Two men from Georgia were sentenced Monday for orchestrating a massive health care fraud scheme that submitted over $522 million in fraudulent claims to Medicare and Medicaid. Reyad Salahaldeen and Mohamad Mustafa used illegal kickbacks and bribes to obtain genetic tests that were not medically necessary, according to the Department of Justice.
Genetic testing fraud sentence
What we know:
Reyad Salahaldeen, 57, of Buford, was sentenced to 151 months in prison after pleading guilty to conspiracy to commit health care fraud and wire fraud. Mohamad Mustafa, 28, of Duluth, was sentenced to three years in prison for paying health care kickbacks.
Between 2018 and August 2020, the men controlled labs in Georgia, New Jersey, and Texas to bill for tests designed to predict cancer risks and drug reactions. According to court records, the group targeted patients through telemarketing and health fairs to get insurance info and DNA samples.
Millions in fraudulent claims
By the numbers:
The four laboratories involved billed approximately $522 million in false claims, with insurers actually paying out roughly $84 million. Salahaldeen was ordered to pay more than $84.5 million in restitution and must forfeit a 2019 GMC Yukon along with properties in Georgia and Texas.
Mustafa was ordered to pay $64,301,569 in restitution for his role in the scheme. Eleven other co-conspirators, including doctors and nurse practitioners, have already pleaded guilty and received sentences ranging from probation to 46 months in prison.
Unnecessary medical testing
What we don't know:
While officials identified the total amount billed, the Department of Justice did not specify exactly how many individual patients were targeted across the various states. It is also unclear how many of the patients were aware their information was being used for fraudulent purposes.
Attempted escape to Mexico
The backstory:
After an indictment was returned, Salahaldeen tried to hide from law enforcement by traveling from North Carolina to Texas to enter Mexico. Federal agents caught him at the border after he tried to use another person’s identification to get across.
To hide the bribes, Mustafa and Salahaldeen created fake contracts and invoices to make the payments look like legal marketing services. Assistant Attorney General Colin M. McDonald said the scheme destroyed the trust in medicine that patients deserve.
The Source: The information in this story was gathered from a press release provided by the United States Department of Justice, which detailed the sentencing of Reyad Salahaldeen and Mohamad Mustafa and the investigation led by the FBI and the Department of Health and Human Services.