A former Michigan pharmacist and his brother were sentenced yesterday to eight years in prison and five years in prison, respectively, for their roles in a conspiracy to commit $15 million of health care fraud and wire fraud.
According to court documents and evidence presented at trial, from 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 of over $15 million loss to Medicare, Medicaid and Blue Cross Blue Shield of Michigan.
Pharmacist and Brother Sentenced to Prison for $15M Health Care and Wire Fraud Schemehttps://t.co/eTFTwfPgCj
— Criminal Division (@DOJCrimDiv) November 21, 2025
In November 2024, Raad Kouza and Ramis Kouza were convicted of conspiracy to commit health care fraud and wire fraud by a federal jury in the Eastern District of Michigan.
At sentencing, the Court ordered the brothers to pay approximately $15.5 million in restitution and the same amount in forfeiture.
Acting Assistant Attorney General Matthew R. Galeotti of the Justice Department’s Criminal Division; Special Agent in Charge Jennifer Runyan of the FBI Detroit Field Office; and Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
FBI and HHS-OIG investigated the case.
Trial Attorneys Claire Sobczak Pacelli, Jeffrey A. Crapko and Andres Q. Almendarez of the Criminal Division’s Fraud Section prosecuted the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program.
The charges follow skyrocketing healthcare premiums nationwide that consume a higher percentage of one's income.
Health care fraud drives up costs for all consumers. The longest federal shutdown focused on taxpayer subsidies for Americans.
Since March 2007, this program, currently comprised of 9 strike forces operating in 27 federal districts, has charged more than 5,800 defendants who collectively have billed federal health care programs and private insurers more than $30 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.