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health care fraud

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Fifteen individuals, including Mujjahid Huq, a pharmacist from Halesite, have been charged for their participation in schemes in which the Medicare and Medicaid programs, and other health care benefit programs, were fraudulently billed more than $10.6 billion, according to a press release from the U.S. Attorney’s Eastern District office on June 30.

Huq, 45, is charged by indictment with three counts of health care fraud, two counts of unlawful monetary transactions, and conspiracy to make false statements in health care matters in connection with a $2.1 million pharmacy fraud scheme.

As alleged in the indictment, Huq, a licensed pharmacist, owned several pharmacies in Brooklyn, Queens, and Buffalo, New York. Through these pharmacies, Huq billed Medicare and Medicaid $2.1 million for drugs that were not dispensed.  Huq also allegedly agreed with others to make false statements about his ownership of the pharmacies, and used the fraud proceeds for his personal benefit.  Trial Attorneys Patrick J. Campbell and Arun Bodapati of the Northeast Strike Force are in charge of the prosecution.

“This record-setting Health Care Fraud Takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” Attorney General Pamela Bondi said in a statement. “Make no mistake — this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.”

Read more about the case here.

 

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An East Setauket doctor pleaded guilty in federal court in Boston on Nov. 14 for receiving kickbacks in exchange for ordering medically unnecessary brain scans.

Dr. Kenneth Fishberger, 75, pleaded guilty to one count of conspiracy to commit health care fraud. Judge Nathaniel M. Gorton scheduled sentencing for Feb. 25, 2025.

Dr. Kenneth Fishberger

Fishberger, an internist, was a licensed medical doctor in the State of New York for approximately 47 years and had an office at 200 Belle Terre Rd, Suite 110 in Port Jefferson

From approximately June 2013 through December 2019, Fishberger conspired with others, including a principal for a mobile medical diagnostics company that performed transcranial doppler (TCD) scans, and a salesperson for the company, to order hundreds of medically unnecessary TCD scans in exchange for kickbacks.

TCD scans are brain scans that measure blood flow in parts of the brain. Fishberger and his co-conspirators used false diagnoses to order the unnecessary brain scans, for which a co-conspirator would submit claims to Medicare and other insurance companies, including private insurance companies, on behalf of the medical diagnostic company for payment. In exchange, Fishberger was paid cash kickbacks of approximately $100 per test. According to the charging documents, the scheme resulted in fraudulent bills of approximately $891,978 to Medicare and private insurance companies.

The charge of conspiracy to commit health care fraud provides for a sentence of up to 10 years in prison, three years of supervised release and a fine of up to $250,000. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and statutes which govern the determination of a sentence in a criminal case.

Acting United States Attorney Joshua S. Levy; Roberto Coviello, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General; Jodi Cohen, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division; Harry Chavis, Jr., Special Agent in Charge of the Internal Revenue Service’s Criminal Investigation Division, Boston Field Office; Carol S. Hamilton, Regional Director of the U.S. Department of Labor, Employee Benefits Security Administration, Boston Regional Office; Ketty Larco-Ward, Inspector in Charge of the U.S. Postal Inspection Service, Boston Division; and Christopher Algieri, Special Agent in Charge of the U.S. Department of Veterans Affairs Office of Inspector General, Northeast Field Office made the announcement. Assistant U.S. Attorneys Howard Locker and Mackenzie Queenin of the Health Care Fraud Unit are prosecuting the case.