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Data Analysis Exposes Workers’ Comp Billing Fraud

June 22, 2011 - WorkCompWire

COLUMBUS – A pair of Illinois brothers who traveled to Columbus to practice psychiatry were sentenced for workers’ compensation fraud after an investigation showed they were conducting inadequate examinations of injured workers and submitting false bills to the Ohio Bureau of Workers’ Compensation (BWC). Muhammed S. Choudhry, M.D., owner and practitioner at Nehal Psychiatric Group, located at 1100 Morse Rd. in Columbus, pleaded no contest to a felony charge in a Franklin County courtroom. His brother, Naseem M. Chaudhry, M.D, pleaded no contest to a misdemeanor.

“Using some very innovative tools and techniques, analysts in our Automated Detection and Intelligence Unit are able to identify instances of potential fraud,” said BWC Administrator/CEO Stephen Buehrer. “In this case, data analysis exposed the brothers’ wrongdoing and allowed us to bring their fraudulent activity to a halt.”

Dr. Muhammed Choudhry, who traveled from his home in Bolingbrook, Illinois to practice in Columbus three days a month, caught the attention of BWC’s Special Investigations Department (SID) after analysis revealed he billed BWC for more than twenty hours of individual psychotherapy on a single day. A subsequent investigation revealed he was significantly over reporting time spent with his patients, in some cases spending less than five minutes with a patient, while billing BWC in excess of 45 minutes of individual psychotherapy. Agents also found that both he and his brother, Dr. Nassem Chaudhry, who occasionally traveled to Columbus to fill in for him, billed BWC for services when patients did not even make it into the office. During their visits, patients were prescribed a wide variety of narcotics.

Ohio Attorney General Mike DeWine added, “The partnership between BWC and our Health Care Fraud section enables us to effectively expose and prosecute wrongdoing by those providers who try to defraud the workers’ compensation system. We will aggressively pursue this conduct wherever we see it and send the message that cheating the system does not pay.”

Muhammad Saleem Choudhry pleaded no contest and was ordered to pay $78,573.16 in restitution and investigative costs. He also received an eight month prison sentence suspended on the condition that he pay restitution and successfully complete community control. Naseem Chaudhry also pleaded no contest and was ordered to pay restitution and investigative costs totaling $27,422.60, a $250 fine and court costs. He will serve ninety days in jail if he does not pay the full restitution within ninety days.

Source: Ohio BWC

Filed Under: Claims, Legal, & Compliance News, Top Stories - Recent, WCW Inner Page Featured - Recent, Workers' Compensation

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