Carlos Quijada Admits Posing as Licensed Physician in Medicaid and Medicare Fraud Scheme

Source- http://newark.fbi.gov/dojpressrel/pressrel11/nk042711a.htm

NEWARK, NJ—A Hawthorne, N.J., man admitted today to posing as a licensed physician and unlawfully treating patients, prescribing medicine, and ordering procedures at an Elizabeth, N.J., medical practice for $10 an hour, U.S. Attorney Paul J. Fishman announced.

Carlos Quijada, 31, pleaded guilty to an Information charging him with one count of conspiracy to commit health care fraud. The defendant entered his guilty plea before U.S. Magistrate Judge Patty Shwartz in Newark federal court, who recommended to U.S. District Judge Faith S. Hochberg that his plea of guilty be accepted and entered.

According to documents filed in this case and statements made in court:

Quijada posed as a licensed physician at the direction of Yousuf Masood, 47, of Warren, N.J., the doctor who ran the practice. Yousuf Masood and his wife, Maruk Masood, 43—the practice's office manager—pleaded guilty April 21, 2011, before Judge Shwartz to conspiracy to commit health care fraud, admitting that they used unlicensed individuals to treat patients and billed Medicaid and Medicare as if Yousuf Masood provided the services.

At today's hearing, Quijada explained that he had posted an advertisement on craigslist making clear that he was not a licensed physician, and was contacted by the Masoods and offered employment at Yousuf Masood's medical office. Although Quijada told them he had not passed required tests and was not licensed to practice, they directed him to treat, diagnose, and prescribe medication for patients, and to introduce himself to patients as "Dr. Quijada."

Over the course of the scheme, more than 20,000 patient visits were conducted by unlicensed individuals, including Quijada, but billed to Medicaid and Medicare as if Yousuf Masood had examined the patients. Hamid Bhatti, 33, of Rahway, N.J., and Hakim Muta Muhammad, 31, of Newark, are also charged by Complaint for pretending to be doctors during patient visits, and those charges remain pending.

Yousuf Masood was the top prescriber of drugs to Medicaid patients in New Jersey in 2009, prescribing more than $9 million in Medicaid drugs that year. The next-highest prescribing doctor in New Jersey prescribed less than $6 million. Yousuf Masood provided Bhatti, Muhammad, and Quijada with pre-signed, blank prescription forms to write prescriptions in his name for patients they were improperly examining and treating. Quijada admitted today that he wrote prescriptions for a wide variety of drugs, including medications used to treat schizophrenia, bipolar disorder, anxiety, insomnia, and other illnesses.

On some days, more than 100 patients visited the medical practice for treatment, and the majority were treated only by unlicensed individuals. Quijada explained at his plea hearing today that while he and other unlicensed individuals were diagnosing and treating patients, Yousuf Masood was frequently either not in the office at all, or was in his personal office watching television.

In addition to prescribing medication, Quijada ordered that procedures be performed on patients—including electrocardiograms, bronchodilation responsiveness tests, and transnasal eustachian tube inflation. Yousuf Masood and Maruk Masood billed Medicaid and Medicare for these procedures. At his guilty plea, Yousuf Masood agreed to pay more than $1.8 million in restitution and forfeiture based on the fraudulent Medicaid and Medicare billings. The conspiracy charge carries a maximum penalty of 10 years in prison and a fine of $250,000, or twice the gross gain or loss from the offense. Sentencing is currently scheduled for July 27, 2011, before U.S. District Judge Faith S. Hochberg.


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