A serial Medicaid fraudster was sentenced this week to prison for a $7 million scheme to bill federal health programs for fake medical exams.
A state court judge sentenced Imran Shams, a 66-year-old from California with a history of Medicaid and Medicare fraud there and in New York, to up to 25 years for a scam to illegally pay Medicaid recipients to get unnecessary medical tests, charge the federal program and receive kickbacks. Shams’ sentencing Tuesday ends the nearly decade-long investigation and trial of a scheme involving multiple other defendants and tens of millions of dollars in restitution.
The charges stem from a fake medical clinic in Harlem that paid Medicaid recipients between $20 and $50 to submit to unnecessary and at times nonexistent lab tests, according to Attorney General Letitia James’ office, which brought the charges alongside parallel federal cases. The clinic, called Multi-Specialty, was part of multiple similar scams Shams has run over the years, including billing Medicaid $234 million between 2018 and 2022 for fraudulent services, like fake Covid-19 tests. For that crime, he was sentenced in federal court to 10 years in prison and ordered to pay $31.7 million in 2024.
In the Multi-Specialty ruse, Shams hired untrained individuals dressed as clinicians to “lend an appearance of legitimacy to the fraud,” the attorney general’s office said in an announcement of the sentencing.
Shams was convicted of Medicaid and Medicare fraud in New York in 1990 and in California in 2001, excluding him from participating in Medicaid in the future, according to a statement from the U.S. Department of Justice, when Shams was sentenced on federal charges last year.
Shams used licensed providers to submit the fake claims to Medicaid and managed care organizations, insurance plans that administer Medicaid, and received millions in bribes to refer patients for tests exclusively to complicit Brooklyn providers. Those providers, Tea Kaganovich and Ramazi Mitaishvili, were sentenced to 1 to 4 years in 2023, along with a Long Island radiologist who stole $8 million in reimbursements.
Shams also faced federal charges related to this scheme for which he was sentenced to 3 consecutive years, which were merged with his separate federal sentence in the $234-million scheme. Those terms will run concurrently with the new 8 to 25 year state sentence, according to the state attorney general’s office.
