Two doctors charged in $50M fraud scheme

Two doctors were arrested and face charges in a $50 million healthcare fraud case in New York.

A New York cardiologist and neurologist were under arrest this week charged in a $50 million healthcare fraud scheme.

Also charged were four employees or associates at the clinic of cardiologist Asim Hameedi, M.D., City Medical Associates in Bayside, New York, according to an announcement from the United States Attorney's office for the Southern District of New York.

Prosecutors said all of the defendants were involved in a massive healthcare fraud scheme that spanned more than 12 years and involved more than $50 million in fraudulent claims. Along with Hameedi, Emad Soliman, M.D., a neurologist with his own practice, Westchester Neurological Consultants in Westchester, New York, who formerly worked at City Medical Associates, was charged in the case.

All are facing criminal charges for their roles in submitting false insurance claims between 2003 and 2015 to defraud Medicaid, Medicare and other private health insurance companies. Prosecutors said the defendants provided false medical information and used the identities of doctors who did not work at the clinic to submit fraudulent claims. The defendants are charged with healthcare fraud, identity theft and making false statements.

A civil lawsuit was also filed by the U.S. Attorney’s office and one of the doctors whose name was allegedly used by City Medical Associates without permission to submit false claims.

According to prosecutors, the defendants made false representations to insurance providers about the medical condition of patients to obtain preauthorization for medical tests and procedures; submitted claims for tests and procedures that were never performed or were medically unnecessary, as well as for drugs not used; paid what were described as exorbitant kickbacks to local primary care medical offices in exchange for lucrative referrals from those offices; and accessed without authorization electronic health records of patients at a Long Island hospital in violation of HIPAA to identify patients to recruit to the cardiology clinic.

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