Warren doctor pleads guilty to fraud scheme

In 2011, an anonymous caller contacted the Blue Cross Anti-Fraud Hotline suggesting we take a close look at the medical practice of Dr. Hussein “Sam” Awada. Investigators from Blue Cross and the federal Health Care Fraud Task Force combined their efforts and uncovered that Awada had a business arrangement with a man who “recruited” both Blue Cross Blue Shield of Michigan and Medicare members to use Awada’s practice.

The doctor would make these members undergo unnecessary tests, including x-rays and stress tests, and then submitted their claims to Blue Cross or Medicare. He also wrote prescriptions for controlled medications in these patients’ names that his “recruiter” would fill and sell on the streets. Records indicate that from 2010 to 2012, Awada prescribed more than 80,000 pills, including oxycodone. He also reportedly bragged to witnesses that this scheme netted him approximately $20 million. 

This investigation led to a grand jury indictment in 2013 for 68 counts of fraud. In 2015, Awada pled guilty to two counts of the health care fraud and conspiracy to commit health care fraud. He was sentenced to seven years in a federal prison and has been ordered to pay $2.3 million in restitution to Blue Cross and Medicare. Blue Cross was awarded $848,000 of the total amount. In addition, a medical office building in Warren that Awada built using money from his health care fraud schemes was ordered by the court to be sold to help pay for his crimes.

We urge Blue Cross and Blue Care Network members who suspect health care fraud to call our Anti-Fraud Hotline at 1-800-482-3787 or to report fraud online, go to bcbsm.com/health-care-fraud.