Pittsford psychiatrist accused of fraud
By: Bennett Loudon//August 15, 2018
Pittsford psychiatrist accused of fraud
By: Bennett Loudon//August 15, 2018//
Federal prosecutors want to seize more than $1.7 million in assets from a Pittsford psychiatrist accused of fraudulently billing insurance providers.
A civil forfeiture complaint has been filed against Dr. Muhammad A. Cheema, 45, of Pittsford, to seize his $900,000 home at 9 Bromsgrove Hill, Pittsford; $806,871.91 from three separate bank accounts; a 2015 Audi A8; and a 2017 Mercedes Benz.
Last month, Cheema, who operates a private practice in Pittsford called Upstate Psychiatry, 115 Sully’s Trail, and also practices at Rochester Regional Health and various nursing homes, was charged with health care fraud and making false statements relating to health care matters, according to the U.S. Attorney’s Office.
According to a criminal complaint filed July 25, Cheema submitted about $1.8 million in fraudulent insurance claims between January 2012 and January 2017.
Cheema routinely billed health insurance providers the highest leve1 of services for new patient visits, and his medical notes lacked documentation to support the level of evaluation and management services he claimed he provided for other patients, according to prosecutors.
He also is accused of billing for services that he did not provide, and prescribing drugs to an undercover patient without performing any physical exam or psychotherapy.
Cheema also allegedly submitted a fraudulent certificate which purported to show that he is board certified in psychiatry, which he is not. Cheema never passed the certifying examination in psychiatry or neurology.
The document he submitted was created on Cheema’s desktop computer using a valid certificate belonging to a psychiatrist in Arizona, according to prosecutors.
“While the criminal complaint holds Dr. Cheema criminally responsible for his actions, this civil complaint seeks to divest him of his ill-gotten gains,” U.S. Attorney James P. Kennedy Jr. said in a news release.
If convicted of the criminal charges, Cheema faces a maximum penalty of 10 years in prison and a $250,000 fine.
The investigation of Cheema started after Excellus reported to the FBI that he was changing billing codes, filing claims for office visits that were actually telephone appointments, and regularly had 30 or more patients on a daily schedule between 11 a.m. and 5 p.m.
Cheema was paid more than $855,000 by pharmaceutical companies for 341 speaking engagements and 62 consulting opportunities from August 2013 and December 2016, according to the criminal complaint filed July 25.
Over several months in 2017, investigators conducted surveillance of Cheema’s office to determine when he arrived and departed. His patient schedule and billing records were analyzed and compared to the surveillance records.
“That comparison showed that Dr. Cheema falsely reported the time he spent seeing patients and the actual time with patients was not long enough for D. Cheema to provide basic medical services … necessary to support the matters being billed,” according to the complaint.
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