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UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF MICHIGAN 

SOUTHERN DIVISION 

UNITED STATES OF AMERICA, 

Case. No. 13-cr-20892

Plaintiff, 

HON. GEORGE CARAM STEEH

v. 

D-14 KUTUB MESIWALA, M.D., 

Defendant. 

___________________________________/ 

GOVERNMENT’S SENTENCING MEMORANDUM

NOW COMES the United States of America, by and through undersigned 

counsel, and respectfully submits its sentencing memorandum. The sentencing 

hearing for Defendant Kutub Mesiwala is set for December 9, 2021 at 10:00 a.m. 

For the reasons stated herein and any reasons which may be set forth during the 

hearing, the United States recommends a term of imprisonment of 34 months. 

I. FACTUAL BACKGROUND 

For four years, from 2009 through 2013, Dr. Mesiwala engaged in a prolific 

scheme to refer patients to a home health company owned by co-defendant Amer 

Ehsan, in exchange for kickbacks. Dr. Mesiwala referred over 250 patients to 

Ehsan, resulting in approximately 730 episodes of home health care billed to 

Medicare, all in exchange for illegal kickbacks valued between $50 and $200 cash 

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per episode. As a result of the referrals, Medicare reimbursed Ehsan over $1 

million for home health services he purported to provide to Dr. Mesiwala’s 

patients. 

II. RULE 11 PLEA AGREEMENT AND SENTENCING GUIDELINE 

CALCULATION 

On March 23, 2015, Mesiwala pleaded guilty to Count One, Health Care 

Fraud Conspiracy, in violation of 18 U.S.C. § 1349, pursuant to a Rule 11 Plea 

Agreement. The parties agreed to a Guideline range for sentencing of 57-71 months, 

based on a total offense level of 25. Probation agrees with the parties’ determination 

of the appropriate Guidelines. See PSR at ¶ 63.

III. APPLICATION OF 18 U.S.C. § 3553(a) 

Congress has provided, through 18 U.S.C. § 3553(a), the relevant objectives 

and factors to be considered by sentencing courts in imposing a sentence that is 

“sufficient, but not greater than necessary.” Those objectives are: (i) the nature and 

circumstances of the offense, and the history and characteristics of the defendant; 

(ii) the need for a sentence to reflect the basic aims of sentencing (including 

retribution, deterrence, incapacitation, and rehabilitation); (iii) the kinds of 

sentences legally available; (iv) the Sentencing Guidelines; (v) Sentencing 

Commission policy statements; (vi) the need to avoid unwarranted sentencing 

disparities among defendants with similar records who have been found guilty of 

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similar conduct; and (vii) the need for restitution. The most relevant factors 

applicable to the Defendant are set forth below. 

A. Nature and Circumstances of the Offense, and the History and 

Characteristics of the Offender, 18 U.S.C. § 3553(a)(1) 

1. Nature and Circumstances of the Offense

Dr. Mesiwala was the owner and operator of Professional Consultants, Inc., 

the physician practice through which he siphoned patients for home health referrals 

in exchange for illegal kickbacks. By accepting kickbacks for referrals, Dr. 

Mesiwala’s patients, who had placed their trust in him to provide medical care based 

on their needs, were instead funneled to Ehsan to receive home health services 

because of monetary payments. Ehsan billed Medicare for these services, resulting 

in at least $1,031,302.97 being reimbursed for the home health services. 

2. Characteristics of the Defendant

Dr. Mesiwala was born into a loving and caring environment in India. PSR ¶ 

38. He was well-cared for by his parents, who valued and stressed the importance 

of education. PSR ¶¶ 38-39. He has been married for over 43 years and has four 

children. PSR ¶ 40-41. Dr. Mesiwala is well-educated, receiving a bachelor’s degree 

in pre-medicine in 1970, a bachelor’s of medicine and surgery degree in 1976, and 

a medical residency program at Wayne State University, which he completed in 

1981. PSR ¶¶ 50-51. He has been a licensed medical physician in Michigan since 

1979. PSR ¶ 52. Prior to his arrest and prosecution in this case, Dr. Mesiwala did 

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not suffer from any emotional or mental conditions, nor does he use alcohol or have 

an addiction to illicit substances. PSR ¶¶ 48-49. It appears, then, Dr. Mesiwala

benefitted from tremendous foundational supports that are too often absent for 

defendants that come before this Court, yet his greed was overwhelming. Dr, 

Mesiwala had the ability to, and for the better part of his career did, make a 

legitimate, financially secure living as a physician. But beginning in 2009 he chose 

to pursue a get-rich quick scheme. Dr. Mesiwala’s history and characteristics do not 

support a downward variance.

B. To Afford Adequate Deterrence to Criminal Conduct and Protect 

the Public from Further Crimes of the Defendant, 18 U.S.C. § 

3553(a)(2)(B)-(C) 

Dr. Mesiwala’s punishment should account for not only the scope and 

seriousness of his criminal conduct, but also the need to deter future criminals from 

stealing from the Medicare program. Health care fraud, including through the 

payment and receipt of kickbacks, is a substantial problem nationwide and has 

recently been the subject of sustained public discussion and debate. The National 

Health Care Anti-fraud Association, an organization composed of both public and 

private health insurers and regulators, conservatively estimates that three percent of 

all health care spending in the United States is lost due to fraud.

As this Court knows, health care fraud is especially pervasive in the Eastern 

District of Michigan. Since Medicare Fraud Strike Force operations began in 2009, 

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approximately 440 individuals have been indicted in the Eastern District of 

Michigan in connection with Medicare, Medicaid, and private payor fraud schemes, 

placing this District among the nation’s leaders in the number of health care fraud 

indictments returned within that time. The indictments involve over $1.1 billion in 

fraudulent billings to federal health care programs and private insurers.

All of the money involved in this scheme came from the Medicare program. 

The program, funded by American taxpayers, is a public trust intended to provide 

health insurance for the elderly and disabled. Every dollar that Dr. Mesiwala 

diverted from this program—to himself and his co-conspirators—is a dollar that 

could and should have been used to provide valuable services to Medicare 

beneficiaries, without diminishing their ability to receive medical advice and

treatment adulterated by illegal kickbacks. Accordingly, the United States 

respectfully requests that Dr. Mesiwala’s punishment reflect the need to promote 

respect for the laws that protect the public and guard against health care fraud.

C. The Kinds of Sentences Available 

Under 18 U.S.C. § 1349, the maximum sentence is ten years’ imprisonment. 

The maximum fine is $250,000 or twice the pecuniary gain or loss from the instant 

offense. 

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D. Any Pertinent Policy Statement Issued by the United States 

Sentencing Commission 

The United States is unaware of any pertinent policy statements issued by the 

U.S.S.C. However, the Patient Protection and Affordable Care Act (“PPACA”), 

enacted in March 2010, provides the most recent evidence of congressional intent in 

this area of the law. PPACA specifically provides for increased sentences for health 

care fraud offenses, and further requires the U.S.S.C. to “ensure that the Federal 

Sentencing Guidelines and policy statements - (i) reflect the serious harms 

associated with health care fraud and the need for aggressive and appropriate law 

enforcement action to prevent such fraud; and (ii) provide increased penalties for 

persons convicted of health care fraud offenses in appropriate circumstances.” Pub. 

L. No. 111-148, § 10606(a)(3).

E. The Need to Avoid Unwanted Sentencing Disparities

This sentencing factor is intended to address national sentencing disparities, 

and it is widely recognized that a Guidelines sentence is the best way to avoid such 

disparities. See United States v. Smith, 564 F. App’x 200, 205 (6th Cir. 2014) (stating 

that “one of the fundamental purposes of the Guidelines is to help maintain national 

uniformity in sentences, and considering that most sentences are within the 

Guidelines, the Guidelines themselves represent the best indication of national 

sentencing practices”); Rita v. United States, 551 U.S. 338 (2007). Defendant’s 

Guidelines range takes into account the specific characteristics of his offense and 

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imposing a Guidelines sentence is the best way to avoid unwarranted sentencing 

disparities with similarly-situated defendants nationwide. 

While national disparity is the primary concern animating this sentencing 

factor, the Court also has discretion to consider the potential for disparity between 

co-defendants. See United States v. Wallace, 597 F.3d 794, 803 (6th Cir. 2010). Dr. 

Mesiwala was charged for his involvement in a scheme with a number of other 

charged offenders, all of whom have been sentence. Mesiwala’s Guidelines range 

and the government’s recommendation contained in this memorandum are within 

the general realm of others sentenced for similar conduct. Notably, Defendant Ehsan 

was sentenced to 80 months imprisonment. The defendants sentenced in this case 

are the following:

Defendant Guidelines Sentence Imposed

Dr. Walayat Khan 108-135 months 15 months

Dr. Adelina Herrero 57-71 months 36 months

Amer Ehsan 87-108 months 80 months

Haroon Er Rashid 87-108 months 57 months

Mohammad Rafiq 108-135 months 57 months

Farhan Khan 37-46 months 15 months

James Zadorski 37-46 months

12 months and 1 

day

Cynthia Bell 24-30 months 6 months

Salman Ali Sapru 57-71 months 55 months

John Sanders 24-30 months 6 months

Zubair Khan 46-57 months 27 months

Jaweed Mohammad 51-63 months 24 months

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IV. CONCLUSION 

Given the seriousness of the defendant's conduct, and the nature of the 

crime, a sentence of 34 months is fully supported by the factors under Section 

3553.

Dated: December 2, 2021 Respectfully submitted, 

SAIMA MOHSIN 

Acting United States Attorney 

/s/ Shankar Ramamurthy 

SHANKAR RAMAMURTHY

U.S. Dept. of Justice Trial Attorney

211 W. Fort Street, Suite 2001

Detroit, MI 48226-3211

(202) 924-5368

shankar.ramamurthy@usdoj.gov

/s/Regina R. McCullough 

Regina R. McCullough 

Assistant United States Attorney 

211 W. Fort Street, Suite 2001 

Detroit, Michigan 48226 

(313) 226-9618 

 Regina.McCullough@usdoj.gov

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Certificate of Service

I hereby certify that on December 2, 2021, I electronically filed the 

foregoing document with the Clerk of the Court using the CM/ECF system.

Regina.McCullough@usdoj.gov

/s/ Shankar Ramamurthy 

SHANKAR RAMAMURTHY

U.S. Dept. of Justice Trial Attorney

211 W. Fort Street, Suite 2001

Detroit, MI 48226-3211

(202) 924-5368

shankar.ramamurthy@usdoj.gov

/s/Regina R. McCullough 

Regina R. McCullough 

Assistant United States Attorney 

211 W. Fort Street, Suite 2001 

Detroit, Michigan 48226 

(313) 226-9618 

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