Physician Owner of HNC and Wife Sentenced for Health Care Fraud Offenses Involving Prescription Opiate Pain Medication
GREENEVILLE, Tenn. – On March 14, 2018, Dr. Abdelrahman Mohamed, 64, and Cecilia Manacsa, 59, both of Morristown, Tennessee, were sentenced by the Honorable J. Ronnie Greer, U.S. District Judge, to serve 36 months and 16 months respectively in federal prison. In addition to his prison sentence, Mohamed also paid $730,000 in restitution.
Mohamed and Manacsa both pleaded guilty in September 2017, to an 11-count information charging them with one count of conspiracy to commit health care fraud and 10 counts of health care fraud.
Mohamed was the owner and operator of Hamblen Neuroscience Center (HNC), a neurology and pain management facility located in Morristown, Tennessee. Manacsa, his wife, worked at HNC as a supervisor of various employees, including the employee responsible for submitting bills to Medicare and Medicaid (known as TennCare in the state of Tennessee). A detailed account of their offenses is included in the information and plea agreements on file with the U.S. District Court.
Mohamed, who was the only physician on staff at HNC, provided medical treatment to a variety of patients, most of whom sought treatment for chronic pain and had health insurance provided by TennCare or Medicare. Between January 2012 and September 2016 Mohamed and Manacsa developed a scheme to schedule far more patients per day than could be attended to by Mohamed. On average, they scheduled between 40 and 60 pain management patients per day, during the estimated six-hour period that Mohamed worked. To deal with the high volume, on many occasions staff members were instructed to line up the patients in the hallway outside of Mohamed's office, escort the first patient into the office for a one to two minute open-door meeting, then hand Mohamed a partially completed prescription for an opiate pain management medication, which he signed and gave to the patient. This process was repeated until all waiting patients had received a prescription for a controlled substance. Each patient was then scheduled for another appointment the following month at which time the process was repeated.
Mohamed admitted that during the fraud he issued thousands of prescriptions for opiate controlled substances and frequently did so on a recurring monthly basis, often for years. He also admitted that when he issued such prescriptions he was doing so outside of the scope of ordinary medical practice.
After these visits, Mohamed and Manacsa instructed HNC staff members to submit fraudulent bills to TennCare and Medicare claiming that they were owed approximately $1,538,000 for services they had not actually provided to these patients. This fraud resulted in Medicare and TennCare paying approximately $733,000 to HNC.
“This case sends a clear message to physicians and other health care providers in the Eastern District of Tennessee that investigating and prosecuting healthcare fraud related to prescription opioids is a top priority for the Department of Justice as well as the U.S. Attorney’s Office,” said J. Douglas Overbey, U.S. Attorney for the Eastern District of Tennessee. “Our district’s participation in the Opioid Fraud and Abuse Detection Unit will provide us with the resources necessary to effectively investigate and prosecute medical providers, such as Mohamed and Manacsa, who are contributing to this epidemic by unlawfully diverting or dispensing opioids outside the scope of acceptable professional practice,” added U.S. Attorney Overbey.
“These defendants enriched themselves at the expense of taxpayers by defrauding Medicare and TennCare,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General. “Their actions risked the health and safety of patients by prescribing opioids without a comprehensive physical exam. This sentence sends a strong message
that this type of behavior will be dealt with seriously,” added Jackson.
This case was investigated by the Tennessee Bureau of Investigation and the Department of Health and Human Services – Office of the Inspector General. Assistance was provided by the Tennessee Department of Health as well as District Attorney General Dan Armstrong and the District Attorney’s Office for the Third Judicial District. Assistant U.S. Attorney T.J. Harker represented the United States.