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With the Check of a Box

With the Check of a Box

Healthcare-Medicare-6
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Sometimes, the criminal justice system allows individuals or businesses to resolve allegations to avoid incrimination or incarceration. A 49-year-old physician from The Woodlands, Tex., was fortunate to settle allegations he submitted false claims for the placement of electro-acupuncture devices on his patients. (Oh, and there’s more.) He also settled allegations that he made false statements when applying for a loan from the Paycheck Protection Program (PPP). The grand total he had to pay to settle those allegations was $523,331.

Dr. Emad Bishai, an anesthesiologist and pain management physician at Woodland Pain Institute PLLC, incorrectly billed Medicare and TRICARE for the surgical implantation of neurostimulator electrodes over nearly two years. Apparently, the procedure is quite invasive and requires an operating room, for which Medicare pays thousands of dollars. (That would be ok if the procedure was actually performed in an operating room, and by someone qualified to do so.)

It turns out that neither Dr. Bishai, nor his staff performed the surgical procedure. Instead, patients received devices used for electro-accupuncture, but it only involved inserting needles into patient’s ears with the neurostimulator taped behind them with an adhesive. (Not exactly high tech. I’m guessing the procedures were not very successful.)

Dr. Bishai and Woodlands Pain Institute PLLC agreed to the $523,331 financial settlement and also a seven-year-period of exclusion from participating in any federal health care programs. (I think that is a great plan. And a safe one too.)

There’s more. Dr. Bishai purportedly made false statements when submitting an application to the PPP program on behalf of the Woodlands Pain Institute PLLC. He made an error when he confirmed that he, as the applicant (or any individual owning more than 20% equity) was not subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction.

The truth is that Dr. Bishai is the owner of Woodlands Pain Institute PLLC. (He owned 100% to be exact.) And at that time, he was facing criminal charges for prescribing opioid medication. Because he checked the box and lied, Dr. Bishai illegally got the PPP loan. (All it took was a simple check of a box and he became extremely rich at the expense of others.)

He’s fortunate to have walked away from this situation with barely a blemish on his record, although there is a rather large sum of money now missing from his bank account. (Let’s hope the financial settlement serves as a reminder for the lucky doctor to abide by the law.)

Today’s Fraud of the Day comes from a Department of Justice press release, “Woodlands pain doctor pays half million dollars for fraudulent PPP and billing allegations,” dated November 15, 2021.

HOUSTON – A 49-year-old local physician has agreed to pay $523,331 to settle allegations he submitted false claims for the placement of electro-acupuncture devices and for making false statements when applying for a loan from the Paycheck Protection Program (PPP), announced Acting U.S. Attorney Jennifer B. Lowery.

Dr. Emad Bishai is an anesthesiologist and pain management physician who practices in The Woodlands. Woodlands Pain Institute PLLC is his primary practice entity.

 

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