A former Michigan pharmacist and his brother have been sentenced to eight years in prison and five years in prison, respectively, for their roles in a conspiracy to commit health care fraud and wire fraud.
According to court documents and evidence presented at trial, from approximately 2010 to 2019, Raad Kouza, 59, of Wayne County, a pharmacist, and his brother, Ramis Kouza, 46, of Oakland County, a pharmacy manager, billed Medicare, Medicaid and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated in Michigan.
The defendants executed this fraud by targeting the billing of expensive medications, such as antipsychotics and inhalers, and by concealing inventory shortages at their pharmacies from multiple auditors.
As a result of their criminal conduct, the defendants caused a total loss of over $15 million to Medicare, Medicaid, and Blue Cross Blue Shield of Michigan.
In November 2024, Raad Kouza and Ramis Kouza were convicted by a federal jury in the Eastern District of Michigan of conspiracy to commit health care fraud and wire fraud.
At sentencing, the Court ordered the brothers to pay approximately $15.5 million in restitution and the same amount in forfeiture.
