May 14, 09

NEWS / Last Two Defendants Convicted in Ambulance Fraud Case Sentenced

HOUSTON—Mazen Abdallah and Wesam Abdallah, of Houston, have each been sentenced to 30 months in federal prison for their roles in a multi-million dollar ambulance fraud case, acting U.S. Attorney Tim Johnson announced today.

The prison terms were handed down on Tuesday, May 12, 2009, by United States District Judge Lee H. Rosenthal. In addition to the prison terms, the court ordered Mazen, 28, and Wesam, 33, to pay restitution of $637,425 to Medicare and Medicaid and to forfeit a similar amount to the United States. The brothers were ordered into federal custody immediately after yesterday’s hearing to begin serving their sentences.

The two brothers were indicted in June 2007 along with three other defendants and convicted by a jury’s verdict in May 2008 after a five-week trial where more than 50 witnesses testified. Mazen and Wesam Abdallah were each convicted of conspiracy to commit health care fraud. Wesam Abdallah was also convicted of health care fraud and an anti-kickback violation.

Americare Ambulance Service, a Medicare and Medicaid provider, primarily engaged in transporting non-emergency dialysis patients to dialysis treatment. Dialysis patients typically need dialysis three times a week and the average reimbursement rate for each roundtrip to/from treatment with mileage is approximately $400-$500.

Americare, owned and operated by the Abdallahs, filed false and fraudulent reimbursement claims for transporting dialysis patients to and from their homes for dialysis treatments. A prescription is required for transport, but many of Americare patients did not qualify for transport and either had no prescription, used a prescription where the doctor’s signature was photocopied or procured by trick from two nursing home doctors. In addition, the defendants paid many patients kickbacks to ride with their ambulance service, instead of another, in violation of the law. Some patients were transported by cars, but the service was billed as if by ambulance.

Two other defendants who owned and operated Americare before selling it to Mazen Abdallah - Ayad Fallah and Murad Almasri, a cousin to the Abdallahs - have each already been sentenced to 20 months in federal prison and ordered to pay $1.6 million in restitution. These two defendants pleaded guilty and testified at trial against the Abdallah brothers. The remaining defendant, Raed Elmasri, is a fugitive.

This case was the result of the investigative efforts of the FBI, the Texas Attorney General’s Medicaid Fraud Unit in Houston, the Department of Health & Human Services - Office of the Inspector General Office of Investigations and the U.S. Attorney’s Office. Special Assistant United States Attorney Suzanne Bradley and Assistant United States Attorney Albert A. Balboni prosecuted the case.