A. Rahway Admits Posing as Licensed Physician in Medicaid and Medicare Fraud Scheme

Source- http://newark.fbi.gov/dojpressrel/pressrel11/nk050911.htm

NEWARK, NJ—A Rahway, 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 in a Medicaid and Medicare fraud scheme through which more than 20,000 patient visits were conducted by unlicensed individuals, U.S. Attorney Paul J. Fishman announced.

Hamid Bhatti, 33, was the fourth individual to plead guilty in connection with the scheme. Bhatti entered his guilty plea, to an information charging him with one count of conspiracy to commit health care fraud, before U.S. Magistrate Judge Patty Shwartz in Newark federal court. Judge Shwartz 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:

Bhatti 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 on 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. Another individual, Carlos Quijada, 31, of Hawthorne, NJ, pleaded guilty on April 27, 2011, before Judge Shwartz to conspiracy to commit health care fraud, admitting to posing as a licensed physician at the direction of the Masoods.

At today's hearing, Bhatti explained that he had responded to an advertisement the Masoods had placed on craigslist. Although Bhatti 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, introducing himself to patients as "Dr. Bhatti." Bhatti admitted that he worked six days per week and regularly saw and treated 30 to 40 patients each day.

Over the course of the scheme, more than 20,000 patient visits were conducted by unlicensed individuals, including Bhatti, but billed to Medicaid and Medicare as if Yousuf Masood had examined the patients. Hakim Muta Muhammad, 31, of Newark, is also charged by complaint for pretending to be a doctor 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. Bhatti 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. Bhatti stated 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, Bhatti 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 before Judge Hochberg for July 27, 2011 for Yousuf Masood, Maruk Masood, and Carlos Quijada, and for September 12, 2011 for Bhatti.


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