Indian-American couple charged with $8.8 million in Medicare fraud

This is a retelling, in our own words, of the federal case announced in July 2012. The defendants were charged, not convicted; the allegations below are from the indictment.

An Indian-American couple from Michigan was charged by U.S. federal authorities with running a healthcare fraud scheme that submitted more than $8.8 million in allegedly false medical bills to Medicare.

Usha Shah and Deepak Shah, both 63, were named in a federal indictment announced by U.S. Attorney Barbara McQuade. According to the indictment, the Shahs ran a series of Medicare fraud schemes involving home health services through their company, Miracle Home Health of Southfield, billing for home health care services that were medically unnecessary and, in many cases, never provided.

The indictment also alleged that the couple conspired to pay cash kickbacks in exchange for obtaining Medicare beneficiaries — recruiting patients whose information could be used to generate the fraudulent claims.

Medicare fraud prosecutions of this kind were a major federal enforcement priority in this period, with the Justice Department running dedicated strike forces in cities with high fraud rates. Home health care was a particular focus: it was a fast-growing, lightly supervised corner of Medicare spending, and schemes built on billing for services never rendered had become one of the program's most persistent vulnerabilities.

The case was, at the time of reporting, at the indictment stage — the charges were allegations, and the defendants were presumed innocent unless proven guilty.