Brother Sentenced, Health Care, Wire Fraud Scheme Friday — Pharmacist and Brother Sentenced to Prison for $15M Health Care and Wire Fraud Scheme | United States Justice Department.
Pharmacist and Brother Sentenced to Prison for $15M Health Care and Wire Fraud Scheme Friday. A former Michigan pharmacist and his brother were sentenced yesterday to eight years in prison and five years in prison, respectively, for their roles in a conspiracy to commit health care fraud and wire fraud.court filings state and evidence presented at trial, from approximately 2010 to 2019, Raad Kouza, 59, of Wayne County, a pharmacist, and his brother, Ramis Kouza, 46, of Oakland County, a pharmacy manager, billed Medicare, Medicaid and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated in Michigan. As a result of their criminal conduct, the defendants caused a total of over $15 million loss to Medicare, Medicaid and Blue Cross Blue Shield of Michigan.In November 2024, Raad Kouza and Ramis Kouza were convicted of conspiracy to commit health care fraud and wire fraud by a federal jury in the Eastern District of Michigan. In addition, the Centers
for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. The defendants executed this fraud by targeting the billing of expensive medications, such as antipsychotics and inhalers, and by concealing inventory shortages at their pharmacies from multiple auditors. Galeotti of the Justice Department’s Criminal Division; Special Agent in Charge Jennifer Runyan 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) made the announcement.