Aziz also admitted that between approximately May 2005 and December 2006, he falsified physical therapy files that supported claims to the Medicare program totaling approximately $1,895,000. According to court documents, Medicare paid approximately $817,000 on those claims. Aziz admitted that throughout the conspiracy he was fully aware that Medicare was being billed for physical therapy services that he falsely indicated he had performed.

At sentencing, scheduled for Feb. 3, 2010, Aziz faces a maximum prison sentence of 10 years and a $250,000 fine.

The case is being prosecuted by Trial Attorneys John K. Neal, Gejaa T. Gobena and Benjamin Singer of the Criminal Division’s Fraud Section and by Special Assistant U.S. Attorney Thomas W. Beimers of the Eastern District of Michigan. The FBI and the HHS Office of Inspector General (HHS-OIG) conducted the investigation. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since the inception of Strike Force operations in March 2007 – Miami (Phase One), Los Angeles (Phase Two), Detroit (Phase Three) and Houston (Phase Four) – the Strike Force has obtained indictments of more than 331 individuals and organizations that collectively have billed the Medicare program for more than $720 million.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Each of the Strike Force teams across the separate phases is led by a federal prosecutor from the Criminal Division’s Fraud Section or the U.S. Attorney’s Office.  Each team has an agent from the FBI and HHS-OIG.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT) , go to:  www.stopmedicarefraud.gov.

D.C. Lobbyist Indicted for Conspiring to Violate Sudanese Sanctions and to Act as Illegal Agent of Sudan

Source: United States Department of Justice Criminal Division

Robert J. Cabelly, 61, of Washington, D.C., has been indicted in the District of Columbia in an eight-count indictment charging him with conspiracy to violate the Sudanese sanctions regulations and to act as an unregistered agent of a foreign power, four counts of violating the Sudanese sanctions regulations, as well as one count apiece of money laundering, passport fraud and making false statements.

Cabelly, who was the principal and managing director of a Washington, D.C. consulting firm and a former State Department employee, is scheduled to appear in federal court today in the District of Columbia at 1:30 p.m. before U.S. Magistrate Judge Deborah Robinson. If convicted, he faces up 20 years in prison on each of the substantive Sudanese Sanctions Regulations counts, 20 years for the money laundering count, 10 years for the passport fraud, and five years each for the conspiracy and false statement counts.

According to the indictment, between early 2005 and mid-2007, Cabelly performed work on behalf of the Republic of Sudan, a country currently on the State Department’s State Sponsors of Terrorism list, without the approval of the U.S. government as is required by law under the Sudanese sanctions regulations. In an effort to make money, Cabelly brokered business contracts and transactions benefiting Sudan. He also provided Sudan with U.S. government information that was sensitive and controlled. All the while, Cabelly affirmatively misrepresented to U.S. officials the nature of his relationship with Sudan, as well as his relationship with the foreign entities doing business in Sudan.

Among other acts alleged in the indictment, Cabelly engaged in illicit contractual relationships with the oil industry in Sudan, operating as an intermediary between Sudanese government officials and oil company executives and a foreign oil company, and sought additional investors on behalf of that foreign oil company so that it could do business in the Sudan. He also allegedly provided strategic advice and counsel to Sudanese officials, including in the areas of economic development and trade, especially as it pertained to the development of the country’s petroleum natural resource and its government controlled airline industry.

According to the indictment, Cabelly was paid for these services by Sudanese government officials as well as by a foreign oil company. Cabelly allegedly directed a foreign oil company to deposit over $180,000 of the fees he received in an offshore account he maintained in the Cook Islands, an account he used to launder the funds in order to conceal the fact that it was proceeds obtained in violation of the sanctions. Cabelly also concealed his travel to the Sudan from U.S. authorities by misusing U.S. passports.

“The conduct alleged in this indictment is broad in scope and very serious,” said David Kris, Assistant Attorney General for National Security. “We will continue to pursue anyone who seeks to violate U.S. sanctions.”

“Those who pursue their own personal gain at the expense of our nation’s trade embargoes can expect to be aggressively prosecuted,” said Acting U.S. Attorney Channing Phillips.  “Our national security depends on strict enforcement of U.S. export laws such as the Sudanese Sanctions Regulations.”

“The FBI is committed to enforcing all laws pertaining to U.S. persons and the representations of foreign governments to ensure those relationships aren’t counterproductive to our fight against terrorism,” said Joseph Persichini, Jr., Assistant Director for the FBI’s Washington Field Office.

“The activities detailed in this indictment – including facilitation of Sudanese oil transactions – would represent serious violations of U.S. sanctions law. We commend our federal law enforcement colleagues for their dedicated and collaborative efforts,” said Adam J. Szubin, Director of the Treasury Department’s Office of Foreign Assets Control.

The investigation was conducted through the collaborative efforts of the FBI’s Washington Field Office, the State Department’s Bureau of Diplomatic Security, the Naval Criminal Investigative Service (NCIS) and the U.S. Customs and Border Protection. The Department of Treasury’s Office of Foreign Assets Control (OFAC) also provided substantial assistance and cooperation throughout the course of the investigation.

The prosecution is being handled by Assistant U.S. Attorney Michael C. DiLorenzo from the U.S. Attorney’s Office for the District of Columbia, and Trial Attorney Patrick T. Murphy from the Counterespionage Section of the Justice Department’s National Security Division.

The public is reminded that a criminal indictment contains mere allegations and is not evidence of guilt. A defendant is presumed innocent unless and until proven guilty.

Security News: OIP Issues New Guidance on the Definition of a Record and the Processing of Records Responsive to a Request

Source: United States Department of Justice 2

One of the first questions that an agency must answer as it begins to process a FOIA request is: “What exactly is the requester seeking?” The answer to that question will determine the scope of the agency’s search for responsive records and that in turn will create the universe of records that needs to be processed for release. Sometimes a requester seeks information on a particular topic and in the course of conducting their search for records on that topic, the agency may locate documents that discuss a number of different subjects, only some of which relate to the topic of the FOIA request. If only a portion of a document concerned the topic of a request, a common practice has been for an agency to process only the responsive portion and redact the other portions as “non-responsive” or “outside the scope” of the request. Given that the processing of FOIA requests can be very labor-intensive and time-consuming, it is in both the requesters’ interests and the agencies’ that time and resources not be expended unnecessarily by reviewing material that was not requested. While many district courts had approved the practice of agencies redacting “non-responsive” material from records processed for release under the FOIA, in July 2016, the issue was addressed by the Court of Appeals for the District of Columbia Circuit in American Immigration Lawyers Association v. EOIR, 830 F.3d 667 (D.C. Cir. 2016).

OIP’s guidance summarizes the Court of Appeals for the District of Columbia’s holding that the FOIA “does not provide for . . . redacting non-exempt information within responsive records.” As declared by the court, “once an agency identifies a record it deems responsive to a FOIA request, the statute compels disclosure of the responsive record—i.e., as a unit—except insofar as the agency may redact information falling within a statutory exemption.” As a result of the ruling in AILA, it will be important for agencies to carefully define what they consider to be the “records” responsive to any given FOIA request. In addition to some practical considerations, OIP’s guidance provides principles for agencies to follow when determining what constitutes a “record” responsive to a FOIA request.

The full text of the guidance, along with all other guidance issued by OIP, is available on our guidance page. If you have any questions regarding this new guidance, please contact OIP’s FOIA Counselor Service at (202) 514-FOIA (3642).

Security News: DOJ Publishes Updated FOIA Regulation

Source: United States Department of Justice 2

The FOIA Improvement Act of 2016 required all agencies to review and update their FOIA regulations in accordance with the amendments to the FOIA. The Department of Justice has completed its review and today has published an Interim Final Rule that brings the regulation into alignment with the provisions contained in the FOIA Improvement Act of 2016. For example, the Department has updated its FOIA regulation to:

  • provide requesters 90 days to file administrative appeals, and
  • require components to notify requesters about the availability of the component’s FOIA Public Liaison and the Office of Government Information Services (OGIS) to provide assistance at various stages throughout the request process.

The Department has also amended the fee provisions of the regulation to incorporate the new statutory restrictions on charging fees in certain circumstances and has included a new paragraph regarding engaging in dispute resolution services provided by OGIS.

The updated regulation also reflects recent developments in the case law addressing two FOIA fee categories: “representative of the news media” and “educational institution.” See Cause of Action v. FTC, 799 F.3d 1108 (D.C. Cir. 2015); Sack v. DOD, 823 F.2d 687 (D.C. Cir 2016). Finally, the Department of Justice has streamlined the description of the factors to be considered when making fee waiver determinations. These updates do not substantively change the analysis, but instead present the fee waiver factors in a way that is clearer for both components and requesters to understand and apply.    

The Department issued these updates as an Interim Final Rule, with a request for comments. The rule will be effective February 3, 2017. For additional information, please refer to the Federal Register notice.  

Security News: Request for Public Comment on Draft “Release to One, Release to All” Presumption

Source: United States Department of Justice 2

Today, DOJ published for public comment in the Federal Register a draft policy implementing a “Release to One, Release to All” presumption for FOIA processed records.  The notice and the draft policy can be accessed on Regulations.gov.  This draft policy reflects a series of efforts going back to 2015.

In July 2015, DOJ launched a 6-month pilot program with seven volunteer Federal agencies to assess the viability of a policy that would direct agencies to proactively post online their FOIA responses.  This concept would ensure that all citizens—not just those making a request—have access to information released under FOIA.  Over the course of the pilot, DOJ worked with participating agencies to capture metrics on the time and resources associated with implementing this policy, as well as any impacts on interested stakeholders. 

In June 2016, in conjunction with President Obama signing the FOIA Improvement Act of 2016, the White House released a fact sheet announcing a number of new steps to build on all the progress made in the implementation of FOIA, including working on the establishment of a “Release to one, Release to all” presumption.  The President directed the newly established Chief FOIA Officers Council to consider the lessons learned from the DOJ pilot program, and to work on the development of a Federal Government policy establishing a “release to one, release to all” presumptive standard.  Through the Chief FOIA Officers Council, DOJ examined issues critical to this policy’s implementation, including assessing the impact on investigative journalism efforts, as well as how best to address technological and resource challenges.  

The draft policy published today reflects DOJ’s considerations from both the lessons learned from the DOJ pilot and all of the issues examined through the Chief FOIA Officers Council, including certain exceptions to the policy and two different options for the timing of when documents should be posted online.  DOJ welcomes your comments on the entire draft policy and all public comments will be considered when finalizing the guidance.

You may download the draft policy directly through the link below.  If you would like to provide feedback on this draft policy, please submit your comments by no later than Friday, December 23, 2016.  All comments should be provided through Regulations.gov.

Draft “Release to One, Release to All” Policy