Brooklyn doctor charged with over-billing Medicaid, Medicare by hundreds of thousands

On Monday, the Kings County District Attorney’s Office announced its indictment of Dr. Naveed Ahmad, who is charged with bilking Medicare and Medicaid out of approximately $500,000 over the course of three years. 

Kings County District Attorney Charles J. Hynes also announced the creation of a first-of-its-kind anti-health fraud collaboration, where local prosecutors and city agencies team up with the federal Health and Human Services Office of the Inspector General and the United States Attorney’s Office.

In addition, Hynes announced the creation of a new Healthcare Fraud Division within his office to handle the cases generated by the collaboration.

“Prosecution of Medicaid and Medicare fraud is a new game thanks to Senator Charles Schumer, the inspiration behind this extraordinary team,” said Hynes. “For years I have wanted to go after crooked providers but lacked the resources to handle such cumbersome investigations, so when Senator Schumer suggested combining my efforts with those of the federal authorities, I was glad for the opportunity.”
 
Loretta Lynch, the Brooklyn-based federal prosecutor for the Eastern District of New York, said, “Here in Brooklyn, we look forward to working with the able prosecutors of the Kings County District Attorney’s Office to continue to hold accountable those who would seek to manipulate the healthcare system.”

As for Dr. Ahmad, records indicate may have fraudulently billed Medicare for an additional $2 million and Medicaid an additional $716,000 for procedures and $7 million for prescriptions, according to the District Attorney’s Office.

Ahmad is charged with getting patients through “steerers” who would pay Medicaid and Medicare recipients up to $300 to visit the doctor, then bill their health plans and then fill prescriptions, which they turned over to the steerers.

Some of the steerers are also charged with using their own government health plans to make office visits and fill prescriptions.

Dr. Ahmad, whose office is at East 52nd Street and Church Avenue, is also charged with providing patients only cursory examinations before prescribing them HIV medications.

Suspected steerers and patients are charged with selling the medication on the black market, to actual HIV patients, or on a gray market, to wholesalers who would then sell them back to pharmacies for a profit, according to the District Attorney’s Office.

Two undercover HRA investigators posed as Medicaid patients and visited Dr. Ahmad’s office. One claimed to have HIV, and the other told the doctor that he did not have HIV. The indictment charges that one was treated twice and her Medicaid account billed twice. She received prescriptions for HIV medication both visits without ever having any HIV tests conducted, according to the indictment.

The other undercover visited Dr. Ahmad only once. He presented Dr. Ahmad a list of HIV medications he wanted, and though he admitted not having HIV, the doctor prescribed some of the medications on the list, according to the indictment.