Insurance Fraud NEWS
Doc sells painkiller scripts for $500 each in Connecticut
November 09, 2019, East Hartford, CT
A doctor with a practice in East Hartford pleaded guilty Thursday to federal charges that he prescribed the opioid pain medication oxycodone illegally and that he failed to pay the IRS more than $117,000 in withholding taxes for employees of five of his businesses.
Dr. Sheikh Ahmed, 56, who lives in Orange and practices under the name East Hartford Medical Center at 580 Burnside Ave., pleaded guilty in U.S. District Court in Bridgeport to prescribing outside the scope of medical practice and willful failure to pay withholding taxes, U.S. Attorney John H. Durham announced.
The drug crime carries up to 20 years in prison, and the tax crime carries up to five years. Ahmed’s sentencing has yet to be scheduled. He remains free on a $200,000 bond since his arrest last November.
Ahmed was convicted of health insurance fraud in Hartford Superior Court in a July 2018 plea bargain, online state court records show. He was put on probation for two years, with the possibility of up to three years in prison if he violates release conditions.
A condition of his probation is that he not seek reinstatement as a Medicaid provider in Connecticut through next July 20, according to an affidavit by Special Agent Victoria Edwards of the U.S. Drug Enforcement Administration.
Ahmed was ordered to pay $260,000 restitution before his sentencing, and Medicaid had previously suspended payment on almost $55,000 of his billings, the agent reported.
But Ahmed’s license to practice medicine in Connecticut remains active, according to the state’s online licensing database. He received an annual renewal of his license to practice medicine in May despite the health insurance fraud conviction and the pending federal case.
Ahmed is a pediatrician. But, during more than 10 visits to his office by a DEA confidential informant and an undercover officer, the majority of the patients seen in the officer were adults, Edwards wrote.
She went on to report the following:
During the investigation, either an informant or the undercover officer visited Ahmed’s office every month from December 2017 through May 2018 to get prescriptions for oxycodone. They usually carried recording equipment. Each time, Ahmed asked for and received a cash payment, typically $500, for a prescription.
Ahmed didn’t do a medical examination of the informant when prescribing oxycodone. His conversations with the informant primarily involved issues such as which dosage would be least likely to attract attention of regulators and which pharmacy was least careful about monitoring prescriptions, the agent reported.
The informant introduced the undercover officer to Ahmed in February 2018, at which time the undercover officer paid Ahmed $500 for the informant’s prescription. Ahmed also agreed to write a seven-day oxycodone prescription for the undercover officer for $125.
Ahmed told the undercover officer that he would have to undergo a physical examination. That consisted of the undercover officer answering questions from Ahmed’s billing specialist, having his vital signs checked by a nurse, giving a urine sample, and having Ahmed briefly touch his shoulder, the agent reported.
The prescription was submitted electronically before the exam was complete. And Ahmed instructed his billing specialist to enter into the computer that the undercover officer had back and shoulder pain before any exam took place, according to the agent.
On subsequent visits, the undercover officer paid Ahmed $500 for increased doses of oxycodone “without any examination or substantive medical discussion,” the agent wrote. During the four months he treated the undercover officer, Ahmed should have given him a second urine test to confirm that the officer was taking the medications rather than selling them, the agent wrote. “He did not do so,” she added.
Source: Journal Inquirer