Here are 10 recent stories involving physician fraud.
Louisiana internist is indicted for Medicaid fraud — Fiaz Afzal, MD, an internist and owner of Claiborne Medical Corporation in Kenner, La., has been charged with Medicaid fraud. Between Jan. 2009 and March 2010, he allegedly billed the Medicaid program for tests, procedures and treatments that were never rendered. He has also been accused of falsifying documentation and writing false diagnoses and symptoms to support the fraudulent billing, according to the report.
New Jersey pain management physician is accused of filing $52 million in false claims — Amgad Hessein, MD, a pain management physician and anesthesiologist from Newark, N.J., has been arrested on charges he submitted approximately $52 million in false claims to Medicare and private insurers for treatments for which he did not possess the necessary equipment to perform or for more complex and expensive treatments than were actually rendered.
Oklahoma Health Care Authority terminates three physicians from participation in Medicaid — The Oklahoma Health Care Authority has terminated three physicians and barred them from participating in the federal Medicaid program and is currently reviewing the status of 10 other physicians after their names appeared on a list of the top prescribers of frequently abused pain and mood-altering medications.
Kansas internist will serve three years in prison for healthcare fraud and illegally distributing prescription drugs — Wayne Williamson, a former Olathe, Kan., internist, admitted in July to billing Medicare and Medicaid for longer visits to government-subsidized low-income apartment complexes than what actually occurred. He also pleaded guilty to selling prescription drugs, such as Oxycontin, Percocet and Xanax.
Michigan plastic surgeon is charged with filing false claims to Medicaid and Blue Cross Blue Shield of Michigan — Doris Annette Nelson, MD, a plastic surgeon from Sterling, Mich., has been accused of allegedly filing false claims as a dermatologist, even though her license is in plastic surgery. Dr. Nelson has also been accused of falsifying patient information in order to support her fraudulent claims.
Missouri pediatrician and employer settle lawsuit alleging unnecessary treatment and false diagnoses — Carol Ann Ryser, MD, who worked at Health Centers of America-Kansas City, was accused of knowingly misdiagnosing patients with conditions they did not have in order to prescribe medically unnecessary supplements and treatments for profit.
Former podiatrist from New York avoids prison time after pleading guilty to bilking $750,000 from Medicare — Michael Akyuz admitted to billing Medicare for expensive podiatry procedures when, in fact, he did not do much more than clip elderly patients' toenails. As a result, he bilked almost $750,000 from the federal healthcare program. Mr. Akyuz avoided a prison term after the judge ruled his imprisonment would negatively impact his four autistic children.
Texas family practitioner pleads guilty to conspiring with an employee to submit fraudulent claims to federal healthcare programs — Alexander Orlov, DO, who owns a Lufkin, Texas, medical practice and urgent care clinic, admitted to conspiring with an employee to submit claims for services to Medicare and Medicaid that were fraudulently rendered to patients. The employee, Haseeb Rehman, was hired to run the urgent care clinic, where he treated patients, prescribed medication, performed minor surgical procedures without a medical license and then billed Medicare and Medicaid for his services.
Two Los Angeles physicians are arrested on charges they led a $5 million Medicare scam — Homeless individuals were allegedly transported to RSB Medical Group in San Fernando Valley, Calif., where they were paid $100 by the physicians in exchange for undergoing a variety of tests, including abdominal ultrasounds, regardless of their medical conditions. The homeless patients also allegedly had their blood drawn, which was later dripped into open jars and packaged for sale.
Surgeon from Iowa will serve six months in prison after being convicted on 31 counts of healthcare fraud — Between 2005 and 2007, Angel Serafin Martin, MD, filed fraudulent claims to private health insurers and federal healthcare programs in order to receive higher payments than were actually due. In addition to his prison sentence, Dr. Martin must pay more than $5,000 in restitution, a $12,500 fine and more than $3,000 to a crime victims' fund.
Louisiana internist is indicted for Medicaid fraud — Fiaz Afzal, MD, an internist and owner of Claiborne Medical Corporation in Kenner, La., has been charged with Medicaid fraud. Between Jan. 2009 and March 2010, he allegedly billed the Medicaid program for tests, procedures and treatments that were never rendered. He has also been accused of falsifying documentation and writing false diagnoses and symptoms to support the fraudulent billing, according to the report.
New Jersey pain management physician is accused of filing $52 million in false claims — Amgad Hessein, MD, a pain management physician and anesthesiologist from Newark, N.J., has been arrested on charges he submitted approximately $52 million in false claims to Medicare and private insurers for treatments for which he did not possess the necessary equipment to perform or for more complex and expensive treatments than were actually rendered.
Oklahoma Health Care Authority terminates three physicians from participation in Medicaid — The Oklahoma Health Care Authority has terminated three physicians and barred them from participating in the federal Medicaid program and is currently reviewing the status of 10 other physicians after their names appeared on a list of the top prescribers of frequently abused pain and mood-altering medications.
Kansas internist will serve three years in prison for healthcare fraud and illegally distributing prescription drugs — Wayne Williamson, a former Olathe, Kan., internist, admitted in July to billing Medicare and Medicaid for longer visits to government-subsidized low-income apartment complexes than what actually occurred. He also pleaded guilty to selling prescription drugs, such as Oxycontin, Percocet and Xanax.
Michigan plastic surgeon is charged with filing false claims to Medicaid and Blue Cross Blue Shield of Michigan — Doris Annette Nelson, MD, a plastic surgeon from Sterling, Mich., has been accused of allegedly filing false claims as a dermatologist, even though her license is in plastic surgery. Dr. Nelson has also been accused of falsifying patient information in order to support her fraudulent claims.
Missouri pediatrician and employer settle lawsuit alleging unnecessary treatment and false diagnoses — Carol Ann Ryser, MD, who worked at Health Centers of America-Kansas City, was accused of knowingly misdiagnosing patients with conditions they did not have in order to prescribe medically unnecessary supplements and treatments for profit.
Former podiatrist from New York avoids prison time after pleading guilty to bilking $750,000 from Medicare — Michael Akyuz admitted to billing Medicare for expensive podiatry procedures when, in fact, he did not do much more than clip elderly patients' toenails. As a result, he bilked almost $750,000 from the federal healthcare program. Mr. Akyuz avoided a prison term after the judge ruled his imprisonment would negatively impact his four autistic children.
Texas family practitioner pleads guilty to conspiring with an employee to submit fraudulent claims to federal healthcare programs — Alexander Orlov, DO, who owns a Lufkin, Texas, medical practice and urgent care clinic, admitted to conspiring with an employee to submit claims for services to Medicare and Medicaid that were fraudulently rendered to patients. The employee, Haseeb Rehman, was hired to run the urgent care clinic, where he treated patients, prescribed medication, performed minor surgical procedures without a medical license and then billed Medicare and Medicaid for his services.
Two Los Angeles physicians are arrested on charges they led a $5 million Medicare scam — Homeless individuals were allegedly transported to RSB Medical Group in San Fernando Valley, Calif., where they were paid $100 by the physicians in exchange for undergoing a variety of tests, including abdominal ultrasounds, regardless of their medical conditions. The homeless patients also allegedly had their blood drawn, which was later dripped into open jars and packaged for sale.
Surgeon from Iowa will serve six months in prison after being convicted on 31 counts of healthcare fraud — Between 2005 and 2007, Angel Serafin Martin, MD, filed fraudulent claims to private health insurers and federal healthcare programs in order to receive higher payments than were actually due. In addition to his prison sentence, Dr. Martin must pay more than $5,000 in restitution, a $12,500 fine and more than $3,000 to a crime victims' fund.