Florida ‘sober homes’ owner, clinic directors sentenced to prison for healthcare fraud
Ali and Sebastian Ahmed adopted a seemingly straightforward business plan: Market to people addicted to drugs and alcohol from across the country to live in their “sober homes” in sunny South Florida while receiving treatment for substance abuse at their chain of “Serenity” clinics.
The brothers even gave the patients free rent while major private insurers such as Aetna, Cigna and Blue Cross Blue Shield covered some of the treatment costs at their facilities in Broward County under a provision of the Affordable Care Act.
For a few years, the brothers’ plan worked while their chain collected more than $4 million. But then the Ahmed brothers and two clinical directors were charged with conspiring to commit healthcare fraud for failing to provide actual substance-abuse services between June 2016 and April 2019. All but Sebastian Ahmed, who awaits trial next month, pleaded guilty to the conspiracy charge.
On Tuesday, Ali Ahmed, 38, the former operations director and co-owner of Medi MD in Davie, was sentenced to 10 years in prison and ordered to pay $4.2 million in restitution to the bilked private health insurers.
Prosecutors urged the judge to give Ahmed almost the maximum sentence of 20 years, saying he impregnated a woman with a heroin addiction who was living in a “Serenity” sober home and plied her with the drug. When their child was born, he tested positive for heroin and other drugs.
Assistant U.S. Attorney Christopher Clark scoffed at the idea that Ahmed sought as little as five years in prison while citing his devotion to his son as a basis for leniency, highlighting that he was “providing heroin to his girlfriend who was bearing his son.”
In the end, U.S. District Judge Federico Moreno recognized the “vulnerability” of the addicts who were lured to the brothers’ chain of sober homes and substance abuse facilities in Broward. But Moreno also said Ahmed pleaded guilty and accepted responsibility, qualifying him for a potential guideline sentence between 9 and 11 years. So, Moreno split the difference.
Ahmed, standing alongside his attorney, Bradley Horenstein, said: “I am very sorry for the damage I have done to my family. My son will grow up without a father because of me.”
Moreno ordered Ahmed into custody immediately.
Also sentenced Tuesday were two clinical directors who worked for the Ahmed brothers: Hector Efrain Alvarez, 49, and Mauren Morel, 45, who both received prison sentences of roughly 2 1/2 years. Alvarez was ordered to pay about $3.9 million and Morel $320,000 to the private health insurance companies for their losses.
Both defendants, represented respectively by Walter Reynoso and Carlos Ziegenhirt, received significant sentencing breaks from the judge because they have been cooperating with prosecutors since last year and plan to testify at the trial of Sebastian Ahmed in mid-February. The two convicted defendants must surrender to prison authorities on April 15.
Overall, the Ahmed brothers’ substance-abuse treatment centers, Medi MD, Jacob’s Well and Amica Health, all based in Davie, “fraudulently” filed claims with Blue Cross Blue Shield and the other private health insurance companies that totaled about $24 million, according to prosecutors Clark and Lisa Miller. The companies paid out $4.2 million in coverage.
Sebastian Ahmed, the CEO and co-owner of all three treatment centers, pleaded not guilty last year and was granted a bond as he awaits trial.
