DEARBORN – 10 residents of Dearborn and Dearborn Heights have been indicted under the Eastern District Court of Michigan for defrauding pharmaceutical companies in an elaborate scheme involving co-pay assistance reimbursement claims.
The indictment alleges that the 10 conspirators worked together to defraud pharmaceutical manufacturers by submitting co-pay claims for medications that were never prescribed or dispensed.
The individuals named in the indictment are:
Hussein Abdallah, 36, of Dearborn Heights.
Mohamad Abou-Khodr, 30, of Dearborn.
Daniel Haidar, 30, of Dearborn Heights.
Nabil Chehadeh, 39, of Dearborn.
Ali El-Moussawi, 29, of Dearborn.
Bassem Farhat, 46, of Dearborn.
Hussein Wazne, 50, of Dearborn.
Bahia Zeidan, 28, of Dearborn.
Linda Fawaz, 25, of Dearborn Heights.
Suzan Berro, 20, of Dearborn.
U.S. Attorney Matthew Schneider announced in a statement on Wednesday that the alleged scheme amounted to more than $46 million in profits for the defendants between 2014 and November of this year.
Eight of those named were in court on Wednesday with five returning Thursday for detention hearings.
Co-pay assistance programs, also known as co-pay savings programs, help to defray the costs of prescription medications for individuals whose commercial insurance doesn’t fully cover their medicines or doesn’t cover a particular medicine. The programs also aid people who do not have commercial insurance.
Pharmacies submit co-pay claims that go through several third-party administrative entities that relay the information to pharmaceutical companies. The layered structure is intended to protect the sensitive personal information of patients.
The indictment names a large number of pharmacies involved in the alleged scheme, located in cities like Canton, Dearborn Heights, Garden City, Westland, Taylor and Sterling Heights. It also names certain “affiliated companies” that provided consulting services or acted as shell companies for some of the main conspirators.
According to the indictment, some of the defendants, like Abdallah, Abou-Khodr and Haidar, were businessmen who owned the pharmacies involved and coordinated that defrauding scheme. Farhat was an accountant who helped prepare legal documents for the pharmacies. Berro was simply an employee of Abdallah’s who worked under the direction of office manager Fawaz to process coupon reimbursements for Abdallah’s various pharmacies.
Allegedly, many of the pharmacies had physical locations but no actual inventory and no legitimate prescription business. They routinely submitted claims on behalf of patients who did not exist. When third-party administrators became suspicious of the pharmacy’s billing documentation, the defendants would close the pharmacy and then open a new one in the same location.
The counts against those involved in the scheme range from conspiracy to commit wire and mail-fraud to aiding and abetting and money laundering. If convicted, the government may forfeit from the defendants personal property like vehicles, homes in Dearborn Heights and money equaling what was made in the scheme. It is unclear whether the defendants will see jail time.