Husam Thamin Abed, DAB CR6661 (2025)

DECISION

Petitioner, Husam Thamin Abed, was a urogynecologist, practicing in Grand Rapids, Michigan.  Citing his unorthodox treatments, which caused irreparable damage to at least one teenage girl, the Michigan Licensing Board charged him with negligence and failing to conform to minimal standards of acceptable practice.  The Board suspended his medical license.  Yet, Petitioner continued to practice medicine and to perform the same questionable procedures. 

He was subsequently charged with six felony counts of practicing medicine without a license and convicted on all six counts.  Based on his convictions, the Inspector General (IG) has excluded him for 25 years from participating in federal health care programs under section 1128(a)(2) of the Social Security Act (Act).  Petitioner appeals the exclusion. 

For the reasons discussed below, I find that the IG properly excluded Petitioner Abed and that a 25-year exclusion is reasonable. 

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Background

In a letter dated September 30, 2024, the IG notified Petitioner that he was excluded from participating in Medicare, Medicaid, and all federal health care programs for a period of 25 years because he had been convicted of a criminal offense related to the neglect or abuse of patients in connection with the delivery of a health care item or service.  The letter explained that section 1128(a)(2) of the Act authorizes the exclusion.  IG Ex. 1. 

Petitioner timely requested review. 

Petitioner concedes that he was convicted of six felonies but argues that he is not subject to exclusion under section 1128(a)(2) because he was not convicted of patient abuse or neglect.  P. Br. at 3-6.  Petitioner also argues that the length of his exclusion is not reasonable and challenges each of the factors the IG relied on in determining that length.  P. Br. at 6-9.  

The IG has submitted a written argument (IG Br.) and 11 exhibits (IG Exs. 1-11).  Petitioner responded to the IG’s brief (P. Br.) and submitted five exhibits (P. Exs. 1-5).  The IG submitted a reply (IG Reply).  In the absence of any objections, I admit into evidence IG Exs. 1-11 and P. Exs. 1-5. 

The parties agree that an in-person hearing is not necessary.  IG Br. at 19; P. Br. at 9. 

Issues

The issues before me are:  whether the IG is authorized to exclude Petitioner from program participation; and whether the length of the exclusion (25 years) is reasonable.  42 C.F.R. § 1001.2007. 

Discussion

1. 1. Petitioner must be excluded from program participation for a minimum of five years because he was convicted of criminal offenses related to the neglect or abuse of patients, in connection with the delivery of a healthcare item or service.1

Under section 1128(a)(2) of the Act, the Secretary of Health and Human Services must exclude an individual who has been convicted, under federal or state law, of “a criminal offense related to neglect or abuse of patients, in connection with the delivery of a health care item or service.”  42 C.F.R. § 1001.101(b).  The “delivery of a health care item or 

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service” includes providing any item or service to an individual to meet his or her physical, mental, or emotional needs or well-being, whether or not reimbursed by Medicare, Medicaid, or any federal health care program.  Id. 

License suspension.  Here, Petitioner Abed was a urogynecologist, practicing in Grand Rapids, Michigan.  He performed medical procedures that were “outside standard, normal practice, especially when it comes to providing treatment to minors.”  IG Ex. 5 at 5.  When they learned of these practices, the three hospitals to which he had admitted patients revoked his hospital privileges and reported him to the licensing board.  IG Ex. 5 at 8. 

In an Order of Summary Suspension, dated May 23, 2022, the Michigan Licensing Board’s Disciplinary Subcommittee concluded that “the public health, safety, or welfare requires emergency action” and ordered that Petitioner’s license to practice medicine in the State of Michigan be summarily suspended.  IG Ex. 5 at 17-18.  Petitioner, however, disregarded the suspension and continued to meet with and treat patients.  IG Ex. 5 at 12‑13. 

In an administrative complaint, dated December 15, 2022, the Michigan Licensing Board’s Disciplinary Subcommittee charged Petitioner with four counts of misconduct: 

1. Violating his “general duty, consisting of negligence or failure to exercise due care . . . or any conduct, practice, or condition that impairs or may impair [his] ability to safely and skillfully engage in the practice of the health profession”;
2. Departing from or failing to conform to “minimal standards of acceptable and prevailing practice for a health profession”;
3. Demonstrating “a lack of good moral character”; and
4. Practicing medicine without a license.   

IG Ex. 5 at 13-14. 

In a Consent Order, dated May 3, 2023, the Disciplinary Subcommittee accepted the allegations, found that Petitioner had violated the Michigan Public Health Code, and suspended Petitioner’s medical license for a minimum period of 18 months.  IG Ex. 5 at 1-3.  Notwithstanding the license suspension, Petitioner continued to meet with and treat patients. 

Felony convictions.  In criminal informations, dated October 14 and October 20, 2022, Petitioner was charged with six felony counts of unauthorized practice of medicine, in 

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violation of MCL (Michigan Compiled Laws) § 333.16294.2  IG Exs. 6, 7.  In support of the charges, investigators cited specific instances of Petitioner continuing to see patients and to perform procedures after his license was suspended.  IG Exs. 8, 9.  On March 6, 2024, a jury found Petitioner guilty on all six felony charges.  IG Exs. 10, 11. 

The presiding judge sentenced Petitioner to 30 days in jail and ordered him to pay a $2,000 fine plus court costs.  IG Exs. 2, 3. 

Petitioner’s defenses.  Petitioner concedes, as he must, that he was convicted of felonies but argues that he is not subject to an exclusion because he was convicted of unauthorized practice, not patient abuse or neglect.  P. Br. at 4. 

Although the unauthorized practice statute does not mention patient abuse or neglect, the facts underlying Petitioner’s convictions establish that they were related to patient abuse.  It is beyond well-settled that, in determining whether a conviction is program-related within the meaning of section 1128, I am not limited to the language of the statute under which the individual was convicted.  Dr. Timothy Baxter, DAB No. 3074 at 15-16 (2022); Yolanda Hamilton, M.D., DAB No. 3061 at 10 (2022); Shaun Thaxter, DAB No. 3053 at 11 (2021); Funmilola Mary Taiwo, DAB No. 2995 at 8 (2020); Summit S. Shah, M.D., DAB No. 2836 at 7 (2017) (“The Board has long held . . . that an ALJ is free to look beyond the narrow constructs of a state’s criminal statutes.”); Janet R. Constantino, DAB No. 2666 at 7-8 (2015) (holding that the basis for the underlying conviction may be established by judicial records or other probative evidence); Timothy Wayne Hensley, DAB No. 2044 (2006); Scott D. Augustine, DAB No. 2043 (2006); Lyle Kai, R.Ph., DAB No. 1979 at 5 (2005), aff’d, Kai v. Leavitt, No. 05-00514 (D. Haw. July 17, 2006); Narendra M. Patel, M.D. DAB No. 1736 at 7 (2000), aff’d sub nom. Patel v. Thompson, 319 F.3d 1317 (11th Cir. 2003) (“We see nothing in section 1128(a)(2) that requires that the necessary elements of the criminal offense must mirror the elements of the exclusion authority, nor that all statutory elements required for an exclusion must be contained in the findings or record of the state criminal court.”); Berton Siegel, D.O., DAB No. 1467 at 5 (1994); Carolyn Westin, DAB No. 1381 (1993), aff’d sub nom. Westin v. Shalala, 845 F. Supp. 1446 (D. Kan. 1994). 

Here, the conduct underlying Petitioner’s convictions plainly involved patient abuse.  As the Licensing Board concluded, the physician failed to conform to “minimal standards of acceptable and prevailing practice for a health professional.”  He violated his duty to 

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“exercise due care” in treating his patients.  IG Ex. 5 at 13-14.  Yet, even after his medical license was twice suspended because of his unorthodox (even dangerous) practices, Petitioner persisted.  IG Ex. 5 at 12-13, 17-18.  As a direct result, he was convicted on the six felony counts.  His criminal convictions were thus related to the abuse of patients. 

Petitioner also insists that the treatments he provided improved the quality of life for most of his patients and that he had been “subjected to harassment from competitors” who “started a smear campaign” against him.  P. Br. at 2.  He asserts that, in treating patients after his license had been suspended, he was caring for people “as a good Samaritan,” helping a few patients in need, “just like caring for family members.”  P. Br. at 3. 

Petitioner, however, may not use this forum to argue that he did not, in fact, commit the crimes.  The regulations preclude such a collateral attack on an underlying conviction: 

• When the exclusion is based on the existence of a criminal conviction . . . or any other prior determination where the facts were adjudicated and a final decision was made, the basis for the underlying conviction . . . is not reviewable, and the individual or entity may not collaterally attack it, either on substantive or procedural grounds, in this appeal.   

42 C.F.R. § 1001.2007(d); Janice Cassandra Wrenn, DAB No. 3118 at 8-11 (2023); Yolanda Hamilton, M.D., DAB No. 3061 at 9-10; Funmilola Mary Taiwo, DAB No. 2995 at 8; Delores L. Knight, DAB No. 2945 at 9 (2019); Marvin L. Gibbs, Jr., M.D., DAB No. 2279 at 8-10 (2009); Roy Cosby Stark, DAB No. 1746 (2000). 

1. 2. Based on three aggravating factors and the absence of mitigating factors, the 25-year exclusion is reasonable.

Individuals excluded under section 1128(a)(2) must be excluded for a period of not less than five years.  Act § 1128(a)(3)(B); 42 C.F.R. §§ 1001.102(a), 1001.2007(a)(2).  Federal regulations set forth criteria for lengthening exclusions beyond the five-year minimum.  42 C.F.R. § 1001.102(b).  Evidence that does not pertain to one of the aggravating or mitigating factors listed in the regulations may not be used to decide whether an exclusion of a particular length is reasonable. 

So long as the period of exclusion is within a reasonable range, based on demonstrated criteria, I have no authority to change it.  Craig Richard Wilder, DAB No. 2416 at 8 (2011); Joann Fletcher Cash, DAB No. 1725 at 17 (2000) (citing 57 Fed. Reg. 3,298, 3,321 (Jan. 29, 1992)) (finding it appropriate to defer to the IG’s “broad discretion” in setting the length of an exclusion, “given the [IG’s] vast experience in implementing exclusions”). 

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“Simply meeting the threshold for an aggravating factor is a clear indication of untrustworthiness.”  Hussein Awada, M.D., DAB No. 2788 at 10 (2017). 

Among the factors that may serve as a basis for lengthening the period of exclusion are the three that the IG relies on in this case:  1) in convictions involving patient abuse or neglect, the action that resulted in the conviction was premediated, was part of a continuing pattern of behavior, or consisted of non-consensual sexual acts; 2) the sentence imposed by the court included incarceration; and 3) the individual has been the subject of any other adverse action by any Federal, State, or local government agency or board, if the adverse action is based as the same set of circumstances that serve as the basis for the imposition of the exclusion.  42 C.F.R. § 1001.102(b). 

The presence of an aggravating factor or factors, not offset by any mitigating factor or factors, justifies lengthening the mandatory period of exclusion. 

Continuing pattern of behavior (42 C.F.R. § 1001.102(b)(4)).  There is no question that the actions for which Petitioner was convicted represented a continuing pattern of behavior, and that factor, by itself, justifies significantly increasing the period of his exclusion.  In reporting him to the licensing board, the hospitals characterized the procedures he performed as “outside standard, normal practice, especially when it comes to providing treatment to minors.”  IG Ex. 5 at 5. 

The licensing board agreed and summarily suspended his license, advising him that “public health, safety, or welfare” required the emergency action.  IG Ex. 5 at 17-18.  And yet, with his license suspended, Petitioner continued to practice.  IG Ex. 5 at 12-13. 

The Disciplinary Subcommittee subsequently accepted the allegations against him and suspended his medical license for a minimum of 18 months.  Again, Petitioner continued to practice.  IG Exs. 8, 9.  Only after six felony convictions and a jail sentence, did Petitioner’s behavior stop. 

Petitioner determined that he was above the law and that his opinions outweighed those of multiple practitioners, including those charged with protecting public health and safety.  Based on his defenses here, he continues to hold those views.  That he would not honor the legitimate directives from his state licensing board establishes that he is exceptionally untrustworthy and, by itself, justifies increasing the period of exclusion well beyond the minimum. 

Incarceration (42 C.F.R. § 1001.102(b)(5)).  The court sentenced Petitioner to 30 days in jail.  Any period of incarceration is consequential and justifies increasing the period of exclusion.  “It is the fact that the sentence included incarceration that demonstrates the excluded individual’s underlying conduct was deemed sufficiently serious that it merited 

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this form of punishment.”  Roji Esha, DAB No. 3076 at 29 (2022); Eugene Goldman, M.D. a/k/a Yevgeniy Goldman, M.D., DAB No. 2635 at 6 (2015).  See Jason Hollady, M.D., DAB No. 1855 at 12 (2002); Stacy Ann Battle, DDS., DAB No. 1843 (2002); Brenda Mills, M.D., DAB CR1461, aff’d DAB No. 2061 (2007). 

Prior administrative sanction (42 C.F.R. § 1001.102(b)(9)).  As noted above, the Michigan State Board of Medicine twice suspended Petitioner’s license to practice medicine.  First, it summarily suspended his license based on the danger he posed to public health and safety.  IG Ex. 5 at 17-18.  The second suspension cited both his unacceptable treatment practices and his practicing medicine without a license – the same circumstances that serve as the basis for this exclusion.  IG Ex. 5 at 13-14. 

Petitioner argues that his license suspension should not be considered because it was based on a “sham investigation” and “false allegations.”  P. Br. at 7.  As I explained above, the Medical Board adjudicated the facts and made a final decision.  Petitioner may not now collaterally attack the Medical Board’s findings or actions.  42 C.F.R. § 1001.2007(d). 

Petitioner also maintains that he signed the consent order and allowed the Medical Board to treat the allegations as true solely for the purpose of resolving the complaint against him, not for any other purpose.  The argument has no merit.  The “pertinent fact for purposes of section 1001.102(b)(9)” is that the State Board’s adverse action and the criminal convictions were based on the same underlying facts.  Robert Kolbusz, M.D., DAB No. 2759 at 8 (2017); see Kimberly Jones, DAB No. 3033 at 12 (2021) (“The suspension of a state professional license for any period of time is significant.”). 

Mitigating factors.  The regulations consider mitigating just three factors:  1) a petitioner was convicted of three or fewer misdemeanor offenses and the resulting financial loss to the program was less than $5,000; 2) the record in the criminal proceedings demonstrates that a petitioner had a mental, physical, or emotional condition that reduced his culpability; and 3) a petitioner’s cooperation with federal or state officials resulted in others being convicted or excluded, or additional cases being investigated, or a civil money penalty being imposed.  42 C.F.R. § 1001.102(c).  Petitioner bears the burden of proving any mitigating factor by a preponderance of the evidence.  42 C.F.R. § 1005.15(c); Barry D. Garfinkel, DAB No. 1572 at 8 (1996). 

No mitigating factor applies here.  Petitioner was convicted of multiple felonies; he does not allege a mental, physical, or emotional condition that reduces his culpability; and he did not cooperate with law enforcement. 

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Petitioner nevertheless points to a physician shortage generally and the significant shortage of physicians in his specialty; he argues that excluding him would be “an unwise waste of talent and money invested” in his training to reach his level of expertise.  P. Br. at 9.3  These are not mitigating factors. 

Conclusion

For these reasons, I conclude that the IG properly excluded Petitioner from participating in Medicare, Medicaid and all federal health care programs, and I sustain the 25-year exclusion.