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Case Number: 0:19-cr-60200-FAM
Judge: Federico A. Moreno
Court: United States District Court for the Southern District of Florida (Miami-Dade County)
Plaintiff's Attorney: United States District Attorney’s Office, Miami, Florida
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Description: Miami, Florida white collar criminal defense lawyer represented defendant charged with conspiracy to commit health care fraud and wire fraud, five counts of health care fraud, conspiracy to commit money laundering, and eleven counts of money laundering.
Sebastian Ahmed, 42, of Delray Beach, Florida, was charged with conspiracy to commit health care fraud and wire fraud, five counts of health care fraud, conspiracy to commit money laundering, and eleven counts of money laundering.
As part of the scheme, the conspirators exploited vulnerable drug addicts, the majority of whom were 18 to 26 years ago; falsified paperwork; and entered into various kickback arrangements, all in order to receive millions of dollars of falsely and fraudulently obtained funds for their own personal use and benefit. As demonstrated by the trial record, of all the conspirators, no one profited more than Sebastian Ahmed, who netted more than $2.8 million in less than three years.
The government established at trial that Sebastian Ahmed was the CEO, president and CFO of the two substance abuse treatment centers: Jacob’s Well and Medí MD; and the medical health clinic, Arnica Health, all of which he operated under the umbrella of Serenity Treatment Center, Serenity Living, and “Serenity Ranch Recovery” in Davie, Florida. Ahmed operated the three clinics from in or around June 2016 through May 2019. He employed his brother, Ali a/k/a “Al” Ahmed as the COO. Testimony revealed that Al Ahmed had previously declared bankruptcy having been found liable in a civil suit brought by his former employer, Kaplan University, for stealing confidential lead information from Kaplan.
The government emphasized at trial that defendant (1) engaged in illegal billing to private insurance plans through Jacob’s Well prior to the clinic being certified by DCF in February 9, 2017; (2) provided unlawful inducements to the approximately 500 patients consisting of free airline travel, housing, vapes, manicures, cash, and failure to collect patient responsibilities for co-pays and deductibles; and (3) billed for medically unnecessary therapeutic services consisting of therapy and urine analyses, the former having not been provided but billed by defendant’s substance abuse clinics. The patients were also permitted to reside in co-ed housing in which destructive sexual relationships, not conducive to real addiction treatment, formed – sometimes between the staff and patients, according to the testimony and evidence.
According to court documents and evidence presented at trial, the patients consisted of young adults in their twenties who primarily were addicted to opioids and other drugs of abuse. Many of the patients were permitted to remain on their parents’ private insurance plans up to age 26.
The patients resided in a series of so-called sober homes maintained by defendant in Davie, Southwest Ranches, Hollywood and Pompano. None of these homes were certified by DCF as approved community housing for persons engaged in a substance abuse treatment program.
Former Serenity employees including co-defendants Mauren Morel and Hector Alvarez, both Clinical Social Workers in the State of Florida, testified that they prepared fake progress notes to support fraudulent billing for daily group therapy sessions that patients did not attend. They testified that they did so at the defendant’s direction, and that claims were even submitted for dates when patients were not physically present.
Government expert witness Dr. Kelly Clark was a board certified addiction medicine specialist and clinical psychiatrist. She focused her career on issues of addictive disease. She testified that the manner in which Serenity’s medical providers prescribed buprenorphine and benzodiazepines to a drug abusing population was medically inappropriate and potentially dangerous. Patient-witnesses and the parent of a former patient likewise testified that Serenity caused their addictions to intensify rather than improve, and that multiple patients suffered overdoses and relapses that went unaddressed by the staff at Serenity. Indeed, the record showed that Sebastian Ahmed failed to report a single overdose incident to DCF as required by law, and that multiple patients were cycled back and forth between detox centers and Serenity without apparent improvement in their condition. Evidence that Serenity permitted and even procured addictive drugs for its patients was presented at trial, and medical records introduced as trial exhibits revealed that the doctors did not check the expensive urine screens that were being ordered until well after patients’ discharge. These urine screens revealed repeat positives for, among other drugs, methamphetamine, heroin, cocaine, and prescription narcotics.
From June 2016 through May 2019, the government attributed approximately $38 million in fraudulent billing submitted by defendant’s clinics which resulted in the reimbursement of over $6 million in payments.
Co-conspirators and former co-defendants Ali a/k/a Al Ahmed, the defendant’s brother; and Hector Alvarez and Mauren Morel, the clinical directors at two of the facilities, were also charged and pled guilty in connection with the fraud. Ali a/k/a Al Ahmed, who served as a Chief Operating Officer and co-owner of the facilities, was sentenced to ten years’ imprisonment. Hector Alvarez and Mauren Morel, both of whom testified at trial against Sebastian Ahmed, each received sentences of 32 months’ imprisonment. These three former co-defendants were sentenced by United States District Judge Federico A. Moreno prior to the trial.
Ms. Fajardo Orshan commended the investigative efforts of FBI and HHS-OIG. Support for the investigation was also provided by the Drug Enforcement Administration, Davie Police Department, Broward Sheriff’s Office, Palm Beach Sober Homes Task Force, and the Florida Department of Children and Families. The case is being prosecuted by Assistant U.S. Attorneys Christopher J. Clark and Lisa H. Miller. Assistant U.S. Attorneys Nicole Grosnoff and Peter Laserna are handling the asset forfeiture component of the case.
Outcome: Defendant was sentenced to 210 months’ imprisonment and restitution in the amount of $ 4,231,288 following his conviction after a six-week jury trial.