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Former Pain Clinic Employee Charged in Health Care Fraud Scheme
A former employee of a Massachusetts and Rhode Island pain clinic has been charged with health care fraud, according to a recent indictment.
Moustafa Moataz Aboshady, 35, an Egyptian national residing in Lake Forest, California, was indicted in September 2016, in U.S. District Court in Boston, on one count of conspiracy and two counts of making false statements in connection with health care benefit programs.
The indictment alleges that Aboshady was part of a conspiracy involving other members of New England Wellness & Pain Management, P.C., also known as New England Pain Associates, P.C., Greystone Pain Management, Inc., and New England Pain Institute, P.C., or NEPA, in connection with a scheme to falsify patient medical records in order to obtain payments from the Medicare program and commercial health insurance companies.
As part of the alleged scheme, Aboshady falsified, and instructed others to falsify, patient encounter notes, including detailed descriptions of extensive physical examinations and treatment plans and durations of face-to-face interactions with patients, to create the appearance of lengthy and involved patient appointments, when in fact these services did not take place.
Aboshady is also alleged to have been responsible, in conjunction with the NEPA owner and the Cairo office, for fabricating the dates of urine drug test results so that the tests appeared to have been performed within days of specimen collection rather than weeks or months thereafter.
Insurance companies and patients who believe they may be potential victims of this fraudulent billing case are advised to visit the U.S. Attorney’s Office website at https://www.justice.gov/usao-ma and the U.S. Department of Justice website at https://www.justice.gov/largecases for additional information.
The details contained in the charging documents are allegations. The defendant is presumed to be innocent unless and until proven guilty beyond a reasonable doubt in a court of law.
Aboshady’s case is ongoing, with a trial date not yet scheduled.
The alleged conduct included submitting claims for payment to Medicare and commercial health insurance companies for services not rendered.
As a former medical resident in Massachusetts and Rhode Island, Aboshady was employed at New England Wellness & Pain Management, P.C., which had locations in Massachusetts and Rhode Island.
Key Facts
- State: Massachusetts
- Category: Health Care Fraud
- Source: DOJ Press Release â†â€â€
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