News Release
U.S. Department of Justice
United States Attorney
District of Rhode Island
April 10, 2008
U.S. seeks forfeiture of physician’s assets, alleging nearly $3,000,000 in fraudulent reimbursement billings
The federal government has filed a forfeiture complaint against assets traced to Tarek Wehbe, a physician with a practice in Providence and North Providence, alleging that he fraudulently billed Medicare, Medicaid, and private health insurers nearly $3,000,000. The complaint and a supporting affidavit allege that Dr. Wehbe billed for services not performed, inflated the type of treatment given, and billed for “impossible days,” consisting of more than 24 hours worth of visits.
United States Attorney Robert Clark Corrente, Rhode Island Attorney General Patrick C. Lynch, Susan Waddell, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General, and Douglas A. Bricker, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation, jointly announced the forfeiture complaint, which was filed on April 8 in U.S. District Court, Providence.
The complaint seeks the forfeiture of an account at Citizens Bank, and real estate located in North Providence, Lincoln, Jamestown, and Smithfield, all wholly or partially owned by Dr. Wehbe, either directly or through corporate entities. The complaint alleges that the cited properties are the proceeds of health care fraud.
Renaissance Medical Group
According to a federal affidavit supporting the complaint, Dr. Wehbe owns and operates Renaissance Medical Group, which has offices on North Main Street, Providence, and on Mineral Spring Avenue, North Providence. According to the affidavit, Dr. Wehbe submitted fraudulent claims to Medicare, Medicaid, and private health insurers to obtain reimbursements for services that were not rendered, were medically unnecessary, or were “upcoded,” meaning they were billed at higher rates than warranted.
According to the affidavit, audits performed on behalf of the carriers revealed that Dr. Wehbe submitted bills at substantially higher rates than other internists practicing in Rhode Island. He allegedly billed for lab procedures that were ordered excessively or appeared to be medically unnecessary.
“Impossible days”
A federal search warrant executed at Renaissance Medical Group offices on North Main Street in December 2006 turned up information supporting what is called in the affidavit “impossible days.” Dr. Wehbe allegedly billed for visits and treatments that, if performed properly, would have taken more than 24 hours in a single day. For instance, according to the affidavit, Dr. Wehbe billed for 87 patient visits on March 7, 2006. Based on federal medical coding standards, the approximate time necessary to perform those visits would have been more than 30 hours. On other occasions, he billed for 28, 27, and 23.6 hours worth of visits in a single day, according to the affidavit.
Infusion treatments
According to the affidavit, Dr. Wehbe also fraudulently billed for infusion treatments of Remicade, which is used to treat inflammatory disorders, and for treatments of chemotherapy drugs such as Paclitaxel and Gemzar. Based on the amount of Remicade that he ordered from suppliers, he billed for more treatments than he could have performed, according to the affidavit. According to the affidavit, between November 2001 and December 2006, suppliersdelivered
22,890 units of Remicade to Renaissance Medical Group. Dr. Wehbe subsequently billed carriers for 39,239 units, about 16,000 more than he had received from suppliers. He also failed to test patients for their suitability to receive Remicade treatments, according to the affidavit. A similar pattern of overbilling was detected for chemotherapy treatments that Dr. Wehbe performed.
According to the affidavit, from 2002 to 2006, Medicare, Medicaid, and private insurers overpaid Dr. Wehbe $2,995,863: $1,815,034 for infusion drug treatments, and $1,180,829 for fraudulent and upcoded office visits and treatments.
The complaint seeks the forfeiture of an account in Dr. Wehbe’s name at Citizens Bank, and real estate located at: 1630 Mineral Spring Avenue, North Providence; 566 East Shore Road, Jamestown; 6 Pine Tree Lane, Lincoln; 15 Dennell Drive, Lincoln; and 78 Farnum Pike, Smithfield. Federal agents have attached notification of the forfeiture complaint to real estate property records of the parcels in question.
A multi agency investigation resulted in the forfeiture complaint. The U.S. Department of Health and Human Services, Office of Inspector General, the Internal Revenue Service, Criminal Investigation, the Rhode Island Attorney General’s Medicare Fraud Control Unit, and the Food and Drug Administration, Office of Criminal Investigation participated in the investigation. Immigration and Customs Enforcement provided assistance.
Assistant U.S. Attorneys Adi Goldstein, Richard B. Myrus, and Milind M. Shah are prosecuting the forfeiture complaint.
Contact: 401-709-5032 Thomas.connell@usdoj.gov