Pittsford Psychiatrist Charged With Health Care Fraud
CONTACT: Barbara Burns
PHONE: (716) 843-5817
FAX: (716) 551-3051
ROCHESTER, N.Y.--U.S. Attorney James P. Kennedy, Jr. announced today that Dr. Muhammad A. Cheema, 45, of Pittsford, NY, was charged by criminal complaint with health care fraud and making false statements relating to health care matters. The charges carry a maximum penalty of 10 years in prison and a $250,000 fine.
Assistant U.S. Attorney Craig R. Gestring, who is handling the case, stated that Dr. Cheema is a licensed physician who provides psychiatric services at his private practice, Upstate Psychiatry in Pittsford, NY, as well as at Rochester Regional Health, and various nursing homes. In addition to his private practice, Dr. Cheema was paid over $855,000 by multiple pharmaceutical companies for 341 promotional speaking engagements and 62 consulting opportunities between August 2013 and December 2016.
According to the complaint, the FBI began an investigation after learning from Excellus BlueCross BlueShield that the defendant routinely and systematically changed office visit billing codes, billed insurance companies for telephone appointments as office visits, and regularly had 30 or more patients on his daily schedule despite the fact that his daily private practice office hours were 11:00 a.m. to 5:00 p.m. A 2015 audit conducted by Excellus on eight patients during a six month time period revealed an overpayment of 54% to the defendant for services not rendered and upcoding of office visits. Dr. Cheema routinely billed the highest leve1 of evaluation and management services for new patient visits, and his medical notes were missing the documentation to support the level of evaluation and management services for his established patients.
Subsequent investigation by the FBI revealed that the defendant routinely upcoded office visits of patients, improperly billed health care benefit programs for services that he did not provided, and, on more than one occasion, prescribed drugs to an undercover patient without performing an physical exam or psychotherapy.
In addition, he defendant submitted a fraudulent certificate which purported to show him to be board certified in Psychiatry. In fact, the defendant was not board certified in Psychiatry, has never passed the ABPN certifying examination in Psychiatry or Neurology. The FBI investigation determined that the document submitted by the defendant was fraudulent, and was generated on his desktop computer using a valid Certificate belonging a psychiatrist in Arizona.
The defendant made an initial appearance this afternoon before U.S. Magistrate Judge Marian W. Payson and was released on conditions. Dr. Cheema is due back in court on September 25, 2018, at 9:30 a.m.
“These charges highlight our continued commitment to ensuring that those who seek unjustly to enrich themselves by perpetrating frauds against the health care system are brought to justice,” said U.S. Attorney Kennedy.
“Investigations like the Cheema case highlight this crime problem,” said Gary Loeffert, Special Agent-in-Charge of the FBI's Buffalo Office. “We are committed to rooting out fraud in health care to protect patients, their insurance companies, and the economy overall.”
New York State Financial Services Superintendent Maria T. Vullo said, “As regulator of New York’s insurance industry, DFS commends the Office of the U.S. Attorney for aggressively pursuing those who unlawfully enrich themselves at the expense of hard-working taxpayers, and looks forward to continuing our partnership to stamp out this kind of criminal activity.”
The complaint is the result of an investigation by the Federal Bureau of Investigation, under the direction of Special Agent-in-Charge Gary Loeffert, and the New York State Department of Financial Services, under the direction of Superintendent Maria T. Vullo.
The fact that a defendant has been charged with a crime is merely an accusation and the defendant is presumed innocent until and unless proven guilty.