Lexington doctor took part in Medicare fraud of more than $28 million, indictment says
A Kentucky doctor took part in a conspiracy to submit more than $28 million in false and fraudulent claims to Medicare, a federal grand jury has charged.
The grand jury in Lexington indicted Dr. Amr Mohamed Thursday on one charge of conspiring to violate a law against doctors taking kickbacks, and one charge of conspiring to defraud Medicare between March 2018 and July 2022.
The indictment says Mohamed worked in Lexington at a university during the events covered in the charges. The indictment does not name the university because the charges don’t involve the school.
However, Mohamed works at the University of Kentucky. His specialty is nephrology, which involves diseases of the kidney.
In an interview Friday morning, Mohamed said he had been made aware of the investigation several months ago, but had not been notified of the indictment.
He said his work that is the subject of the indictment was legitimate.
Mohamed’s clinical privileges at UK HealthCare have been suspended, spokesperson Kristi Willett said Monday.
Mohamed also worked for telemedicine companies, and that’s where the alleged fraud happened, not at UK, according to the indictment.
Federal rules at the time required doctors to provide telemedicine services by video in real time, so the doctor and patient could see each other and communicate, in order for the service to be covered by Medicare.
The indictment charges that Mohamed agreed with a telemedicine company called RediDoc to write prescriptions for medical equipment and services such as braces, creams and genetic testing that were not medically necessary.
The grand jury charged that the goods and services Mohamed ordered for people were fraudulent for a number of reasons, including that he was not the treating physician for the beneficiaries; he didn’t have a real doctor-patient relationship with them; he didn’t make a meaningful diagnosis of medical necessity using independent medical judgment; and he was getting kickbacks.
Mohamed wrote orders through RediDoc for unnecessary goods or services for more than 7,000 Medicare beneficiaries between March 2018 and April 2019, and received $261,054 from the telemedicine company, the indictment alleges.
The indictment cited one case in Kentucky in July 2018 in which a woman received an unsolicited telephone call saying she was eligible for medical braces.
The woman, who was not named in the document, told the caller she couldn’t wear the braces because of a skin condition and not to send them, but Mohamed allegedly ordered the equipment for her anyway, causing Medicare to be billed $1,695.
In another case in Kentucky in 2019, a person suffering from dementia received a call offering free medical braces, but a family member told the caller the person didn’t need the braces.
Mohamed ordered them anyway, causing Medicare to be billed $3,650. RediDoc paid Mohamed $20 for writing the order, the indictment alleges.
Mohamed electronically signed orders and prescriptions for medical equipment, topical creams and genetic testing based only on a brief telephone conversation, or after no conversation at all, the indictment alleges.
Mohamed was supposed to tell UK about any outside income he received, but didn’t do so, according to the indictment.
The most serious charge against Mohamed, the health care fraud conspiracy, is punishable by up to 10 years in prison.
The government also will try to recoup the money Mohamed received as a result of the alleged fraud.
Two owners of RediDoc pleaded guilty to conspiring to bribe doctors and commit health care fraud, but have not been sentenced.
This story was originally published March 3, 2023 at 1:18 PM.
