Texas Doctor Sentenced to Prison for Health Care Fraud Scheme

If you were ever a patient at one of these hospitals, you might want to get your medical records and check them for accuracy. Also check your Explanation of Benefits from your insurer to make sure that your records accurately reflect services you received and for what. Previous coverage of this case can be found on PHIprivacy.net, here and here.

A 63-year-old Dallas County, Texas, physician, has been sentenced to federal prison for health care fraud and identity theft violations in the Eastern District of Texas. The sentencing was announced by U.S. Attorney John M. Bales.

Tariq Mahmood, 63, of Cedar Hill, Texas, was found guilty by a jury of conspiracy to commit health care fraud, seven counts of health care fraud, and seven counts of aggravated identity theft following a four day trial before U.S. District Judge Michael Schneider.  He was sentenced to 135 months in federal prison and ordered to pay restitution in the amount of $599,128.02 to Medicare, Medicaid, and Blue Cross Blue Shield of Texas.

According to information presented in court, Mahmood, a general practitioner, owned and operated several hospitals in the state of Texas, including Cozby Germany Hospital in Grand Saline, Renaissance Terrell Hospital in Terrell, Central Texas Hospital in Cameron, Community General Hospital in Dilley, and Lake Whitney Medical Center in Whitney.  From January 2010 to April 2013, Mahmood and others carried out a scheme to defraud Medicare and Medicaid through the submission of false and fraudulent claims.

Mahmood and others added, changed, and incorrectly sequenced diagnostic codes in a way that did not reflect the actual diagnoses and conditions of the patients and often did so without reviewing the medical records.  They submitted false and fraudulent claims to Medicare and Medicaid based on the added, changed, and incorrectly sequenced diagnostic codes.  Mahmood and others also unlawfully used Medicare beneficiaries’ names and Medicare numbers in order to commit health care fraud.  Mahmood was indicted by a federal grand jury on April 11, 2013.

SOURCE: U.S. Attorney’s Office, Eastern District of Texas

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