Pharmacists Sent to Prison for Insurance Fraud

The US Department of Justice has announced that 4 pharmacy owners have been sentenced to prison following their convictions by a federal jury for health care and wire fraud.

Just the Facts

Pharmacist Raef Hamaed of Arizona, pharmacist Tarek Fakhuri of Canada, pharmacist Ali Abdelrazzaq of Michigan, and pharmacist Kindy Ghussin of Ohio owned and operated 5 pharmacies in Michigan and Ohio—Eastside Pharmacy, Harper Drugs, and Wayne Campus Pharmacy in Michigan, and 2 Heartland Pharmacies in Ohio. According to evidence presented at trial in 2024, the pharmacists billed Medicare, Medicaid, and Blue Cross Blue Shield of Michigan for prescription drugs that were never dispensed. In total, the defendants resulted in more than $13 million in loss to Medicare, Medicaid and Blue Cross Blue Shield.

The Trial

The pharmacists stood trial in 2024. On September 5, all 4 pharmacists were convicted by a federal jury of conspiracy to commit health care fraud and wire fraud. In addition, the jury convicted Fakhuri of 1 count of health care fraud. Hamaed was found guilty for his role in the conspiracy at all 5 pharmacies. Fakhuri was convicted for his part in the conspiracy at Harper Drugs, Wayne Campus Pharmacy, and Heartland Pharmacy. Ghussin was convicted for his role in the conspiracy at Wayne Campus Pharmacy and both Heartland Pharmacies. Abdelrazzaq was convicted for his part in the Wayne Campus Pharmacy conspiracy.

The Sentencing

The 4 pharmacists were sentenced in early 2025. All received prison time. Hamaed received the longest sentence of 8 to 10 years. Fakhuri was sentenced to7 years. Ghussin was sentenced to 5 years and 5 months, while Abdelrazzeq received the shortest sentence of 2 years.

The Takeaway

This investigation was led by the Health Care Fraud Strike Force Program. The program is made up of 9 strike forces operating in 27 federal districts. Since it’s inception in March 2007, the program has charged over 5800 defendants who have collectively billed over $30 billion to both federal health care programs, such as Medicare and Medicaid, and private insurers.

The core mission of the Justice Department’s Health Care Fraud Unit is to protect the public from fraud involving benefits programs and to protect patients from schemes that result in patient harm, such as the overprescribing of controlled substances. The government takes this very seriously and routinely prosecutes individuals who attempt to commit fraud on patients or government programs. Great care should always be used when filing claims for federal programs.

References

Four pharmacists sentenced for roles in $13M Medicare, Medicaid, and private insurer fraud conspiracy. Press release. Office of Public Affairs, US Department of Justice. Published February 6, 2025. Accessed March 7, 2025. https://www.justice.gov/opa/pr/four-pharmacists-sentenced-roles-13m-medicare-medicaid-and-private-insurer-fraud-conspiracy

Criminal Division, US Department of Justice. Health Care Fraud Unit. Updated February 16, 2024. Accessed March 7, 2025. https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit