UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF MICHIGAN 

SOUTHERN DIVISION 

UNITED STATES OF AMERICA, 

 Plaintiff, 

v. 

D-14 KUTUB MESIWALA, M.D., 

Defendant. 

Case No. 13-cr-20892 

Hon. Paul D. Borman 

UNITED STATES’ OPPOSITION TO 

DEFENDANT’S MOTION TO TRAVEL TO CANADA

 The United States of America, through its undersigned counsel, opposes 

defendant Kutub Mesiwala’s Motion to Travel to Canada (R. 246). For the reasons 

stated in the accompanying Memorandum in Opposition to Defendant’s Motion to 

Travel to Canada, the defendant’s motion should be denied. 

Respectfully submitted, 

BARBARA L. MCQUADE 

United States Attorney 

By: /s Katharine A. Wagner 

 Katharine A. Wagner 

Trial Attorney 

U.S. Department of Justice 

Criminal Division, Fraud Section 

Washington, DC 20005 

Phone: (202) 341-8882 

Email: katharine.wagner@usdoj.gov 

Dated: November 14, 2014 

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UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF MICHIGAN 

SOUTHERN DIVISION 

UNITED STATES OF AMERICA, 

 Plaintiff, 

v. 

D-14 KUTUB MESIWALA, M.D., 

Defendant. 

Case No. 13-cr-20892 

Hon. Paul D. Borman 

MEMORANDUM IN SUPPORT OF UNITED STATES’ 

OPPOSITION TO DEFENDANT’S MOTION TO TRAVEL TO CANADA

Defendant Kutub Mesiwala, M.D. (“Mesiwala”) moves this Court for 

permission to travel to Canada on December 25–28, 2014. (R. 246). Because the 

defendant is a flight risk and the condition of release requiring the defendant to 

surrender any passport to Pretrial Services remains the least restrictive condition 

that will reasonably assure his appearance in court as required, the defendant’s 

Motion must be denied. 

 

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I. FACTUAL AND PROCEDURAL BACKGROUND 

On September 25, 2014, a grand jury returned a Second Superseding 

Indictment charging defendant Mesiwala with one count of conspiracy to commit 

health care fraud, in violation of 18 U.S.C. § 1349, and one count of conspiracy to 

pay or receive health care kickbacks, in violation of 18 U.S.C. § 371, for his role in 

conspiring to execute a health care benefit fraud scheme that fraudulently billed 

millions of dollars to the Medicare program. (R. 196). In the same Second 

Superseding Indictment, defendant Mesiwala was also charged with two counts of 

health care fraud, in violation of 18 U.S.C. §§ 1347 and 2, for billing Medicare for 

home visits that Mesiwala purportedly rendered while he was out of the country. 

A. Mesiwala Admits to Receiving Kickbacks 

Defendant Mesiwala admitted to federal agents that he received cash 

kickbacks in exchange for home health referrals to Amer Ehsan (“Ehsan”), who 

owned Advance Home Care Services LLC (“Advance”) and sold patient 

information, including defendant Mesiwala’s referrals, to other home health care 

agencies in the Detroit area. See Interview of Kutub Mesiwala on September 5, 

2014, attached hereto as Attachment A (hereinafter, “Mesiwala Interview”); 

Interview of Amer Ehsan on August 14, 2014, attached hereto as Attachment B. 

Advance and other home health agencies then used Mesiwala’s home health 

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referrals to submit claims to Medicare for home health care services that were not 

medically necessary and, in some cases, not provided. In total, between 2009 and 

2013, Medicare paid Advance more than $770,000 for home health care services 

purportedly rendered to Medicare beneficiaries referred by Mesiwala. 

Mesiwala further admitted to agents that he referred two types of Medicare 

beneficiaries to Ehsan in exchange for cash kickbacks: (1) his long-standing 

patients from his visiting physician practice; and (2) Medicare beneficiaries that 

Ehsan sent to Mesiwala for the express purpose of obtaining home health referrals. 

Mesiwala Interview, Attachment A. Defendant Mesiwala admitted to receiving 

$200 per referral for patients referred to Ehsan from the first group (those he 

originated) and $50 per beneficiary referred to Ehsan from the second group (those 

Ehsan originated). Id. 

B. Mesiwala Admits to Billing Physician Services for Beneficiaries 

Sent to Him Through the Kickback Arrangement 

Medicare claims further data reveals that defendant Mesiwala also billed 

Medicare for home visits and other visiting physician services purportedly 

rendered to the Medicare beneficiaries Ehsan sent to him and for home health 

supervision services supposedly rendered to the Medicare beneficiaries he referred 

to Ehsan in exchange for cash kickbacks. The kickback exchange that Mesiwala 

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described is unfortunately a common one in health care fraud cases in Detroit: 

doctors are incentivized to refer non-homebound patients both through direct 

(cash) kickbacks and the opportunity to bill the patients sent to them by the 

fraudulent home health care companies. 

C. Mesiwala Bills For Services When He Is Out Of The Country 

Finally, as outlined in Counts 7 and 8 of the Second Superseding Indictment, 

defendant Mesiwala billed Medicare for visiting physician services that he 

purportedly rendered while travel records indicate that he was out of the country. 

(R. 196 ¶¶ 80–85.) Mesiwala billed Medicare directly under his own provider 

number and indirectly through Professional Consultants, Inc., a Michigan company 

owned by his wife. Professional Consultants billed Medicare solely for 

Mesiwala’s services, and all income goes to a bank account controlled by his wife. 

In total, Medicare claims data reveals that defendant Mesiwala billed Medicare for 

approximately $87,940 for services he purportedly rendered in Michigan while he 

was not in the United States. 

D. Mesiwala Lies to Pretrial Services About His Income and Assets 

Prior to defendant Mesiwala’s arraignment on September 20, 2012, he was 

interviewed by Pretrial Services. According to Pretrial Services, defendant 

Mesiwala reported that he had an average monthly income of $7,000 and the 

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following assets: (1) $5,000 in a checking account; (2) his residence in Bloomfield 

Hills, Michigan; (3) a 2005 Nissan automobile; and (4) real property in Florida 

valued at approximately $2,000. However, bank records indicate that between 

August 2013 and July 2014, an account held in Mesiwala’s name received an 

average of approximately $11,870 in direct deposits from Medicare per month; 

and, during the same time period, an account held in the name of Professional 

Consultants received an average of approximately $14,150 in direct deposits per 

month from Medicare for services purportedly provided by defendant Mesiwala. 

In total, Medicare paid these two accounts more than $300,000 in the year leading 

up to the defendant’s arrest (August 2013 through July 2014). 

E. Mesiwala’s Conditions of Release 

Magistrate Judge R. Steven Whalen ordered conditions of release placed on 

the defendant, including the requirement that he surrender any passport or 

enhanced driver’s license to Pretrial Services within 24 hours. (R. 216.) The 

defendant now moves this Court to modify his conditions of release to allow him 

access to a passport so that he may travel to Canada in December 2014 to stay with 

family and attend his son’s wedding. (R. 246). 

 

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II. LEGAL STANDARD 

Under the Bail Reform Act of 1984, the Court should seek to apply the least 

restrictive condition or combination of conditions that will “reasonably assure the 

appearance of the person as required and the safety of any other person and the 

community[.]” 18 U.S.C. § 3142(b). The Court considers the following factors in 

making its determination as to whether there are conditions of release that will 

reasonably assure the appearance of the defendant as required: (1) the nature and 

circumstances of the offenses charged, including whether they are crimes of 

violence; (2) the weight of the evidence against the accused; (3) the history and 

characteristics of the individual, such as his or her character, physical and mental 

condition, family and community ties, criminal history and record concerning 

appearances in court when required; and (4) the nature and seriousness of the 

danger to any person or the community that would be posed by the person's 

release. 18 U.S.C. § 3142(g). 

III. Factors Regarding Risk of Flight 

Defendant Mesiwala’s Motion to Travel to Canada should be denied because 

the defendant continues to present a risk of flight given his substantial resources, 

family connections overseas, and the weight of the evidence in this case. Granting 

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defendant’s Motion and returning the defendant’s passport would strip away any 

reasonable assurance that the defendant will appear at trial as required. 

Defendant’s expressed basis for requesting that the Court allow him to travel 

to Canada is his desire to attend his son’s wedding. Although the defendant would 

miss the official ceremony, denying the defendant’s request to leave the United 

States does not preclude him from celebrating the occasion with his son and new 

daughter-in-law in Michigan. 

The defendant has not articulated any change in circumstances since the time 

his conditions of release were put in place that should persuade the Court to 

remove the requirement that she surrender any passport to Pretrial Services. The 

condition of release requiring him to surrender any passport to Pretrial Services 

remains the least restrictive condition that will reasonably assure his appearance in 

court as required. 

As demonstrated below, the factors regarding risk of flight weigh heavily 

against permitting defendant Mesiwala to travel to India because he (1) has close 

ties to other countries; (2) has substantial financial resources at his disposal, most 

of them undisclosed to Pretrial Services; (3) has a prior criminal history both of 

distributing illegal prescription drugs and also of money laundering; and (4) faces 

strong evidence of his guilt, including his own admissions. 

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A. Resources and Family Contacts Outside of the United States 

Defendant Mesiwala has substantial family contacts available to him outside 

of the United States. Defendant Mesiwala’s own motion establishes (1) that he has 

relatives in Toronto, Canada; and (2) he maintains connections in his country of 

origin, India. (R. 246 ¶¶ 5, 8.) Travel records also indicate that defendant 

Mesiwala regularly travels abroad, mostly to India, including on the following 

dates: 

Departure Date Transit/Destination Return Date 

9/3/2008 Frankfurt 9/17/2008 

2/21/2009 Mumbai 3/16/2009 

4/11/2009 Amsterdam 4/26/2009 

2/16/2010 Amsterdam 2/25/2010 

3/23/2010 Amsterdam 4/8/2010 

4/29/2011 Turkey 5/8/2011 

10/23/2011 New Delhi 11/8/2011 

2/20/2012 Turkey 3/7/2012 

8/22/2012 Heathrow 9/9/2012 

3/17/2013 Dubai 4/9/2013 

11/19/2013 Beijing 11/26/2013 

2/15/2014 Munich 3/2/2014 

The defendant also made trips to Canada on at least the following days: 

(1) 12/18/2006; (2) 6/15/2007; (3) 6/7/2008; (4) 12/29/2008; (5) 1/2/2011; and (6) 

8/27/2014. 

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Additionally, if the defendant is convicted of the charged crimes, in addition 

to facing a significant prison sentence, the defendant will also face an exclusion 

from treating Medicare beneficiaries and causing the submission of claims to the 

Medicare program. As such, the defendant may view his prospects for finding 

future employment as a physician to be better outside of the United States. 

Finally, the defendant’s Motion raises the argument that he would not 

abandon his children who are residing in this country by fleeing. (R. 246 at 3). 

The more logical possibility, since his children appear not to live locally in the 

Detroit area and there is no restraint on the children’s ability to leave the United 

States, is that defendant Mesiwala would be able to maintain his ties with his 

family while abroad. 

B. Undisclosed Financial Resources 

In addition to his ties to Canada and India, bank records and Medicare 

claims data reveal that defendant Mesiwala has substantial income—which he did 

not disclose to Pretrial Services—at his disposal. On October 2, 2014, defendant 

Mesiwala reported to Pretrial Services (and, as a result, to the Court) that his 

monthly income was approximately $7,000. Bank records indicate otherwise. In 

fact, bank records and Medicare claims data reveal that Medicare paid the 

defendant approximately $25,600 per month between August 2013 and July 2014 

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alone. Mesiwala received these payments both directly through his individual 

Medicare provider identification number (“PIN”) and through his wife’s company, 

Professional Consultants. 

Between August 2013 and July 2014, Medicare made approximately the 

following direct deposits into accounts held by Mesiwala and his wife’s company, 

Professional Consultants: 

Date Mesiwala Professional 

Consultants 

Total Monthly 

Medicare Income 

August 2013 $7,809.52 $19,563.18 $27,372.70

September 2013 $7,291.72 $19,354.31 $26,646.03

October 2013 $8,766.16 $19,835.04 $28,601.20

November 2013 $16,064.35 $5,583.08 $21,647.43

December 2013 $16,526.50 $6,588.85 $23,115.35

January 2014 $24,996.09 $22,245.50 $47,241.59

February 2014 $3,306.45 $11,952.89 $15,259.34

March 2014 $10,607.42 $11,208.35 $21,815.77

April 2014 $1,542.77 $15,920.46 $17,463.23

May 2014 $10,685.72 $11,333.99 $22,019.71

June 2014 $9,655.47 $10,650.63 $20,306.10

July 2014 $13,927.83 $15,562.31 $29,490.14

Total: $131,180.00 $169,798.59 $300,978.59

With the addition of between $1,560 and $1,597 per month from the Social 

Security Administration, defendant Mesiwala received approximately $27,613.23 

per month in income in the year before his arrest. Over the same time period, 

Mesiwala and Professional Consultants received a total of approximately 

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$300,978.59, not including additional payments from Blue Cross Blue Shield and 

other deposits. 

 In fact, defendant Mesiwala’s medical practice—primarily funded by 

Medicare reimbursements—was a lucrative one throughout the period of the 

charged health care fraud conspiracy. For services purportedly rendered during the 

period of the conspiracy (February 2009 through December 2013), defendant 

Mesiwala was paid $535,439.47 and Professional Consultants was paid 

$948,966.25 by Medicare for services purportedly rendered by the defendant. The 

current location of those funds is unknown and, as such, could support defendant 

Mesiwala should he decide not to return to the United States following any trip to 

Canada or elsewhere. 

C. Prior Criminal History 

The importance of the assets available to defendant Mesiwala becomes even 

more important in light of his prior criminal history. In 1990, Mesiwala was 

convicted of money laundering, in violation of 18 U.S.C. § 1956, and an additional 

charge in violation of Title 21 related to the illegal distribution of prescription 

drugs.1

 He served time in a federal prison for those convictions and also lost his 

 1

 The government has requested defendant’s earlier case file from off-site 

storage, but that request remains pending. The government will update the Court 

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license to practice medicine in the State of Michigan until the mid-2000s. 

Consequently, defendant Mesiwala is aware of the ramifications of a conviction in 

the instant case, that is, a return to prison and the loss of his livelihood. As this 

criminal history demonstrates, the defendant has not only the resources to flee, but 

he has experience in laundering the proceeds of his criminal activity, both of which 

weigh heavily against permitting his travel to Canada. 

D. Strength of the Evidence 

The evidence against defendant Mesiwala is strong. First, defendant 

Mesiwala admitted to receiving kickbacks in exchange for referring Medicare 

beneficiaries to Ehsan and Advance. (See Mesiwala Interview, Attachment A.) 

The defendant also appears to admit to receiving kickbacks from Ehsan in 

exchange for referrals in his Motion for Reconsideration filed on November 10, 

2014. (R. 250 at 5, 9.) Although this motion mischaracterizes his involvement as 

“simply a kick back arrangement,” such an arrangement is a violation of law and 

tantamount to an admission to Count 2 of the Second Superseding Indictment. 

(See id. at 9; R. 196 ¶¶ 59–75.) Count 2 carries a five-year statutory maximum, 18 

U.S.C. § 371 and 42 U.S.C. § 1320a-7b, and the loss amount associated with 

 

on the defendant’s criminal history once the prior case file has arrived from offsite 

storage. 

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defendant Mesiwala’s referrals to Advance alone—not including the referrals to 

other home health agencies associated with Ehsan—is more than $770,000. 

 Second, the evidence against defendant Mesiwala as to Counts 7 and 8 

(health care fraud) is likewise formidable. According to Medicare claims data, 

between 2009 and 2013, Mesiwala billed Medicare approximately $87,940 for 

services that he purportedly rendered in Michigan between 2010 and 2013 when 

travel records indicate that he was out of the country. As alleged in Counts 7 and 

8, the substantive health care fraud counts are but two examples of this more 

widespread form of fraudulent billing by the defendant over five years. (See 

R. 196 ¶¶ 84–85.) 

Finally, Count 1 of the Second Superseding Indictment charges defendant 

Mesiwala with health care fraud conspiracy. Defendant Mesiwala admitted to 

federal agents that at least some of the home health referrals that he sold to Ehsan 

were for Medicare beneficiaries who requested the referrals but did not need them. 

Mesiwala Interview, Attachment A. Mesiwala further told the agents that he 

referred them because he feared that the beneficiaries would find another visiting 

doctor. Id. Additionally, agents interviewed five beneficiaries who were referred 

home health services by the defendant, and all five stated that they were able to 

leave the home and get around by bus or by car during the time that they were 

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referred for home health services by Mesiwala. One of those beneficiaries was codefendant James Zadorski, who asked the defendant for a home health referral and 

was actively traversing the Detroit area as a patient recruiter at the time. 

In addition to referring Medicare beneficiaries to Ehsan for home health 

services that he knew were unnecessary, the defendant also billed Medicare for 

visiting physician services related to the home health referrals. (See R. 196 ¶¶ 48, 

49, 57.) Medicare claims data reveals that he billed Medicare for home health care 

supervision services purportedly rendered to the Medicare beneficiaries who he 

referred to Ehsan in exchange for kickbacks. Mesiwala also billed Medicare for 

home visits for Medicare beneficiaries who Ehsan referred to him for the sole 

purpose of obtaining home health care referrals. The ability to bill Medicare Part 

B for physician services constitutes a form of inducement or kickback prohibited 

by 42 U.S.C. § 1320a-7b, and Medicare does not pay claims for services procured 

through kickbacks. 

 

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IV. Conclusion 

 For the foregoing reasons, the United States respectfully requests that the 

Court deny the defendant’s Motion to Travel to Canada. 

 

 Respectfully submitted, 

BARBARA L. MCQUADE 

 United States Attorney 

 

 By: /s Katharine A. Wagner 

Katharine A. Wagner 

Trial Attorney 

Patrick J. Hurford 

Assistant United States Attorney 

U.S. Department of Justice 

Criminal Division, Fraud Section 

1400 New York Ave, NW 

Washington, DC 20005 

Cell: (202) 341-8882 

Email: katharine.wagner@usdoj.gov 

Dated: November 14, 2014

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CERTIFICATE OF SERVICE 

I hereby certify that on November 14, 2014, I electronically filed the 

foregoing document with the Clerk of the Court using the ECF system, which will 

send notification of such filing to counsel for defendant Kutub Mesiwala, M.D. 

 

 /s Katharine A. Wagner 

Katharine A. Wagner 

Trial Attorney 

U.S. Department of Justice 

Criminal Division, Fraud Section 

1400 New York Ave, NW 

Washington, DC 20005 

Cell: (202) 341-8882 

Email: katharine.wagner@usdoj.gov 

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