Pharmacy Owner and Brother Convicted of Health Care Fraud
Pharmacy Owner and Brother Convicted of Health Care Fraud
A federal jury has convicted a Michigan pharmacy owner, Raad Kouza, and his brother, Ramis Kouza, of conspiracy to commit health care fraud and wire fraud.
According to court documents and evidence presented at trial, the Kouza brothers submitted fraudulent claims to Medicare, Medicaid, and Blue Cross Blue Shield of Michigan for prescription medications they did not dispense. The fraudulent billing occurred at pharmacies they owned or operated within Michigan, resulting in over $15 million in losses to these health care programs.
Both Raad Kouza and Ramis Kouza were found guilty of conspiracy to commit health care fraud and wire fraud. In addition, Raad Kouza was convicted of an additional count of health care fraud.
Raad and Ramis Kouza face significant penalties for their crimes. On the conspiracy count, each defendant could receive a maximum penalty of 20 years in prison. Additionally, Raad Kouza faces up to 10 years in prison for the health care fraud count. A federal district court judge will set the sentencing date and determine the final penalties, taking into account the U.S. Sentencing Guidelines and other legal factors.
The announcement of the conviction was made by Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division, Special Agent in Charge Cheyvoryea Gibson of the FBI Detroit Field Office, and Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG).
The FBI Detroit Field Office and HHS-OIG conducted the investigation leading to the conviction of the Kouza brothers.
The case was prosecuted by Trial Attorneys Claire Sobczak Pacelli, Jeffrey A. Crapko, and Andres Q. Almendarez from the Criminal Division’s Fraud Section.
The Justice Department’s Fraud Section leads efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Established in March 2007, this initiative now includes nine strike forces across 27 federal districts. To date, it has charged over 5,400 defendants involved in schemes that have collectively billed federal health care programs and private insurers more than $27 billion.
In addition, the Centers for Medicare & Medicaid Services, in coordination with HHS-OIG, is taking measures to hold providers accountable for participating in health care fraud schemes.
