两人被控向医保虚报2.27亿美元新冠试剂费：被指买数十万受益人信息、连已故者都报了账
美国司法部2025年5月22日宣布，伊利诺伊州库克县 Arlington Heights 的 Syed Murtuza Kablazada（34岁）与邻县 DuPage 县 Carol Stream 的 Syed Mehdi Hussain（32岁）已于前一天被捕。两人被起诉，指其经营多家所谓医学实验室，向联邦医疗保险（Medicare）提交逾2.27亿美元的虚假报销申请，涉及受益人从未申领的非处方新冠检测试剂。
起诉书指，两人安插外国公民充当实验室的名义业主，由这些「挂名业主」以实验室名义提交虚假报销；双方事先说好，一旦实验室被调查，这些挂名业主就逃离美国。检方指，实验室实际上很少向受益人提供试剂，却拿从未申领过试剂的受益人名义报账，其中甚至包括已经去世的人。两人还被指付钱给一家营销公司，买下数十万名医保受益人的姓名用以批量造假。
检方指，2022年9月至2023年6月间，两人的实验室向 Medicare 提交了约2.27亿美元的虚假报销，Medicare 实际支付了约1.36亿美元。司法部刑事司司长 Matthew R. Galeotti 说，两人被指利用多家实验室的挂名业主，提交了逾2亿美元的新冠试剂虚假报销，医疗诈骗挥霍纳税人的钱、挤占最需要者的有限资源。联邦调查局芝加哥（Chicago）外勤办公室特别探员主管 Douglas S. DePodesta 说，这起调查揭出的巨额诈骗，是对美国关键医疗保障计划 Medicare 的公然蔑视。卫生与公众服务部监察长办公室调查副监察长 Christian J. Schrank 说，为从未发放或并无医疗必要的产品服务向 Medicare 报假账，破坏了这一保护社区最弱势人群的计划的根基。
两人各被控四项医疗诈骗罪，若定罪，每项最高可判10年监禁。本案由联邦调查局芝加哥外勤办公室与卫生与公众服务部监察长办公室调查，刑事司诈骗科审判律师 Andres Q. Almendarez 承办起诉，伊利诺伊北区助理联邦检察官 Jasmina Vajzovic 协助。起诉书仅为指控，两名被告在被法庭以排除合理怀疑的标准定罪之前均推定无罪。
关联：2.27亿美元医保诈骗认罪：印度籍男子买数十万受益人信息虚报新冠试剂，医保实付1.36亿美元
（来源：美国司法部）
Two Charged in $227 Million Medicare Fraud Scheme over COVID-19 Test Kits Beneficiaries Never Requested
The Justice Department announced on May 22, 2025, that Syed Murtuza Kablazada, 34, of Arlington Heights, in Cook County, Illinois, and Syed Mehdi Hussain, 32, of Carol Stream, in neighboring DuPage County, were arrested the previous day on criminal charges related to their alleged submission of more than $227 million in fraudulent claims to Medicare. The two men allegedly owned and operated purported medical laboratories that submitted claims for over-the-counter COVID-19 test kits that beneficiaries had allegedly been provided.
According to court documents, the defendants installed foreign nationals to act as nominee owners at the laboratories to submit fraudulent claims, with the understanding that the nominee owners would flee the United States when they learned their laboratory was under investigation. Prosecutors allege the defendants rarely provided COVID-19 test kits to Medicare beneficiaries, but instead submitted reimbursement claims on behalf of beneficiaries who had not requested the kits, including individuals who were deceased. The defendants also allegedly paid a marketing company to provide the names of hundreds of thousands of Medicare beneficiaries, which they used to submit the fraudulent claims.
In total, between September 2022 and June 2023, the defendants' laboratories billed Medicare approximately $227 million in fraudulent claims, of which Medicare paid approximately $136 million. Matthew R. Galeotti, head of the Justice Department's Criminal Division, said the defendants allegedly used straw owners at multiple laboratories to cause the submission of more than $200 million in fraudulent claims for COVID-19 test kits, and that health care fraud squanders taxpayer money and diverts limited resources from those who need them most. Douglas S. DePodesta, Special Agent in Charge of the FBI's Chicago Field Office, said the overwhelming fraud uncovered in the investigation showed a blatant disregard for Medicare and put all patients at risk. Christian J. Schrank, Deputy Inspector General for Investigations at the Department of Health and Human Services Office of Inspector General, said submitting fraudulent claims for products or services not dispensed or not medically necessary undermines the integrity of a program intended to protect the most vulnerable.
Kablazada and Hussain are each charged by indictment with four counts of health care fraud; if convicted, they face a maximum penalty of 10 years in prison on each count. The FBI's Chicago Field Office and HHS-OIG are investigating the case. Trial Attorney Andres Q. Almendarez of the Criminal Division's Fraud Section is prosecuting, with assistance from Assistant U.S. Attorney Jasmina Vajzovic for the Northern District of Illinois. An indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
(Source: U.S. Department of Justice)
来源：美国司法部
发布：GSM·美国（发布链接）
图片来源：图：位于伊利诺伊州芝加哥（Chicago）的 Everett M. Dirksen 美国法院大楼（资料图），本案起诉书即向设于该楼的伊利诺伊北区联邦地区法院提交。Ken Lund 摄，CC BY-SA 2.0，经 Wikimedia Commons。 / Photo: The Everett M. Dirksen United States Courthouse in Chicago, Illinois (file photo); the indictment was filed in the U.S. District Court for the Northern District of Illinois housed there. By Ken Lund, CC BY-SA 2.0, via Wikimedia Commons.
GSM Global · 本篇英文版 English edition of this story
- 2025-05-22 01:40两人被控向医保虚报2.27亿美元新冠试剂费：被指买数十万受益人信息、连已故者都报了账本篇
- 2026-10-30 14:322.27亿美元医保诈骗认罪：印度籍男子买数十万受益人信息虚报新冠试剂，医保实付1.36亿美元
