Muhamad Aly Rifai, Healthcare Fraud, Pennsylvania 2024

Lehigh Valley Psychiatrist Charged with $1.36 Million Medicare Billing Scheme

A federal jury acquitted Dr. Muhamad Aly Rifai, 49, of Easton, PA, on May 9, 2024, of four counts of healthcare fraud stemming from his alleged scheme to improperly and fraudulently bill the federal Medicare program for services not provided, or not provided at the level which was claimed.

The indictment alleges that for several years, Rifai, the sole owner of Blue Mountain Psychiatry, routinely and improperly billed Medicare for services which he did not provide to Medicare beneficiaries and nursing home patients. These services included billing for treating dead beneficiaries; billing for treating the same patient at the same time at different nursing homes; and billing for providing more than 24 hours' worth of services to patients on a single day.

The indictment further alleges that the defendant routinely billed for higher levels of care than he or his staff provided to nursing home patients. According to the indictment, despite not having actually seen the patient, Rifai added a pre-printed stamp to medical progress notes to support billing for psychological and add-on services which were not provided by his staff.

Rifai, through Blue Mountain, obtained Medicare payments of at least approximately $1.36 million based on fraudulent claims from about January 2015 until October 2022.

The defendant made an initial appearance in federal court on these charges before U.S. Magistrate Judge Richard Lloret.

If the public has any information regarding Blue Mountain Psychiatry or any other healthcare fraud allegation, individuals should contact the HHS-OIG hotline at 800-HHS-TIPS.

According to the indictment, if convicted, the defendant faces a maximum possible sentence of 40 years in prison, and a fine of up to $1 million.

Source: https://www.justice.gov/usao-edpa/pr/lehigh-valley-psychiatrist-charged-stealing-medicare-through-improper-billing-scheme