Two Youngstown-area physicians indicted for health care fraud and kickback schemes; third charged by bill of information
(STL.News) Acting U.S. Attorney Bridget M. Brennan announced today that a grand jury sitting in Cleveland, Ohio returned an eleven-count indictment charging Samir Wahib, age 53, of Canfield, and Joni Canby, age 62, of Poland, for their roles in a scheme to defraud Medicare and Medicaid and obtain reimbursement for testing that was not medically necessary.
Michelle Kapon, age 41, of Youngstown, was also named in the indictment, but charged separately in a bill of information for conspiring with Wahib and Canby to accept kickbacks from Wahib.
“These defendants are physicians accused of orchestrating a scheme to defraud a tax-payer funded health care benefit program created to assist vulnerable populations,” said Acting U.S. Attorney Bridget M. Brennan. “Their alleged conduct, which included kickbacks and medically unnecessary testing, was designed specifically to enrich themselves. We are grateful for the hard work of the investigating agencies who, like us, are dedicated to bringing allegations of fraud and illegal kickbacks before the Court.”
“The payment of kickbacks is a corrupt and illegal practice that inappropriately influences an individual or entity’s capacity to make unbiased decisions, which is of particular concern in the health care environment,” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “Kickbacks can result in the overutilization of diagnostic testing and other services that ultimately lead to an increase in program costs, waste valuable tax-payer dollars, and can expose patients to medically unnecessary services. The OIG will continue to work with our law enforcement partners to ensure that those who choose to engage in this type of practice are held accountable.”
“These doctors schemed and defrauded a taxpayer-funded program that assists individuals in obtaining needed healthcare,” said FBI Special Agent in Charge Eric B. Smith. “Healthcare fraud is a concern to all of us; our tax dollars should be utilized responsibly, not to line the pockets of greedy physicians. The FBI will continue to work with our partners to ensure healthcare fraud is rooted out and those responsible answer in a court of law”
“Subjecting patients to unnecessary tests is bad medicine,” Ohio Attorney General Dave Yost said. “Stealing from taxpayer-funded healthcare while doing so is criminal, and that’s when we, and our federal law enforcement partners, come in.”
The indictment charges defendants Wahib and Canby with conspiring with Kapon to solicit, receive, offer and pay kickbacks in connection with a federal health care program; and it charges Wahib and Canby with conspiracy to commit health care fraud and health care fraud. Defendant Wahib is also charged with obstruction of a criminal investigation of federal health care offenses, as well as four additional counts of paying kickbacks in connection with a federal health care program. Defendant Canby is charged with two additional counts of receipt of kickbacks in connection with a federal health care program.
At the time of the allegations, Wahib was a Doctor of Osteopathic Medicine and an obstetrics and gynecological (“OBGYN”) specialist; Canby was a Doctor of Osteopathic Medicine and an OBGYN specialist and Kapon was a Doctor of Medicine. All three physicians were licensed in the State of Ohio and practiced medicine in the Youngstown area.
According to the indictment, Wahib is accused of conspiring, from March of 2014 through January of 2017, to pay kickbacks to Canby and Kapon to induce them to order gonorrhea and chlamydia testing to be performed by Wahib on specimens of Canby’s and Kapon’s patients. Wahib allegedly then billed and was paid by the federal government for this testing. Wahib and Canby are also accused of conspiring, through this scheme, to test Canby’s and Wahib’s patients when it was medically unnecessary to do so.
The indictment alleges that Wahib paid Canby and Kapon per specimen that they sent to him for testing. Wahib would then submit claims for reimbursement through the Medicaid and Medicare programs. Furthermore, Wahib allegedly provided Kapon, who was not an OBGYN specialist, with compensation in kind in the form of supervision of her OBGYN treatment of patients at a Youngstown-area hospital.
Wahib allegedly paid kickbacks with checks drawn on his business checking account, which he attempted to disguise as “physician coverage” by noting this on the memo line of the checks. Wahib intended to make these checks appear that they were payment for Canby and Kapon having treated Wahib’s patients when he was unavailable. The indictment further states that an employee and relative of Wahib, working on his behalf, provided Canby and Kapon with the necessary supplies to collect and retrieve the specimens. That employee would also retrieve the specimens from Canby’s and Kapon’s offices and perform testing of the specimens on a specialized machine at Wahib’s medical office.
An indictment is only a charge and is not evidence of guilt. A defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.
If convicted, the defendant’s sentence will be determined by the Court after review of factors unique to this case, including the defendant’s prior criminal record, if any, the defendant’s role in the offense, and the characteristics of the violation.
In all cases, the sentence will not exceed the statutory maximum, and in most cases, it will be less than the maximum.
The investigation preceding the indictment was conducted by the United States Department of Health and Human Services – Office of Inspector General, the FBI, and the Healthcare Fraud section of the Ohio Attorney General’s Office. The case is being prosecuted by Assistant U.S. Attorney Brendan O’Shea, and Special Assistant U.S. Attorney Jonathan Metzler of the Ohio AG’s Office.