Pain clinic CEO ran $150 million health care fraud scheme that helped fuel the opioid crisis

The Golden Horseshoe is a weekly designation from Just the News intended to highlight egregious examples of wasteful taxpayer spending by the government. The award is named for the horseshoe-shaped toilet seats for military airplanes that cost the Pentagon a whopping $640 each back in the 1980s. 

This week, our award is going to the Department of Health and Human Services for falling prey to a several-hundred-million dollar Medicare fraud scheme.

Mashiyat Rashid of West Bloomfield, Mich. was the CEO of the Tri-County Wellness Group,a network of pain clinics in Michigan and Ohio. Last week, he was sentenced to 15 years in prison for masterminding a $150 million health care fraud scheme "to administer unnecessary back injections to patients in exchange for prescriptions of over 6.6 million doses of medically unnecessary opioids." 

For years, the clinics had a standing policy of offering patients — some of whom were suffering from legitimate pain, others of whom were addicts and drug dealers — prescriptions for often Oxycodone in exchange for submitting to a series of often painful, medically unnecessary back injections that the clinics would then bill back to insurers at lucrative reimbursement rates.

According to trial testimony, some patients suffered extreme pain and open holes in their backs as a result of the injections. "Audible screams from patients were observed throughout the clinics," according to the Department of Justice release announcing Rashid's sentence.

The clinics specifically targeted the Medicare program by recruiting vulnerable patients from homeless shelters and area soup kitchens. According to the DOJ, Rashid exclusively hired physicians who were willing to disregard patient wellbeing for a monetary payoff. He "incentivized the physicians to follow the Tri-County protocol of offering opioid prescriptions and administering unnecessary injections by offering to split the Medicare reimbursements for these lucrative procedures," the DOJ reported.

Rashid and his corrupt doctors and employees were ultimately brought down by a joint investigation between the FBI, the IRS criminal investigation unit, and the Department of Health and Human Service's office of inspector  general. They were prosecuted by DOJ's Health Care Fraud Strike Force, which since its inception in 2007 has charged more than 4,200 defendants for fraudulently billing Medicare almost $19 billion combined.

Investigators concluded that 100% of Tri-County's Medicare injection claims were ineligible for Medicare reimbursement. When the Centers for Medicare and Medicaid Services (a division of HHS) suspended billing by one of the clinics, Rashid and his co-conspirators set up shell companies that they enrolled in Medicare in order to continue filing the same type of fraudulent claims.

In addition to Rashid, 21 others, including 12 physicians, have been convicted for their roles in the scheme. Rashid is just the second member of the plot to receive sentencing.

Rashid pleaded guilty in 2018 to one count of conspiracy to commit health care fraud and wire fraud, and one count of money laundering.

At the time, Matthew Schneider, the U.S. Attorney for the Eastern District of Michigan said, "This case is particularly troubling in that Rashid, through his clinics, made Michigan's opioid crisis even worse by prescribing over six million dosages of medically unnecessary opioids to individuals who were already suffering from opioid addiction." 

"Health Care Fraud diverts taxpayer dollars from Medicare and lines the pockets of dishonest health care providers," said Schneider.

As part of his sentence, Rashid has been ordered to repay more than $51 million to Medicare  and forfeit $11.5 million in real estate holdings, as well as his Detroit Pistons season tickets.