FTC shuts down alleged health insurance fraud scheme involving the sale of low-quality plans
An alleged healthcare fraud scheme that was targeting Americans in need of medical insurance has been shut down by federal regulators—at least for now, pending the outcome of a lawsuit.
The Federal Trade Commission (FTC) said it intervened to halt a group of telemarketers from making future calls to consumers, in an attempt to scam them into buying low-quality health plans that do not meet their needs as patients.
According to the agency, the group sometimes posed as the government, offering supposedly “comprehensive” PPO plans that provide limited coverage. In some cases, the FTC said the company or companies involved would call patients who already were members of a plan, claiming that renewal payments were necessary to stay enrolled.
In its lawsuit filed against Ahmed Ibrahim Shokry and Amani Ibrahim Shokry—along with their companies, including American Collective and Innovative Partners—the agency alleges that unwitting citizens paid out millions of dollars in supposed premiums “for products they did not want or need,” and which carry the risk of exposing the alleged victims to “potentially significant and unexpected medical costs.”
The FTC alleges that Ahmed and Amani were the owners of the various telemarketing businesses, though they are being treated as one group for the purpose of the lawsuit given their close association.
A complaint against the defendants, dated April 7, was filed in a U.S. District Court for Southern Florida.
According to an announcement this week, filing court documents came shortly after Chairman Andrew N. Ferguson launched the agency’s Healthcare Task Force in March.
“The Healthcare Task Force launched last month underscores my commitment to bringing the full strength of the agency to bear on the challenges facing American patients, providers, and communities,” Ferguson said in the announcement. “The [FTC’s] work here is essential: When companies engage in practices that inflate prices, limit patient access to medical care, or undermine the integrity of the healthcare system, consumers suffer.”
“Under my leadership, the Commission will continue to pursue fraudsters who deceive or disadvantage people seeking medical treatment, and we will do so with every enforcement tool at my disposal,” he added.
Three years in business
The lawsuit claims that patients who signed up for coverage from Ahmed and Amani later found out that the benefits were lacking, and many weren’t even entirely sure what they purchased as brokers working for the defendants did not seek fully informed consent.
As for what was truly being offered, the FTC said it wasn’t actual PPO plans or comprehensive health coverage at all, as what was being peddled wasn’t suitable to be listed on any state or federal medical insurance marketplace, despite being marketed as “state-issued.”
The supposed plans being offered by defendants included an “assortment of medical discounts, ancillary products, and capped payouts for certain medical events such as emergency room visits—while some plans exclude hospital care entirely,” the agency stated.
It added that the alleged scheme dates back to early 2023.
HealthExec reached out to one of the companies, Innovative Partners, for comment.
A website for Innovative Partners still lists health insurance offerings for sale, including dental coverage.
None of the allegations made by the FTC have been proven in court, despite regulators shutting down operations.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.