|TRENTON – Acting Attorney General John J. Hoffman announced that the Office of Insurance Fraud Prosecutor today obtained a state grand jury indictment charging a Passaic County doctor with allegedly billing an insurance provider for services that were never rendered.
Mohammad Ibrahim, 46, of Clifton, was charged with 151 counts of second-degree health care claims fraud as well as one count each of third-degree Medicaid fraud and third-degree theft by deception.
“Today’s indictment sends a clear message that we will continue to aggressively investigate and prosecute those who abuse the Medicaid program, including licensed professionals,” said Acting Attorney General Hoffman. “We are vigorously committed to prosecuting cases of this nature because money stolen from Medicaid is money stolen from all of us.”
The state grand jury indictment alleges that between Aug. 1, 2008 and Dec. 31, 2009, Ibrahim, the owner of West Paterson Specialty Clinic in Woodland Park, submitted a total of 151 fraudulent claims for 40 patients for services that were not rendered. The indictment alleges that Ibrahim received payment from Medicaid for examinations, evaluations, procedures or tests that had not been provided. The bills were submitted to Amerigroup, a managed care organization that provides insurance coverage to Medicaid beneficiaries. As a result of the alleged fraud, Ibrahim allegedly received $43,790 to which he was not entitled.
Deputy Attorney General Peter Sepulveda and Detective Audrey Young coordinated the investigation. Acting Insurance Fraud Prosecutor Ronald Chillemi thanked Amerigroup for referring the matter to the Medicaid Fraud Control Unit within the Office of the Insurance Fraud Prosecutor.
The indictment is merely an accusation and the defendant is presumed innocent until proven guilty. Second-degree crimes carry a maximum sentence of ten years in state prison and a criminal fine of up to $150,000 while third-degree crimes carry a maximum sentence of five years in prison and a criminal fine of up to $15,000. This matter will be referred to the state Board of Medical Examiners for any licensing action it deems appropriate.