Cardiologist, Neurologist, And Others Charged In $50 Million Health Care Fraud Scheme

https://www.justice.gov/usao-sdny/pr/cardiologist-neurologist-and-others-charged-50-million-health-care-fraud-scheme-and

Department of Justice
U.S. Attorney’s Office
Southern District of New York

FOR IMMEDIATE RELEASE
Wednesday, March 1, 2017

Cardiologist, Neurologist, And Others Charged In $50 Million Health Care Fraud Scheme, And Civil Suit Filed Against Clinic And Participants In The Fraud

Defendants Provided False Patient Medical Information and Used the Identities of Doctors Who Did Not Work at the Clinic to Submit More Than $50 Million in Fraudulent Health Care Claims

Preet Bharara, the United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation (“FBI”), Scott J. Lampert, Special Agent-in-Charge of the New York Regional Office of the United States Department of Health and Human Services Office of the Inspector General (“HHS-OIG”), and James P. O’Neill, the Commissioner of the New York City Police Department (“NYPD”), announced today criminal and civil actions relating to a 12-year scheme to defraud Medicaid, Medicare, and other private health insurance companies out of more than $50 million. Today’s actions include the unsealing of an Indictment charging ASIM HAMEEDI, FAWAD HAMEEDI, MICHELLE LANDOY, DESIREE SCOTT, EMAD SOLIMAN, and ARIF HAMEEDI with, among other things, health care fraud, identity theft, and making false statements, and the filing of a civil fraud lawsuit against CITY MEDICAL ASSOCIATES, P.C., and ASIM HAMEEDI, among others, seeking treble damages and civil penalties under the False Claims Act for the fraudulent claims for reimbursement submitted by CITY MEDICAL ASSOCIATES to Medicare and Medicaid between 2003 and November 2015.
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ASIM HAMEEDI, a board-certified interventional cardiologist who was the president and owner of City Medical Associates, a cardiology and neurology clinic based in Bayside, New York (“CMA””), together with others employed by CMA, conducted a massive health care fraud scheme spanning 12 years and involving more than $50 million in fraudulent claims. ASIM HAMEEDI conducted this scheme with others employed at or associated with CMA, including ASIM HAMEEDI’s nephew, FAWAD HAMEEDI, ASIM HAMEEDI’s brother, ARIF HAMEEDI, MICHELLE LANDOY, and DESIREE SCOTT, who were also employees of CMA, and EMAD SOLIMAN, a board-certified neurologist with his own practice in Westchester, New York.

The multi-faceted scheme included, among other things: (1) making false representations to insurance providers, including providers paid through Medicaid and Medicare, about the medical condition of patients in order to obtain preauthorization for medical tests and procedures; (2) submitting false claims to insurance providers for tests and procedures that were not performed and/or medically unnecessary, as well as for drug items not used or provided; (3) paying exorbitant kickbacks to local primary care medical offices in exchange for lucrative referrals from these offices; (4) and accessing, without authorization, electronic health records of patients at a particular hospital based on Long Island, New York (“Hospital-1”), in violation of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) in order to identify patients to be recruited to CMA.

In furtherance of the scheme, and to hide from the insurance providers the huge volume of claims, including fraudulent claims, being submitted by CMA, ASIM HAMEEDI, FAWAD HAMEEDI, ARIF HAMEEDI, MICHELLE LANDOY, and DESIREE SCOTT submitted claims to the insurance providers falsely representing that medical tests had been ordered or performed by doctors who did not work at CMA and who had not ordered or performed the tests. These doctors included EMAD SOLIMAN, who knowingly participated in the scheme to allow CMA to submit false claims to the insurance providers in his name, as well as two other doctors who did not know that their identities were being used to further the fraud (“Doctor-1” and “Doctor-2”).

In addition, ASIM HAMEEDI and FAWAD HAMEEDI, with the assistance of ARIF HAMEEDI, used various unlawful means to obtain and maintain a high volume of patients for use in the fraudulent scheme, including, among other things, paying exorbitant kickbacks to local primary care offices and practitioners in exchange for referrals of patients by those offices and practitioners to CMA. Moreover, ASIM HAMEEDI and FAWAD HAMEEDI repeatedly, and without authorization, accessed information in electronic health records of patients of Hospital-1 to identify and recruit patients to the practice of ASIM HAMEEDI and CMA.
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