The Justice Department has continued to pursue healthcare fraud and bribery criminal prosecutions.  Healthcare fraud remains a high priority for criminal enforcement.

With the pervasive problem of fraud and bribery, the healthcare industry continues to suffer from corrupt officials and physicians.  Government regulation of the healthcare industry provides many opportunities and incentives for industry participants to cheat the system.

In a recent case, the Justice Department convicted the chief operating officer and three dentists for a board RICO conspiracy, including a conspiracy to defraud the MetroHealth Hospital System in Ohio, involving bribes and kickbacks totaling hundreds of thousands of dollars.

The blatant greed and corruption outlined in this criminal prosecution serves as an important reminder to healthcare officials – corrupt administrators and physicians are a significant risk.  In the case of MetroHealth, greed coalesced among key actors resulting in a broad multi-year conspiracy to defraud, cheat and steal from MetroHealth, Medicare and Medicaid.

Edward Hills worked in various positions at MetroHealth, including COO and Director of MetroHealth Dental.  He also served as interim President and CEO.  Sari Alqsous, Yazan Al-Madani, and Tariq Savegh, all dentists who worked for MetroHealth.

Over an eight year period, from 2008 to 2016, the defendants engaged in a racketeering conspiracy involving bribery, witness tampering and other crimes – Hills collected cash, checks, a Louis Vuitton briefcase, a television, airline flights and use of a downtown apartment from his co-defendants and others.  In return, Hills allowed the co-defendants and others to maintain private dental business during regular working hours while maintaining a salaried position with MetroHealth.

The defendants regularly communicated with each other and met at expensive restaurants.  The co-defendants and others regularly made cash deposits to Hills’ bank accounts.  Alqsous also made available an apartment for Hill’s use and made all rental payments to benefit Hill.  In addition, Hill requested and received new furniture for use in the apartment.

In December 2012, Hills became the interim CEO of MetroHealth.  Hills demanded payment of a Louis Vuitton briefcase worth approximately $4000, and the co-defendants purchased the briefcase for Hills.

As part of the overall bribery and kickback scheme, Hills rewarded the co-defendant dentists with bonuses, notwithstanding the fact that they did not actually work fulltime at MetroHealth and continued their private dental practices. Hills assigned residency candidates to work at the co-defendants’ dental clinics.

Hills and the co-defendants controlled the selection of residency candidates at MetroHealth.  The co-defendants demanded bribes which were paid by prospective candidates in exchange for selection by the MetroHealth residency program.  A portion of the bribes were paid, in turn, to Hills.

In another scheme, two of the co-defendants paid bribes to Hills to refer Medicaid patients to their private dental clinics instead of MetroHealth.  The defendants tried to disguise the bribes by labeling them as consulting fees.

The defendants were taken into custody after the verdicts were returned.  The defendants are expected to be sentenced in November 2018.