There will be no compassionate release for a sick man serving 18 years in prison for collecting more than $9 million from Medicare and Medicaid while banned for fraud, a New Jersey federal court decided.

U.S. District Judge Susan D. Wigenton said in her unpublished letter and opinion issued Tuesday that though Imadeldin Awad Khair, 63, had asked the Federal Bureau of Prisons for compassionate release previously, he did not ask due to his current health conditions within the proper time frame, so his request must be denied.

Khair suffers from kidney failure, pneumonia, diabetes, heart and lung problems and is "almost entirely bed-ridden," his motion for emergency sentence reduction said. The judge said that before debating the merits of the motion, Khair would need to provide the Bureau of Prisons with the opportunity to argue for compassionate relief on his behalf. "The burden is on the defendant to demonstrate that he satisfied this procedural prerequisite for judicial review," she wrote.

The ailing man had argued that his multiple requests to the BOP prior to July were sufficient to show he had asked for compassionate relief.

"Those requests, however, predate the onset of the medical conditions for which defendant now seeks compassionate release," the judge wrote. She added that "tellingly, none of those requests sought compassionate release under the [First Step Act]" under which he most recently sought release.

That act allows the BOP "to place certain elderly and terminally ill prisoners on home confinement to serve the remainder of their sentences," the Federal Bureau of Prisons' website says.

Though Khair again asked the BOP for compassionate release on July 3, the judge said his instant motion for emergency sentence reduction was filed only days later. She said the BOP is entitled to 30 days to respond to his request, and so she denied his motion.

Judge Wigenton then commented on the substance of Khair's emergency motion for sentence reduction, writing that though he "pointed to some ostensible inconsistencies in his extensive, 900-page medical history, and has alleged that the care provided by the BOP is contrary to 'the recommendation[s] of specialists,' he has curiously failed to provide any certification from a medical professional indicating whether the BOP's treatment of his complex medical conditions has been inadequate."

She said Khair hadn't explained how he would be better treated if he were at home and called his assertion that his sister-in-law was "trained as a medical doctor" and "would be 'ready to help [him] coordinate amongst specialists to manage his' treatment … insufficient."

Khair was sentenced in 2017 for collecting federal funds through his ambulance company, K&S Invalid Coach, despite being banned from participating in federal health programs after committing New Jersey health care fraud. At the same time, Khair also was sentenced for money laundering, tax evasion and obstructing a federal audit.

In addition to the prison time, Khair was ordered to pay $8.8 million in restitution, according to court records.

While in prison, Khair's health worsened. In 2018, his cancerous right kidney was removed, and a growing tumor was discovered on his left kidney. With other health problems and in the midst of a global pandemic, Khair petitioned the court for a sentence reduction, but was denied in 2020, court records show.

Khair has now served 48% of his sentence and has new and worsening medical conditions, his motion for emergency sentence reduction said. His attorney, Alison Brill, wrote in his motion for emergency sentence reduction that she was not able to determine whether he was receiving adequate physical therapy and called his lack of family contact "additional punishment."

Brill told the court that neither she nor Khair's family had been able to locate him and had to file a Freedom Of Information Act request to determine he was alive. He had been hospitalized for over a month.

Khair was diagnosed with renal cancer in 2017, and was subjected to "delays in treatment and consultation, mismanagement of medication, and disregard of medical recommendations by specialists," Brill wrote in Khair's motion.

He is scheduled to be released in February 2032, according to the federal Bureau of Prisons website.

Representatives of the parties did not immediately respond to requests for comment Wednesday. 

The government is represented by Katherine Marie Romano of the U.S. Attorney's Office for the District of New Jersey.

Khair is represented by Alison Brill of the Federal Public Defender's Office for the District of New Jersey. 

The case is U.S. v. Khair, case number 2:15-cr-00404, in the U.S. District Court for the District of New Jersey.

--Editing by Roy LeBlanc.