Home health care fraud scheme dismantled

A large-scale conspiracy to defraud Medicare and private insurance companies has been dismantled and the criminals are heading to jail. 

Sachin Sharma was the ringleader behind an effort to enrich himself and others by setting up home health care companies whose primary purpose was to generate cash. Sharma also trained people on how to establish and organize similar companies, and how to defraud Medicare and conceal the fraud. Between 2007 and 2012, Sharma and his co-conspirators were affiliated with at least 23 home health care companies, adult day care facilities, psychotherapy and medical clinics.

Recruiters were paid to go into the community and find Medicare beneficiaries who would participate in the scheme or would take money for the use of their contract numbers. Those numbers would be used to bill Medicare and private insurers for services that were never provided or not medically necessary.

The scheme resulted in $29 million in fraudulent claims to Medicare and more than $1 million in claims paid by Blue Cross Blue Shield of Michigan.

Sharma has pled guilty to the charges of conspiracy to commit health care fraud and tax evasion. He will be sentenced in the fall of 2015.

Several of his co-defendants have been sentenced, receiving up to 10 years in jail and ordered to pay millions in dollars of restitution.

We urge Blue Cross Blue Shield of Michigan or Blue Care Network members who suspect health care fraud to call our toll free Anti-Fraud Hotline at 1-800-482-3787 or to report fraud at bcbsm.com.