Lab fraud repeat offender sentenced in $234M Medicare case

Gavel Scale Justice Social

A clinical laboratory owner, operator, and manager was ordered to forfeit nearly $32 million, surrender his personal and business property in California, and serve 10 years in prison for his roles in clinical laboratory fraud.

For nearly four years, Imran Shams of Glendale, CA, concealed his involvement in a clinical laboratory operation that billed approximately $234 million for various lab tests, including COVID-19 and respiratory pathogen panel tests, despite Shams' decades-long exclusion from the Medicare program, according to the U.S. Department of Justice (DOJ). Shams was convicted of Medicare and Medicaid fraud in separate 1990 and 2001 cases in New York and California, respectively.

"After each conviction, he was excluded from participation in Medicare and all federal health care programs, and advised by the Department of Health and Human Services Office of Inspector General (HHS-OIG) that he had to submit a written application to be considered for reinstatement in federal health care programs," the DOJ explained in a statement. "Shams never sought reinstatement, yet he continued to operate health care clinics in New York that billed federal health care programs."

Despite pleading guilty November 2017 to conspiracy in a healthcare kickbacks scheme, by 2018 Shams had become the concealed owner, operator, and manager of another clinical laboratory, Matias Clinical Laboratory, doing business as Health Care Providers Laboratory (HCPL) in Baldwin Park, CA, and continued to participate in billing Medicare and other federal healthcare programs through April 2022.

HCPL fraudulently billed Medicare approximately $234 million. Medicare paid HCPL approximately $31.7 million based on these fraudulent claims, according to case details. Shams worked with Lourdes Navarro, a clinical lab manager who pleaded guilty to related charges in October 2023. Shams had pleaded guilty in the Central District of California for conspiracy to commit healthcare fraud and concealment of his exclusion from Medicare.

Shams was ordered to forfeit $31,761,286.21, including $4,513,106.30 in funds that the government previously seized from two bank accounts, as well as his interest in two residential properties and one business property in the Los Angeles area. Shams was also sentenced to 10 years prison time.

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