California Man Sentenced for $234M Medicare Scam in Healthcare Fraud Case

Imran Shams, a resident of Glendale, California, has received a 10-year federal prison sentence for his involvement in a Medicare fraud scheme worth around $234 million. The scheme centered around a laboratory that fraudulently billed Medicare for a range of lab tests, including those related to COVID-19 and respiratory pathogens. It is important to note that Shams had been excluded from the Medicare program, making his participation in the scheme illegal.

Shams has a track record of engaging in Medicare and Medicaid fraud. He was convicted in two separate cases in New York and California in 1990 and 2001 respectively. Despite being banned from participating in federal health care programs after each conviction, Shams boldly continued to run healthcare clinics in New York, disregarding the regulations imposed by the Department of Health and Human Services Office of Inspector General (HHS-OIG).

In 2018, Shams became heavily involved in the day-to-day operations of Matias Clinical Laboratory, which was operating as Health Care Providers Laboratory (HCPL) in Baldwin Park, California. In order to keep HCPL’s status as a Medicare provider, Shams and a co-conspirator carried out fraudulent activities. These activities included hiding Shams’ ownership and management position in HCPL, submitting falsified documents to Medicare and the California Department of Public Health, and providing false statements to federal authorities.

HCPL fraudulently billed Medicare around $234 million between August 2018 and April 2022, resulting in payments of approximately $31.7 million from these fraudulent claims. Shams pleaded guilty in January 2023 to conspiracy to commit health care fraud and concealment of his exclusion from Medicare.

Shams has been sentenced to 10 years in prison and has also been ordered to forfeit over $31 million and pay restitution. The FBI Los Angeles Field Office and HHS-OIG conducted the investigation, with the Criminal Division’s Fraud Section leading the prosecution.


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