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New England Duo Sentenced To Prison For Defrauding Medicare

Another Super Bowl has come and gone. And yet, nothing much has changed in the world of gridiron. This past Sunday, the New England Patriots picked up their record-tying sixth championship following their 13-3 defeat of the Los Angeles Rams. Unless you’re from the New England area, the Super Bowl probably wasn’t all that exciting for you. Between the low score and the relatively underwhelming halftime performance (by most accounts), it was a snore.

There are two individuals from the New England region who aren’t doing much celebrating this week. 36 year-old, Moustafa Moataz Ibrahim Aboshady was sentenced to 75 months in prison for his role in a scheme to defraud Medicare. Originally from Lake Forest, California, Aboshady helped to run the now-defunct New England Pain Management Associates Inc. with Dr. Moustafa Moataz Mashali.

The duo worked together to defraud Medicare.

According to a new report from the District of Massachusetts branch of the United States Department of Justice, the two co-conspirators falsified patient medical records in order to extract payments from Medicare as well as commercial insurers for medical services that were never performed.

Aboshady was convicted of one count of conspiracy to make false statements in connection with health care benefit programs and two counts of making false statements in connection with health care benefit programs back in September. Dr. Mashali was sentenced to eight years in prison for his role in the scheme in March of 2018. He pleaded guilty to 27 counts of health care fraud, one count of conspiracy to commit mail fraud and 16 counts of money laundering.

In addition to Aboshady’s prison sentence, he will also endure three years of supervised release and must pay restitution in the amount of $1,852,459. As part of the scheme, Aboshady and Mashali dispensed large quantities of narcotics to addicted patients. The two fabricated patient records and lied to regulatory authorities when questioned about their medical practices.

Aboshady and Mashali’s fraudulent teamwork reached as far as Cairo, Egypt.

There, members of a satellite office worked on falsifying medical records and urine drug test results in order to support their claims for payment from Medicare and other insurers. Meanwhile, the services for which claims were submitted were never rendered.

“Aboshady instructed the Cairo office on how to fake patient encounter notes, how to create false electronic signatures on the encounter notes and how to make the timestamps for those signatures look realistic,” the DoJ report details, “Aboshady was also responsible, in conjunction with the office in Cairo, for fabricating urine drug test results with false test dates, so that the tests appeared to have been performed within days of specimen collection rather than weeks or months thereafter.”

Are you an attorney who is currently trying a health care fraud case?

Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Our experts have been providing expert clinical services for nearly two decades and can help your team by bridging the disciplines of medicine, coding and billing to ensure accurate payment and data is achieved. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.

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