Insurance Fraud NEWS
Former Williston chiropractor convicted of defrauding more than $300,000 from insurance company
February 11, 2019, Williston, ND
A Williston chiropractor was sentenced to 10 days in jail and six months on house arrest after he was convicted last month of defrauding an insurance company by overbilling them, the North Dakota Insurance Department announced Monday, Feb. 11.
Dr. Sheryar Masud, who was practicing at Light House Family Chiropractic, entered an Alford plea to one class A felony count of insurance fraud on Monday, Jan. 28, in East Center District Court according to court records. In an Alford plea, a defendant does not admit guilt, but agrees the prosecution likely has enough evidence to convict.
Masud was charged in August 2017 of overbilling Blue Cross Blue Shield of North Dakota. The case was investigated by the state insurance department, according to a new release from Insurance Commissioner Jon Godfread.
As part of a plea agreement, Masud was sentenced to serve 10 days in jail and spend 180 days wearing an ankle monitor. He will also serve one year of unsupervised probation and pay $250,000 in restitution to Blue Cross Blue Shield.
In the affidavit of probable cause, investigators wrote that Masud claimed to have seen patients for more than 24 hours a day on 66 different days. On several of those days, Masud claimed to be seeing patients in Williston, but cell phone records showed he was in other places.
On one day, where Masud claimed to have seen patients for 30.88 hours, he was actually in Illinois, charging documents indicate. On another, he billed Blue Cross Blue Shield for 25.48 hours of patient care in Williston, but his cell phone records showed he was actually in Minneapolis.
Investigators also found that on 54 days between January 2015 and June 2015, Masud billed both Blue Cross Blue Shield of North Dakota and Blue Cross Blue Shield Illinois for seeing patients.
“This case is a great example of how insurance fraud comes in all shapes and sizes,” Godfread said. “I’m proud of the work our department investigators have done because every case of fraud, no matter how big or small, is a huge problem. It adds up and affects all North Dakota consumers negatively.”
Source: Williston Herald