Mental Health Clinic Owner Sentenced to 18 Months of Imprisonment After Making False Claims to Medicaid for Services Allegedly Provided to Deceased Patients

St. Louis, MO – Naim Muhammad, 56, of St. Charles, MO, was sentenced today to 18 months of imprisonment after previously pleading guilty to one count of making a false claim to Medicaid on November 18, 2019 before U.S. District Judge Audrey G. Fleissig.  Mr. Muhammad was also ordered to pay $366,185 as restitution to the Missouri Medicaid program, a health care benefit program that provides medical items, benefits, and services to low income citizens of Missouri.

According to the plea agreement, Mr. Muhammad was the President of a business named Community Behavior Health (“CBH”).  CBH maintained an office in the City of St. Louis, Missouri.  Mr. Muhammad had no psychiatric training or license.

Mr. Muhammad billed the Missouri Medicaid program for mental health therapy services to a patient identified by her initials as W.W.  Mr. Muhammad told Medicaid that a licensed provider with the initials D.P. had provided the therapy to W.W. on June 21, 2017.  However, Mr. Muhammad’s statements were false and fraudulent in that patient W.W. was not treated by the licensed provider D.P. on June 21, 2017, the date of service shown in defendant’s therapy records for W.W.  Mr. Muhammad’s statements were material to the Missouri Medicaid program because the program does not pay for services that are not actually provided to the patient, and does not pay for mental health services that are provided by unlicensed individuals. 

The Indictment in this case further alleged that Mr. Muhammad repeatedly billed the Missouri Medicaid program for therapy services allegedly provided on dates when the patient was actually deceased, and therefore unable to receive any services.  For example, patient W.W. died on June 8, 2017, before the alleged June 21, 2017 session that was billed to the Missouri Medicaid program.       

“When individuals rig the Medicaid system for personal gain, it hurts those who legitimately require treatment and the taxpayers who pay into the system. I’m pleased that our Medicaid Fraud Control Unit and the U.S Attorney’s Office are able to work together to root out and prosecute this fraud” said Eric Schmitt, the Attorney General of Missouri.  

This case was investigated by the Office of Inspector General for the U.S. Department of Health and Human Services and the Medicaid Fraud Control Unit of the Missouri Attorney General’s Office, with assistance from the Federal Bureau of Investigation and the Division of Professional Registration of the Missouri Department of Commerce and Insurance.