Top-Prescribing Medicaid Doctor Used Non-MDs, FBI Says

The biggest prescriber of drugs for Medicaid patients in New Jersey ran a medical practice that used phony physicians to see patients, according to a Federal Bureau of Investigation arrest complaint.

Yousuf Masood, 46, billed Medicaid, the government insurance program for the poor and disabled, for thousands of visits by patients who either got no services or were seen by three employees who had no medical license and posed as doctors, according to the FBI complaint.

Masood, who got more than $13.7 million in Medicaid payments in the past year, and his wife, Muruk, 42, the office manager, were charged with fraudulently getting at least $1.8 million in billings for services by the three employees. Those employees earned as little as $17 an hour at the office in Elizabeth, New Jersey, according to the FBI.

“The defendants are charged with an unconscionable fraud which not only ripped off a vital government program, but exposed patients to treatment by people without medical licenses,” U.S. Attorney Paul Fishman in Newark, New Jersey, said in a statement.

The Masoods were arrested today at their home in Warren Township, New Jersey. Hakim Muta Muhammad, 32, of Newark, and Carlos Quijada, 30, of Hawthorne, New Jersey, were arrested at the office. The third employee, Hamid Bhatti, 32, was expected to surrender, according to Rebekah Carmichael, a spokeswoman for Fishman.

All five were charged with conspiracy to commit health-care fraud, and face as many as 10 years in prison on that count. The Masoods also were charged with a count of conspiracy to commit money laundering, which carries another 10-year penalty.

Bail Hearing

The Masoods appeared in federal court in Newark, where U.S. Magistrate Judge Madeline Cox Arleo set bail at $300,000 each and said they could not practice medicine without disclosing the charges to patients. Arleo set bail at $100,000 for Muhammad and Quijada.

After the hearing, a lawyer for the Masoods, John T. Doyle said: “They say that they’re completely innocent of all charges, and they will be completely vindicated. To my knowledge, any patients that were seen were done so by licensed physicians.”

Muhammad’s attorney, Anthony Mack, said his client is “very upset” at the charges and “maintains his innocence.”

Mack said Muhammad is a graduate of medical school at DeVry Inc.’s Ross University and needs to complete a residency program and pass an exam to get his license.

Quijada attorney Kelly Daniels declined comment.

$9 Million in Medicaid Drugs

Yousuf Masood prescribed $9 million in Medicaid drugs in 2009 while the next-highest doctor in New Jersey prescribed less than $6 million, according to the arrest complaint.

Employees of the Masoods said two-thirds of the patients were seen by Bhatti, Quijada and Muhammad, according to the complaint. The Masoods submitted more than 20,000 “evaluation and management” codes to Medicaid from July 2009 to July 2010 for $2.7 million, meaning $1.8 million was fraudulent, according to the FBI.

During three weeks in the past year, Masood billed Medicaid for services while he was traveling in Europe, Bermuda and the Dominican Republic, according to the FBI.

The U.S. seeks forfeiture of the Masoods’ properties in Basking Ridge, New Jersey, and Davenport, Florida. The Masoods transferred $1.4 million to buy the New Jersey property and $150,000 to buy the Florida property, Assistant U.S. Attorney Jacob Elberg said at the hearing. He said government agents today seized more than $2 million in cash from nine accounts.

The case is U.S. v. Yousuf Masood, 10-mj-08214, U.S. District Court, District of New Jersey (Newark).

To contact the reporter on this story: David Voreacos in New York federal court at dvoreacos@bloomberg.net.

• Tweet
• More
  • Business Exchange
  • Buzz up!
  • Digg
• Print
• Email