Michigan Attorney General Bill Schuette today announced he has filed two felony counts of Medicaid Fraud—False Claim, a four-year felony, against 53-year old Southwest Michigan chiropractor Ahad Lotfi of the community of Lawton.
Lotfi, who owned and operated chiropractic clinics in Hartford, Paw Paw, Bangor, and South Haven, was allegedly billing supplies to the Medicaid program that were not eligible for Medicaid billing. These supplies included custom made shoe inserts and therapeutic pillows, which Medicaid pays $270.50 and $97.96 respectively per item. The Medicaid program allegedly paid Lotfi nearly $200,000.00 over two years as a result of billing these two item codes.
The Attorney General says, “The Michigan Medicaid program exists to pay healthcare costs for eligible Michiganders—not to function as a cash cow for unscrupulous providers.”
Lotfi was arraigned today before Judge Richard D. Ball of the 54B District Court in East Lansing and given a $20,000 personal recognizance bond. Lotfi is next due in court on May 19, 2017 at 8:30am for a pre-exam conference.
Schuette’s Health Care Fraud Division used new techniques involving data mining to identify a stark change in established billing patterns. It is alleged that Lotfi billed the two codes that correspond to the inserts and pillows beginning in 2015 for medical supplies.
Data mining involves actively policing Medicaid data in search of anomalies that could indicate fraud.
Schuette’s Health Care Fraud Division recently became the first such unit in the nation to secure special approval from the federal government to engage in data mining of Medicaid data.
A criminal charge is merely an allegation and the defendant is presumed innocent until and unless proven guilty.
