OIG Excludes Company and Owner from Federal Health Care Programs
15-Year Exclusion A Reminder to Industry
Washington, DC - On August 17, 2018, Administrative Law Judge (ALJ) Bill Thomas upheld OIG's 15-year exclusion of Karim Maghareh, Ph.D. and BestCare Laboratory Services, LLC from participation in all Federal health care programs under section 1128(b)(7) of the Social Security Act, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced today.
"The decision reached in this case illustrates how OIG will use its administrative exclusion authority to protect the Federal health care programs from untrustworthy individuals and entities who engage in Medicare fraud," said Gregory E. Demske, Chief Counsel to the HHS Inspector General.
Maghareh is the majority owner and CEO of BestCare, a clinical laboratory with its primary facility in Webster, Texas. Based on evidence presented at an administrative hearing, ALJ Thomas found that Maghareh and BestCare submitted false claims to Medicare for reimbursement of travel costs associated with the collection of samples on which BestCare performed laboratory tests. Specifically, BestCare billed Medicare for trained personnel travel, but instead used commercial airline flights to ship samples that were unaccompanied by trained personnel.
The ALJ stated that BestCare and Maghareh's "billing scheme involved sending samples by air hundreds of miles for no discernible reason aside from maximizing billing revenue solely for their benefit. They clearly should not be trusted to access program funds."
Under section 1128(b)(7) of the Social Security Act, OIG may exclude persons from the Federal health care programs for presenting or causing to be presented claims for items or services that the person knows or should know were not provided as claimed, or are otherwise false or fraudulent.
OIG's exclusion authority protects the integrity of the Federal health care programs from persons who present a risk to those programs.
Special agents from OIG's Office of Investigations, Dallas Regional Office, under the direction of Special Agent in Charge CJ Porter, investigated this case. Senior Counsels Lauren Marziani, Tamara Forys, and David Fuchs represented the Inspector General in the litigation of this matter.