Fraud and Abuse
Physician Sentence For Medicare/Medicaid Fraud In NJ25 November 2011
Yousuf Masood, 47, of Warren, N.J., was also ordered to pay more than $1.8 million in restitution and forfeiture based on the fraudulent Medicaid and Medicare billings. Yousuf Masood’s wife, Maruk Masood, 43, also of Warren and the practice’s office manager, was sentenced today to five years of probation, to include one year of home confinement. Two of the individuals who posed as licensed physicians – Hamid Bhatti, 34, of Rahway, N.J. and Carlos Quijada, 31, of Hawthorne, N.J. – were each sentenced today to five years of probation.
All four defendants previously entered their guilty pleas to separate Informations charging them each with one count of conspiracy to commit health care fraud. They were previously charged by Complaint on September 7, 2010. The pleas were entered before U.S. Magistrate Judge Patty Shwartz; Chief Judge Garrett E. Brown Jr. imposed the sentences today in Newark federal court.
According to documents filed in this fraud case and statements made in court:
Yousuf Masood used unqualified individuals – including two he had found through craigslist – to diagnose and treat patients in his Elizabeth office and billed Medicaid and Medicare as if he had provided the services. The fake physicians ordered tests and prescribed medications for patients, often using a pre-signed prescription pad Yousuf Masood provided. Yousuf Masood paid the unqualified individuals as little as $10 an hour, and directed them to spend no more than five to 10 minutes with patients. On some days, more than 100 patients visited the medical practice for treatment, and the majority were treated only by unqualified individuals. While they treated patients, Yousuf Masood was often either not in the office at all, or in his personal office watching TV or browsing the Internet.
Bhatti, Muhammad, and Quijada fraudulently introduced themselves as doctors and regularly diagnosed and treated patients with Yousuf and Maruk Masood’s knowledge. The office staff referred to them as “Dr. B.,” “Dr. Q.,” “Dr. Bhatti,” “Dr. Quijada,” or “Dr. Muhammad” in the presence of patients. In addition to prescribing medication, the unqualified individuals ordered that procedures be performed on patients – including electrocardiograms, bronchodilation responsiveness tests, and transnasal eustachian tube inflation.
Yousuf Masood and Maruk Masood were aware that Bhatti, Muhammad, and Quijada had graduated from medical schools in the Dominican Republic and West Indies, but had not passed required tests and were not licensed to practice medicine in New Jersey – including one who had failed Step 1 of the medical boards on two occasions.
Top prescriber- Top Target
The unqualified individuals wrote prescriptions for a wide variety of drugs, including medications used to treat schizophrenia, bipolar disorder, anxiety, insomnia, and other illnesses. Driven by the volume of prescriptions written by the unqualified individuals he employed, Yousuf Masood was the top prescriber of drugs to Medicaid patients in New Jersey in 2009, prescribing more than $9 million in Medicaid drugs that year. The next-highest prescribing doctor in New Jersey prescribed less than $6 million.
On one occasion, an FBI special agent acting in an undercover capacity was diagnosed by one of the unqualified individuals with high blood pressure despite the fact that his blood pressure was within the normal range. The unqualified individual prescribed blood pressure medication for the FBI special agent without any consultation with Yousuf Masood.
In addition to the prison term, restitution and forfeiture, Judge Brown sentenced Yousuf Masood to serve three years of supervised release and ordered him to pay a $75,000 fine. In addition to the home confinement and probation, Judge brown ordered Maruk Masood to pay a $30,000 fine.
Fraud and Abuse charges against a fifth individual, Hakim Muta Muhammad, 31, of Newark, remain pending. As for defendant Muhammad, the charges and allegations contained in the Complaint are merely accusations, and the defendant is presumed innocent unless and until proven guilty.Read More