MM Curator summary
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
[MM Curator Summary]: The “doctor” stole $600k by upcoding smoking cessation counseling sessions.
After investigating state Medicaid overpayments, the state attorney general and the U.S. Attorney’s Office of the Northern District of New York say a medical practice doctor with offices in Tully and Groton has overcharged Medicaid for medical services.
State Attorney General Letitia James said since January 2012, Dr. Ahmad M. Mehdi has submitted up-coded reimbursement bills for Medicaid services.
In a release, James stated the doctor “up-coded” medical services, and billed for smoking cessation counseling without sufficient documentation from 2012 to 2018. Up-coding is the act of requesting more reimbursement for medical procedures that are not as costly as billed for.
Dr. Mehdi also breached the Controlled Substances Act by prescribing opiates outside his normal practice to three patients from 2018 to 2020.
Under the terms of the settlement, the doctor has agreed to pay the State Medicaid Program $260,000 and a penalty of nearly $309,000. He will also pay the federal government $331,250.
“Every dollar scammed from Medicaid is a dollar not spent caring for New Yorkers with actual medical needs,” Attorney General James said in the release. “I am proud of the work my team did, together with the U.S. Attorney’s Office for the Northern District of New York, in uncovering these false claims and securing these funds.
Clipped from: https://www.waer.org/2022-10-25/cny-doctor-to-pay-900-000-for-overcharging-medicaid-services