United States Files False Claim Act Complaint Against Delaware Medical Provider

WILMINGTON, Del. - Acting United States Attorney Dylan J. Steinberg announced that the United States has filed a civil complaint under the False Claims Act against Dr. Shayasta S. Mufti, a Delaware medical provider, alleging that she caused the submission of false claims to Medicare for medically unnecessary genetic laboratory tests.

In its complaint, the United States alleges that between April 2019 and November 2019, Dr. Mufti referred more than 100 Medicare beneficiaries for medically unnecessary genetic tests that were paid for by Medicare. To be covered by Medicare, a diagnostic laboratory test, including a genetic test, must be ordered by the physician who is treating the beneficiary for a specific medical problem and who uses the results in the management of that problem. The United States alleges that Dr. Mufti had no medical relationship with the beneficiaries she referred for genetic testing, never examined them, and never used the test results to manage their medical conditions.  Her referrals were based on brief telemedicine consultations and, in some instances, no consultation at all. The genetic tests that Dr. Mufti ordered often cost thousands of dollars per patient.

“The integrity of our federal healthcare programs, including Medicare, relies on medical providers adhering to professional standards of care and billing accurately for services that are medically necessary for their patients,” said Acting U.S. Attorney Steinberg. “As alleged, Dr. Mufti’s actions violated these critical safeguards, putting taxpayer dollars at risk, draining funds from vital health care programs, and undermining the trust placed in healthcare professionals.  We will continue to work tirelessly with our federal partners to hold accountable those who exploit programs designed to help our most vulnerable citizens and ensure that services are provided based on medical need, not financial gain.”

“HHS-OIG will continue to work with our law enforcement partners to investigate those who allegedly participate in fraud schemes driven by greed and apathy for the laws intended to safeguard Medicare funds,” said Special Agent in Charge Maureen R. Dixon of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “We are unwavering in our dedication to ensuring the integrity of federal health care programs.”

The investigation and litigation are being handled by Assistant United States Attorney Jacob Laksin.

The government’s pursuit of this matter illustrates its emphasis on combating health care fraud.  One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800 HHS TIPS (800-447-8477).

A copy of this press release is located on the website of the U.S. Attorney’s Office for the District of Delaware.  A copy of the complaint is attached to this press release.

The allegations in the complaint are allegations only, and there has been no determination of liability. 

Attachment: