The Bottom Line

249
27327724 - health care costs - stethoscope on money

The term “bottom line” generally refers to the last line of a financial statement that reveals whether an organization is making a profit or loss. It can also describe the most important thing that should be considered. The bottom line of today’s fraud article is that a Frederick, Maryland-based doctor, who was very dishonest, caused the Internal Revenue Service (IRS) and the Medicare program to experience a loss as a result of the fraudster’s healthcare fraud and tax fraud scheme. (That about sums it up.)

The Frederick-based physician previously ran a pain management practice with a partner who (depending on how you look at it) avoided punishment for his involvement in the crime. (The partner died before his case could go to trial.) The scheme involved receiving more than $1.3 million in kickbacks for referrals to one particular medical lab for urinalysis. The urinalysis lab billed both Medicare and private insurers for $4.4 million in claims referred by the Frederick doc over more than a year. (The lab passed on a portion of the profits back to the pain management doctor and his partners as a reward.)

Evidence presented at trial by prosecutors demonstrated that the physician’s pain management company also submitted bogus bills to Medicare and private insurers. (Just like the urinalysis lab did, but for a longer period of time – two-and-a-half years.) The pain practice billed for services supposedly performed by two physicians, when only one had completed the exam. (That qualifies as dishonest. He was just trying to get more money than he deserved.)

After a 13-day trail, the 49-year-old Frederick-based pain management physician and resident of Germantown was convicted on 25 counts of healthcare fraud and tax fraud, to include receiving kickbacks, fraudulent billing and tax evasion. (He neglected to mention the $3.3 million he made from the illegal scam over three years to the IRS.) He was sentenced to eight years in federal prison, followed by three years of supervised probation, a $75,000 fine, $175,000 in restitution and forfeiture of $241,976. When speaking before the judge, he explained that he was remorseful for what he did. He also said that the last eight months spent in a detention facility made him realize that his family and community were very important to him. (Too bad he didn’t figure that out earlier.)

The pain management company’s Chief Financial Officer (CFO) pleaded guilty to healthcare fraud, while the Chief Executive Officer (CEO) was charged with conspiracy to defraud the United States and engage in kickback schemes. At the time the article was written, the CEO was a fugitive. (You can run, but you can’t hide.) The urinalysis lab owner and his marketing agency both pleaded guilty to healthcare fraud.

It is interesting that the physician’s wife described her husband as a “selfless” man with a “brilliant mind.” She pleaded with the court to consider alternatives to prison that would allow her husband to be with his family and be a contributor to society. (The bottom line is that this so-called “brilliant mind” had 49 years to demonstrate that he was a contributor to society. He failed miserably and now he must pay for his dishonesty.)

Today’s “Fraud of the Day” is based on an article entitled, “Former Frederick pain management doctor gets eight years in federal fraud case,” published by The Frederick News-Post on September 11, 2018.

A former Frederick-based doctor was sentenced to eight years in federal prison after being convicted of health care fraud and tax evasion.

Atif Babar Malik, a Germantown resident, received the punishment at a sentencing hearing Tuesday before U.S. District Judge James K. Bredar in Baltimore. Malik, 49, previously ran the Advanced Pain Management Services practice in Frederick with a partner.

SHARE
Previous articleEntitlement Can Be a Dirty Word
Next articleTele-fraudster
Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.