Hudson County, N.J., Pediatrician Charged With Fraudulently Billing Medicaid For Nearly $1 Million

A Hudson County, N.J., pediatrician was arrested January 16 on charges he fraudulently billed Medicaid $900,000 for wound-repair treatments on children that were never rendered, U.S. Attorney Paul J. Fishman announced.

According to the press release, it appears that Badawy M. Badawy, M.D., 50, of Bayonne, N.J., a licensed pediatrician who owns and operates Sinai Medical Center of Jersey City LLC, a medical practice focusing primarily on pediatrics and family medicine, billed Medicaid thousands of times for nearly $900,000 worth of wound repairs on children and adolescents.

Although misusing patient information, the physician reportedly did not, thankfully, alter the patients’ records:

Virtually all of these claims, which were submitted for supposed wound repairs on children, were fraudulent. Badawy’s patient charts for a large sample of these children who supposedly received treatment revealed no entry, notation, or other evidence, such as suturing or other closing methods, to support his claims that these procedures were actually performed.

But presumably, the patients’ Medicaid billing/payment records would have reflected care they did not receive. It’s not obvious to me how that might impact them going forward if the Medicaid records were not corrected, as this is not like creating a record that someone received durable equipment that Medicaid would not want to pay for twice.

Again, it’s important for everyone to check Explanation of Benefits statements from their insurer to ensure that their records do not reveal care or services they did not receive.

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