West Bloomfield, MI (WorkersCompensation.com) – A former chief executive officer that led Tri-County Wellness Group with offices in Michigan and Ohio has been formerly sentenced to 15 years in prison for his role in a $150 Million Health Care fraud scheme. Forty-year-old Mashiyat Rashid from Bloomfield, Mich., initially pleaded guilty in 2018 to one count each of conspiracy to commit healthcare fraud, wire fraud, and money laundering. In addition to the 15-year prison sentence, Rashid was ordered to reimburse Medicare for over $51 million in fraudulent charges, forfeiture of proceeds totaling over $11.5 million in addition to real estate holdings, and confiscation of a Detroit Pistons season ticket membership.
The initial investigation included 22 defendants, of which 12 were physicians that have since been convicted. The federal case alleges that the clinic’s policy was to provide Oxycodone 30 mg to patients in exchange for agreeing to undergo medically unnecessary spinal injections that could be billed to insurance. Additionally, physicians were incentivized by receiving a share of the reimbursement from these injections.
Some of the patients were legitimate back pain cases, but many were also addicts or drug dealers. According to the report from the Department of Justice (DOJ), the clinics intentionally sought out Medicare patients and, thus, commonly recruited from homeless shelters and soup kitchens. Essentially, the investigators allege, that patients were forced to submit to the unnecessary injections in exchange for the prescriptions, and that injections were determined based on reimbursement rates from Medicare.
According to the testimony given at the federal trial, many of the patients experienced drastic side effects from these injections. Several patients complained of an increase in the severity of their back pain. In some cases, patients experienced severe adverse reactions, which included causing a hole in their back. Testimony was also given that there were commonly audible screams heard in the clinic during times when injections were given, and former staff described the practices as “barbaric.”
The number of unnecessary injections was so great, that according to the DOJ press release, Tri-County Wellness Group received more reimbursement for facet joint injections than any other clinic in all of the United States. This was due in part to repeated injections given to opioid addicts that were seeking their supply of Oxycodone.