Federal prosecutors last month accused doctors and staffers associated with a New York City clinic of running a “massive” insurance fraud scheme worth at least $57 million. The alleged 12-year scheme bilked insurers for medically unnecessary tests that prosecutors say were often not even performed was described. Before he was forced out of office, Manhattan U.S. Attorney Preet Bharara had brought a series of charges against interventional cardiologist Asim Hameedi of Manhattan, neurologist Emad Soliman of Westchester County, and employees of a Queens clinic. The charges include health care fraud, wire fraud, conspiracy and making false statements. In addition, the U.S. Attorneys office has joined a whistleblower’s False Claims Act suit against Hameedi, Soliman, Queens clinic City Medical Associates PC and others.

Prosecutors say the doctors and clinic staffers lied to unnamed insurance companies, including providers paid through Medicaid and Medicare, in order to obtain preauthorization for medical tests. They say further that the Defendants submitted false claims for testing and procedures that were medically unnecessary or not performed. Dr. Hameedi and others are also alleged to have paid “exorbitant” kickbacks to primary care offices in exchange for patient referrals. They are accused of illegally accessing patients’ health records from an unidentified hospital to locate recruits for City Medical Associates.

In order to hide the huge volumes of claims being submitted by the clinic, prosecutors say the conspirators falsely told insurers that some medical tests had been ordered or performed by doctors who didn’t work at the clinic.

The case is U.S. v. Asim Hameedi et al. (case number 17-cr-00137) in the U.S. District Court for the Southern District of New York. The civil case is U.S. ex rel. Dr. Patricia A. Kelley et al. v. City Medical Associates et al. (case number 1:15-cv-07261) in the same court.

Source: Law360.com

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