Unnamed Client
[Address]
Detroit, MI 48203
(area code) Phone
July 15, 20xx
The Honorable judge’s name
Federal District Court Judge
Eastern District of Michigan
Detroit, Michigan
Regarding: United States of America—v—defendant
Dear Judge Name:
I stand before you broken and humiliated. As a man who has suffered enormous hardship—a man who nears his 65th birthday—I ask that you take the totality of my life into consideration. In this letter, I will detail my background and service to our country. I will offer an explanation—though not an excuse—for the crimes I stand convicted of having committed. Please take this information into your deliberations as you decide the appropriate sanction for my case. You will see the depth of my remorse for the bad decisions I have made.
With great shame, I acknowledge that I have been convicted of crimes, not once but twice. My financial records reveal that I did not engage in criminal misconduct out of some sense of greed. Despite decades of hard work and service, I never accumulated much in the way of material belongings. At best, I’ve lived a middle-class life that has left me nearly destitute as I approach my senior years. I am guilty of bad planning, bad management, and bad record-keeping. Those flaws have had enormous implications on my life, my profession, my community, and my reputation. I recognize my disregard for keeping good records has contributed to my current struggles. In light of my experience, I should have known better. By revealing my background, you may more fully appreciate the influences that external forces have had on my standing before you as a convicted person.
Background:
I was born on December 22, 1950, in the West Indies. Wanting to provide more opportunities for our family, my father immigrated to the United States from Trinidad when I was eight. My mother cared for my four brothers and me while my father worked to establish himself in New York City as a tailor. After three years, my mother joined my father, leaving my four brothers and me with our grandparents. That began our life of struggle.
The day after our mother left, our grandparents withdrew my brothers and me from school. My grandfather owned a business that provided carpentry and building services. He demanded that my brothers and me labor 12 to 14 hours each day in his shop. His demands robbed us of our childhood. During that time, my oldest brother stepped on a nail, contracted tetanus, and he died.
After two years, our parents were able to send for my brothers and me. We were united as a family in New York. We resumed school, but as a consequence of us having missed two years, the school district held me back by one full year. I was 13, but studying with 12-year-olds.
Our mother worked as a nurse’s aide. She had aspirations of becoming a registered nurse. Six months after we arrived in New York, our mother died in a fire. She was tending to an elderly man on the sixth floor of a building that caught fire. My mother never made it out.
It was difficult for us to live with our father at first. Although he did the best that he could, my father had left us when we were so young that we didn’t have a close relationship with him. Eighteen months after our mother died, my father remarried a wonderful woman. Our stepmother took great care of us and she was even successful in persuading school administrators to accelerate me so that I could graduate with my class.
After high school I enrolled in the City University, pursuing a degree in electrical engineering. I was an excellent student, eager to make a contribution as a professional. After three years, I was drafted into the Army. Following the placement test, the recruiting officer suggested that I enlist as a medic. I agreed to enlist in a three-year program. Following my basic training at Fort Dix, I went to Fort Sam Houston in San Antonio, Texas for medic training. Then I shipped out to Germany where I served as an infantry medic, caring for soldiers who were sick or wounded.
During my time in Germany, I sat for the Expert Field Medical Test. Three thousand infantry medics sat for the exam. Sitting for that exam was the most challenging feat I’d ever accomplished. When I learned that I was one of only 15 medics who earned the badge, distinguishing me as an Expert Field Medic, I realized that I wanted to devote my life to serving others. Since receiving my badge as an Expert Field Medic, several doctors from the military, including Major John Scott, Captain R. Levine, and Major J. Leedy, urged me to attend medical school and gave me letters of recommendation.
While in Germany, I married Pauline, the love of my life. She was my sweetheart from New York. We lived together in Germany for my final year of service. Then, we returned to New York and I resumed my studies. Pauline and I have been married for 42 years. I have not been a perfect husband. I have made mistakes for which I am deeply remorseful. Pauline and I have worked through our challenges. She has forgiven me and I love her deeply.
Rather than returning to City College to complete studies in electrical engineering, I enrolled at Long Island University. My ambition was to advance my education in medicine. Although I didn’t have an undergraduate degree, administrators at the university recognized my training as a military medic. After I did well in testing, the administrators allowed me to enroll in a program that would culminate with a graduate degree and a certification as a physician’s assistant.
I completed the first two years in that Physician’s Assistant program. Then Pauline and I agreed that I should pursue a medical degree. From other students, we learned of a program in Mexico that seemed perfectly suited for me. Rather than completing the PA program, I chose to enroll in Universidad Del Noreste in Tampico, Mexico. For two years, I studied toward my MD in Mexico. I completed my final two years toward the MD at Grace University School of Medicine at Nevis, in the West Indies. Nevis was much closer to my roots in the West Indies and I felt comfortable there. My family and I moved to Detroit, where I would complete my clinical training at Kirwood Hospital and Southwest Hospital in 1983 and 1984.
Grace University School of Medicine awarded my MD degree in 1985.
Family:
Pauline and I have three children. Our son Kareem, born in 1975, is currently a doctor of pharmacology. He has blessed us with two grandchildren. Our granddaughter, Taylor, is currently in her third year of university studies at Oakwood University. Pauline and I helped to raise Taylor while her father completed his pharmacy training. The Lord has also blessed us with Leia, our youngest granddaughter, at two and a half years old. We have another granddaughter on the way. Our second son, Korie, was born in 1980. He is finishing his third year of medical school in St. Kitts. Our third son, Kristen, born in 1983, is a stage actor who performs internationally. He also owns a floral business and holds a degree in psychology. Pauline and I reared our sons to be God-fearing, contributing, law-abiding citizens.
Head-on Collision:
In 1985, just after I earned my medical degree, our family suffered from a head-on automobile collision. We all nearly died, but the good Lord spared our lives. I was bedridden for several months and debilitated for an entire year. As a consequence of the medication and physical therapy, I failed to muster the concentration necessary for my medical board examinations. I never passed the test to begin my residency.
When my health returned to a level that would allow me to work, I joined the practice of a very prominent internist, Dr. Lawrence Lackey. Dr. Lackey allowed me to work under his auspices from 1986 to 1993. Although I never completed my degree as a Physician’s Assistant, a provision in the National Commission on Certification of Physician Assistants allowed me to take the certification test. I passed that exam with honors, allowing me to work with Dr. Lackey. Later, I took advantage of another Michigan law that allowed me to practice as a physician so long as I practiced under the supervision of a licensed physician. I continued working with Dr. Lackey.
My First Conviction for Healthcare Fraud:
When Dr. Lackey passed away in 1993, I needed to make an adjustment. Clearly, I understood that compliance with the law would require a licensed physician to oversee my work. My heart was always set on practicing in an underserved community, providing medical care to the needy. I opened a clinic in 1994 and I hired Dr. Stanley Orowe to oversee the practice. After several years of practicing together, I learned that authorities targeted Dr. Orowe for healthcare fraud in 1999. As the owner of the clinic, I too was liable.
It brings me great pain to acknowledge that I am a failure as a businessman. My irresponsibility with regard to effective oversight resulted in my violating laws. As a consequence, I played a role in victimizing a system that I had a duty and responsibility to support. A guilty plea for that violation of the law resulted in my being sentenced to 18-months probation and requiring that I pay restitution of $2,000 for my culpability. The conviction stained my reputation, branding me as a convicted felon.
Personal Health Complications:
At the same time that I endured those complications with the legal system, my health deteriorated. Horrific back pain—a complication from my earlier automobile accident and exacerbated by the stress from my legal troubles—resulted in my having to endure physical therapy treatment at the Rehab Institute of Michigan for longer than four years. I also attended the Harper Pain Clinic, where I received epidural and intramuscular injections monthly for more than four years.
My doctors routinely prescribed to me Vicodin, Norco, Percocet, muscle relaxers, and Xanax. After taking all of this medication for my chronic pain for longer than seven years, I became addicted. With chronic pain, I couldn’t work. By 2004, I began a string of surgeries. Every nine months I was back in the hospital for surgeries of various sorts. I underwent two back surgeries, hip-replacement surgery, prostate cancer surgery, Inguinal Hernia Repair Surgery. In another surgery, doctors inserted an electrical stimulator into my spine to reduce the pain. There were times during those 10 years of illness that I couldn’t stand or walk for more than 25 feet.
My beloved wife, Pauline, had to work two jobs to support our family. She has always been a public servant, working as a speech therapist for the Detroit Public School System while I was handicapped.
Resuming work in 2010:
In 2010, after a decade, my chronic pain began to subside. Dr. Dwight Smith, an internist who had been treating me, noticed my improvement. He offered me a job and I accepted. I began working in a clinic that I believed he owned. Later, I learned that a man by the name of Tosif owned the clinic and that Tosif employed Dr. Smith. Eventually, Tosif, met with me and asserted his ownership of the clinic. The process I’d been instructed to follow required that I refer patients who needed physical therapy to the front desk. I later learned that the clerk at the desk would then refer those patients to a home-health agency that Tosif owned. I’d been following that process without knowing that Tosif owned the home-health care agency.
Once I learned that Tosif owned both the clinic and the home-healthcare agency. I took actions that I deemed appropriate. I asked another worker in the clinic to recommend other home-health care agencies that were not related to Tosif or our clinic. She recommended Cherish Home Health Care and I began recommending all of my patients to Cherish. I refused to send further patients to Tosif’s agency. When confronted by Tosif, I refused to comply with his request that I send my patients to him. This led to a severing of my employment with Tosif and Dr. Smith.
A few months after I disassociated myself from Tosif and Dr. Smith, in 2011, the federal government indicted them both for massive healthcare fraud. I felt relieved that I had voluntarily left their employment.
The following year, in 2012, I learned from a colleague that authorities had also indicted Zia Hassan, the owner of Cherish. News of the indictment surprised me, as I believed Cherish to be a reputable business that complied with all laws.
News of the Crime:
In 2014, two FBI agents visited me at my home. They told me that a grand jury had indicted the owner of Cherish. The government wanted my help to convict him. I told the agents that I didn’t know anything about Mr. Hassan’s criminal wrongdoing. The agents disagreed. They accused me of conspiring with Cherish in massive healthcare fraud. I didn’t understand. They accused me of sending fake patients to Cherish so Mr. Hassan could use the patients’ Medicare documents for inappropriate billing. The agents mistakenly believed that Zia Hassan would reimburse me with payments. When I denied involvement in any such kickback scheme, the agents told me that they had records of Hassan issuing several checks that totaled $7,607. They cited those checks as evidence that Hassan had been paying me kickbacks for the patients I referred to his agency.
Public Speaking:
I explained to the agents that those checks didn’t have anything to do with kickbacks. I’ve been speaking on healthcare issues for longer than 20 years—long before these issues surfaced. I gave a series of speeches and lectures to educate audiences about prostate cancer, breast cancer, colon cancer, high blood pressure, and diabetes. I wanted to teach seniors, how they could keep their homes safe from falls. In order to hold the attention of the seniors in my audience, I paid for caterers to prepare meals. The checks that Zia Hassan donated, for a total of $7,607, were strictly to cover the costs for meals, eating, and serving goods. Those funds did not relate, in any way, to my patients or their need for home health care.
What I’ve learned from this Process:
Your honor, the trials, and tribulations of being charged with a crime have led me to reflect. Through deep introspection, I must acknowledge that I failed in my duty as a professional. I failed to keep accurate records. There is no excuse for the bad decisions I made which failed to account for all business practices. My addiction to painkillers that included Vicodin, Norco, and Percocet, otherwise known Oxycodone—compromised my ability to appreciate the importance of good and accurate management skills.
In retrospect, I wish that I had done things differently. Introspection has caused me to stop feeling sorry for myself and to think about what I could have done differently. I should have acted in ways that would have eliminated the possibility of anyone accusing me of victimizing the healthcare system. For example, instead of relying on Cherish, I could’ve taken steps to learn about other providers in the area. Then, I could’ve given my patients a list of providers and encouraged them to choose which home health care provider would have been best for them.
Further, with regard to accepting those checks from Cherish, I should have acted differently. Since the $7,607 that Cherish donated was to be used to purchase catering services, I should have had Cherish pay those fees directly. I deeply regret my incompetent record-keeping skills. I should have taken better care to anticipate prudent-practice methods. Good record-keeping, policies, and procedures would’ve eliminated all possibility of my having played a role in victimizing the healthcare system. I deeply regret my errors in judgment. Perhaps my addiction to pain medication contributed to my lack of judgment.
Community Service:
Your honor, as I wrote at the start of this letter, it’s my hope that you will take the totality of my life into consideration. You must deliberate over the appropriate sentence. Our family has worshipped at the Burn’s Seventh Day Adventist Church in Detroit for longer than 15 years on a regular basis. Besides rearing our children in a house of faith, I’m proud to have worked with Pauline to spearhead a mentoring group for students from our church.
My idea of launching a mentoring program began with a tragedy. Someone murdered a student from Redford High while stealing his coat. When I heard about that crime, I decided to launch a group that might help us protect our children. Pauline and I decided to start with the people we love. We banded together with nine other families and we self-funded a mentoring program to achieve two objectives:
- Ensure that each of the 21 children we mentored would never experience the penal system.
- Ensure that each of the 21 children we mentored would advance to a four-year university after graduating high school.
It is with a great sense of pride that I can report on the success of our mentoring program. Those 21 children now live as leading members of our community. They have achieved great distinction. You now have letters from some of those individuals, revealing one who went so far as to achieve a law degree from Harvard and a Ph.D. from UC Berkeley; he’s now a law professor at NYU. From our group, we have two lawyers, three medical doctors, one medical student, one psychologist / actor/ entrepreneur, two chemical engineers, one librarian, a psychologist, an MBA, and several teachers. Some are still students.
Your honor, please consider that I am a loving, kind, gentle, God-fearing family man. I have many friends and family that I love and care for. I loved, respected, and cared for all my patients. I would have never taken advantage of them or the healthcare system. I only wanted to give my patients the best possible care.
Again, your honor, please take my life in its totality into consideration when you impose sentence. Physicians continue treating me for complications to my health. I’m under medical care for prostate problems, back-pain issues, hypothyroidism, and high blood pressure.
On behalf of my family, I ask you for leniency in sentencing.
Sincerely,
Client Name