Attorney General James Announces Settlement in Medicaid Fraud Investigation of Central New York Doctor
Ahmad Mehdi, M.D. Agrees to Pay $568,750 to Medicaid Program
NEW YORK – New York Attorney General Letitia James today announced that her office, in conjunction with the U.S. Attorney’s Office for the Northern District of New York, has reached a settlement with Ahmad M. Mehdi, M.D. and Ahmad M. Mehdi, M.D., P.C. This settlement resolves an investigation involving Medicaid overpayments for “up-coded” medical services, as well as Medicaid payments for smoking cessation counseling that were not sufficiently documented. “Up-coding” is the improper practice of claiming reimbursement for enhanced and more lucrative procedures than were in fact performed. As part of a joint settlement, Mehdi has agreed to reimburse $260,000 to the state Medicaid program and to pay a penalty amount of $308,750. In the companion civil settlement agreement with the U.S. Attorney, Mehdi will pay $331,250 to the federal government to settle up-coding and smoking cessation claims, and certain claims arising under the Controlled Substances Act.
“Every dollar scammed from Medicaid is a dollar not spent caring for New Yorkers with actual medical needs,” said Attorney General James. “I am proud of the work my team did, together with the U.S. Attorney’s Office for the Northern District of New York, in uncovering these false claims and securing these funds. Let this settlement be a clear message: We have zero tolerance for lying to Medicaid, and we will hold those who do accountable.”
“The U.S. Attorney’s Office will continue to work with state and federal enforcement partners to maintain the integrity of public programs and safeguard federal healthcare dollars,” said U.S. Attorney for the Northern District of New York Carla B. Freedman. “This settlement should deter anyone thinking about abusing federal healthcare programs for their own benefit.”
Dr. Mehdi is the principal owner of Ahmad M. Mehdi, M.D., P.C., a general medical practice with offices located in Groton and Tully, New York.
Between January 1, 2012, through September 17, 2018, Dr. Mehdi engaged in up-coding of billings for medical services and billed for smoking cessation counseling services that were not sufficiently documented. He submitted, or caused to be submitted, those claims for payment to the Medicaid program and to various Medicaid Managed Care entities, and these government payors relied on those fraudulent claims to pay him.
An audit and investigation conducted by the Office of the Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) in conjunction with the U.S. Attorney’s Office for the Northern District of New York, uncovered the fraudulent claims.
The OAG MFCU investigation was conducted by Senior Auditor-Investigator Carri Merry, under the supervision of Regional Chief Auditor Dejan Budimir, and Detective Patrick Lynch, under the supervision of Detective Supervisor Christopher Burns and Deputy Chief-Commanding Officer William Falk. The investigation and settlement were handled by MFCU’s Syracuse Regional Director Ralph D. Tortora, III. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. MFCU is a part of the Division for Criminal Justice, which is led Chief Deputy Attorney General José Maldonado and overseen by First Deputy Attorney General Jennifer Levy.
Attorney General James thanks the U.S. Attorney’s Office for the Northern District of New York for its collaboration in the investigation, litigation, and resolution of this matter.
Reporting Medicaid Provider Fraud: MFCU defends the public by addressing Medicaid provider fraud and protecting nursing home residents from abuse and neglect. If you have information about Medicaid provider fraud or know about abuse or neglect of a nursing home resident, please file a confidential complaint online or call the MFCU hotline at (800) 771-7755. If the situation is an emergency, please call 911.
MFCU’s total funding for federal fiscal year (FY) 2023 is $65,717,936. Of that total, 75 percent, or $49,288,452, is awarded under a grant from the U .S. Department of Health and Human Services. The remaining 25 percent, totaling $16,429,484 for FY 2023, is funded by New York state. Through MFCU’s recoveries in law enforcement actions, it regularly returns more to the state than it receives in state funding.