The following ten physicians were either accused or convicted of fraud within the past two months, beginning with the most recent.
1. Retired Chief of Surgery Sentenced to 2 Years Imprisonment For Florida Medicare Fraud Scheme
A retired chief of surgery at Hollywood (Fla.) Medical Center and Memorial Hospital in Pembroke Pines, Fla., has been sentenced to two years in prison for Medicare fraud. Fred Dweck, MD, pleaded guilty last year to playing a central role in a fraud conspiracy by referring 858 Medicare patients to home healthcare agencies for unnecessary diabetic and other medical services. The scheme generated $37 million in fraudulent claims and $22 million in payments between 2006 and 2009.
2. Tennessee Physician Sentenced to 9 Years in Prison for Illegal Substance Distribution
A physician from Fayetteville, Tenn., has been sentenced to serve 108 months in prison for illegal distribution of controlled substances. Samuel Ashby, MD, was sentenced in a U.S. District Court in Chattanooga. Dr. Ashby — who was convicted of illegal distribution as well as defrauding TennCare and attempted tax evasion — was ordered to pay restitution to the IRS and serve three years supervised release upon his release from federal prison. He pleaded guilty to the charges last November.
3. Baltimore Ophthalmologist Accused of Performing Hundreds of Unnecessary Laser Eye Procedures
Baltimore ophthalmologist Arthur Kiely, MD, has been charged with fraudulently billing thousands of dollars for hundreds of medically unnecessary eye procedures performed on dozens of patients. The 33-page civil lawsuit, filed by the U.S. government, claims that Dr. Kiely repeatedly performed unnecessary laser eye surgery between 2002 and 2009, then falsely billed Medicare and Medicaid for the unwarranted work. Dr. Kiely maintains a primary ophthalmology practice at Mercy Medical Center in Baltimore. He also practices at a specialty clinic in Baltimore owned by Bon Secours Hospital.
4. New York Pediatrician Pleads Guilty to Defrauding State Vaccine Program
Pediatrician Ghulam Mustafa, MD, who practiced in Albion and Medina, N.Y., has pleaded guilty to defrauding the state's no-cost vaccine program by selling vaccines he had received for free. Dr. Mustafa, who is employed by the Hassan Medical Group, pleaded guilty to fourth-degree larceny and to selling vaccines he had obtained at no cost from the state program, which offers free vaccines to providers who then administer them without charge to eligible patients such as the uninsured, Native Americans or Medicaid beneficiaries. He agreed to pay the state $179,000 for the vaccines he sold to patients who weren't eligible for free shots from 2004 to 2007. Dr. Mustafa will be sentenced June 13. He faces up to four years in prison.
5. Arizona Pain Management Physician Surrenders License; Pleads Guilty to Fraud, Money Laundering
Albert Yeh, the former operator of a pain management clinic in Golden Valley, Ariz., has surrendered his medical license and has been sentenced to 2.5 years in prison after pleading guilty to fraudulent billing. In January, Mr. Yeh pleaded guilty to three felonies — fraudulent schemes and artifices, illegal control of an enterprise and money laundering — requiring him to surrender his Arizona medical license. He also surrendered his Nevada license and has been ordered to pay $683,038 in restitution to the Arizona Health Care Cost Containment System. Mr. Yeh has agreed to forfeit approximately $2 million in seized assets.
6. Georgia Pediatrician Pleads Guilty to Medicaid Fraud, Sentenced to 10 Years Probation
Kathy Mansfield, MD, a pediatrician from Thomaston, Ga., has pled guilty to one count of Medicaid fraud. Dr. Mansfield overbilled Medicaid approximately $537,428. Her scheme, which involved the drug Synagis, had two parts. She would use "single-dose" or "single-use" drugs more than once but bill Medicaid as if a new vial was used for each patient. Her practice, Pediatric Associates of Thomaston, would also bill for the larger and more expensive size vials of Synagis, costing between $1,100 and $1,300 each. Dr. Mansfield has been sentenced to 10 years probation, restitution in the amount of $537,428, a $10,000 fine and investigative costs to be repaid to the state in the amount of $5,000.
7. Texas Urologist Charged With 9 Counts of Medicare Fraud
Urologist Hossein Lahiji, MD, of McAllen, Texas, and his wife have been indicted for allegedly defrauding Medicare and Medicaid. Dr. Lahiji and Najmeh Vahid Lahiji are accused in the nine-count indictment of defrauding the programs by submitting false and fraudulent claims for payment of urology services either performed by unlicensed and unqualified medical personnel or not rendered. Claims were submitted for urology services purportedly performed by Dr. Lahiji when, in fact, he was traveling outside of Texas or the country at the time of service. The Lahijis each face a sentence of up to 10 years in prison and a maximum fine of $250,000, if convicted.
8. Florida Podiatrist Sentenced to 21 Months of Prison, $325K Restitution for False Claims
Podiatrist Arthur C. Haspel, MD, of Boca Raton, Fla., has been sentenced on two counts of filing false Medicare claims and faces 21 months imprisonment, two years of supervised release and $324,491 in restitution. Dr. Haspel was excluded from participation in the Medicare program in 2003 after he was sentence for unlawful distribution of hydrocodone in 2002. Still, he continued to provide services to Medicare patients and billed the program for the services he provided. In his claims, he stated the services were performed by other physicians, who would receive the Medicare payments and kickback a portion to Dr. Haspel.
9. Tennessee Anesthesiologist Dr. Allen Foster Pleads Guilty to Overbilling Medicare
Anesthesiologist Allen R. Foster, MD, of Knoxville, Tenn., has pleaded guilty to charges of healthcare fraud by billing TennCare and Medicare for face-to-face visits with patients that never occurred. Dr. Foster operated pain clinics in Morristown, Tenn., as well as Knoxville. Established patients never saw Dr. Foster or any of his licensed medical providers. Rather, office workers would check patient vital signs and ask about their conditions. Prosecutors said Dr. Foster billed TennCare and Medicare for face-to-face visits — which paid him more than he would have seen with no face-to-face interaction.
10. Maryland Internist Allegedly Bilked More Than $800K From Medicare, Medicaid
The Department of Health and Human Services has filed a civil complaint against La Plata, Md.-based internist Abdul Fadul, MD, accusing him of fraudulently collecting more than $814,000 from Medicare and Medicaid. The complaint says Dr. Fadul billed the two programs thousands of times for procedures that were not performed between 2004 and 2005. The complaint also alleges that Dr. Fadul set up billing systems at his clinic, Cardio Vascular Center in La Plata, Md., that automatically rendered bills for more tests than a physician performed.
1. Retired Chief of Surgery Sentenced to 2 Years Imprisonment For Florida Medicare Fraud Scheme
A retired chief of surgery at Hollywood (Fla.) Medical Center and Memorial Hospital in Pembroke Pines, Fla., has been sentenced to two years in prison for Medicare fraud. Fred Dweck, MD, pleaded guilty last year to playing a central role in a fraud conspiracy by referring 858 Medicare patients to home healthcare agencies for unnecessary diabetic and other medical services. The scheme generated $37 million in fraudulent claims and $22 million in payments between 2006 and 2009.
2. Tennessee Physician Sentenced to 9 Years in Prison for Illegal Substance Distribution
A physician from Fayetteville, Tenn., has been sentenced to serve 108 months in prison for illegal distribution of controlled substances. Samuel Ashby, MD, was sentenced in a U.S. District Court in Chattanooga. Dr. Ashby — who was convicted of illegal distribution as well as defrauding TennCare and attempted tax evasion — was ordered to pay restitution to the IRS and serve three years supervised release upon his release from federal prison. He pleaded guilty to the charges last November.
3. Baltimore Ophthalmologist Accused of Performing Hundreds of Unnecessary Laser Eye Procedures
Baltimore ophthalmologist Arthur Kiely, MD, has been charged with fraudulently billing thousands of dollars for hundreds of medically unnecessary eye procedures performed on dozens of patients. The 33-page civil lawsuit, filed by the U.S. government, claims that Dr. Kiely repeatedly performed unnecessary laser eye surgery between 2002 and 2009, then falsely billed Medicare and Medicaid for the unwarranted work. Dr. Kiely maintains a primary ophthalmology practice at Mercy Medical Center in Baltimore. He also practices at a specialty clinic in Baltimore owned by Bon Secours Hospital.
4. New York Pediatrician Pleads Guilty to Defrauding State Vaccine Program
Pediatrician Ghulam Mustafa, MD, who practiced in Albion and Medina, N.Y., has pleaded guilty to defrauding the state's no-cost vaccine program by selling vaccines he had received for free. Dr. Mustafa, who is employed by the Hassan Medical Group, pleaded guilty to fourth-degree larceny and to selling vaccines he had obtained at no cost from the state program, which offers free vaccines to providers who then administer them without charge to eligible patients such as the uninsured, Native Americans or Medicaid beneficiaries. He agreed to pay the state $179,000 for the vaccines he sold to patients who weren't eligible for free shots from 2004 to 2007. Dr. Mustafa will be sentenced June 13. He faces up to four years in prison.
5. Arizona Pain Management Physician Surrenders License; Pleads Guilty to Fraud, Money Laundering
Albert Yeh, the former operator of a pain management clinic in Golden Valley, Ariz., has surrendered his medical license and has been sentenced to 2.5 years in prison after pleading guilty to fraudulent billing. In January, Mr. Yeh pleaded guilty to three felonies — fraudulent schemes and artifices, illegal control of an enterprise and money laundering — requiring him to surrender his Arizona medical license. He also surrendered his Nevada license and has been ordered to pay $683,038 in restitution to the Arizona Health Care Cost Containment System. Mr. Yeh has agreed to forfeit approximately $2 million in seized assets.
6. Georgia Pediatrician Pleads Guilty to Medicaid Fraud, Sentenced to 10 Years Probation
Kathy Mansfield, MD, a pediatrician from Thomaston, Ga., has pled guilty to one count of Medicaid fraud. Dr. Mansfield overbilled Medicaid approximately $537,428. Her scheme, which involved the drug Synagis, had two parts. She would use "single-dose" or "single-use" drugs more than once but bill Medicaid as if a new vial was used for each patient. Her practice, Pediatric Associates of Thomaston, would also bill for the larger and more expensive size vials of Synagis, costing between $1,100 and $1,300 each. Dr. Mansfield has been sentenced to 10 years probation, restitution in the amount of $537,428, a $10,000 fine and investigative costs to be repaid to the state in the amount of $5,000.
7. Texas Urologist Charged With 9 Counts of Medicare Fraud
Urologist Hossein Lahiji, MD, of McAllen, Texas, and his wife have been indicted for allegedly defrauding Medicare and Medicaid. Dr. Lahiji and Najmeh Vahid Lahiji are accused in the nine-count indictment of defrauding the programs by submitting false and fraudulent claims for payment of urology services either performed by unlicensed and unqualified medical personnel or not rendered. Claims were submitted for urology services purportedly performed by Dr. Lahiji when, in fact, he was traveling outside of Texas or the country at the time of service. The Lahijis each face a sentence of up to 10 years in prison and a maximum fine of $250,000, if convicted.
8. Florida Podiatrist Sentenced to 21 Months of Prison, $325K Restitution for False Claims
Podiatrist Arthur C. Haspel, MD, of Boca Raton, Fla., has been sentenced on two counts of filing false Medicare claims and faces 21 months imprisonment, two years of supervised release and $324,491 in restitution. Dr. Haspel was excluded from participation in the Medicare program in 2003 after he was sentence for unlawful distribution of hydrocodone in 2002. Still, he continued to provide services to Medicare patients and billed the program for the services he provided. In his claims, he stated the services were performed by other physicians, who would receive the Medicare payments and kickback a portion to Dr. Haspel.
9. Tennessee Anesthesiologist Dr. Allen Foster Pleads Guilty to Overbilling Medicare
Anesthesiologist Allen R. Foster, MD, of Knoxville, Tenn., has pleaded guilty to charges of healthcare fraud by billing TennCare and Medicare for face-to-face visits with patients that never occurred. Dr. Foster operated pain clinics in Morristown, Tenn., as well as Knoxville. Established patients never saw Dr. Foster or any of his licensed medical providers. Rather, office workers would check patient vital signs and ask about their conditions. Prosecutors said Dr. Foster billed TennCare and Medicare for face-to-face visits — which paid him more than he would have seen with no face-to-face interaction.
10. Maryland Internist Allegedly Bilked More Than $800K From Medicare, Medicaid
The Department of Health and Human Services has filed a civil complaint against La Plata, Md.-based internist Abdul Fadul, MD, accusing him of fraudulently collecting more than $814,000 from Medicare and Medicaid. The complaint says Dr. Fadul billed the two programs thousands of times for procedures that were not performed between 2004 and 2005. The complaint also alleges that Dr. Fadul set up billing systems at his clinic, Cardio Vascular Center in La Plata, Md., that automatically rendered bills for more tests than a physician performed.