D.C.-area health insurer linked to alleged $2.3 million doctor fraud case
A Rockville, Md.-based health insurance company has been linked to a federal investigation of two Washington, D.C., doctors who are suspected of charging $2.3 million for services patients never received.
A report in the D.C. Examiner newspaper cites an FBI sworn statement alleging that many of the false claims used names of patients who work at the Egyptian Embassy, which uses Mid Atlantic Medical Services Inc., a subsidiary of UnitedHealth Group, for their employees.
The offices of Drs. Abdul Fadul and Ali Al-Attar were searched earlier this month, according to documents filed in a Maryland federal court and reported by the newspaper.
The doctors run multiple clinics, with offices in Suitland, La Plata and Oxon Hill, Md., and Falls Church, Va.
Federal authorities removed computers, bank statement and patient files from the doctors’ offices in their search following an investigation that started when an employee became suspicious about the doctors’ billing practices and alerted authorities, according to the Examiner.
The doctors were billing insurance companies for patients’ visits at multiple clinics on the same day, according to an FBI informant.
A review of claims, including those submitted to MAMSI, led to the discovery that several Egyptian Embassy employees the doctors claimed were visiting three of their clinics far more often than other patients. MAMSI paid the doctors $55,000 for more than 400 procedures for one of these patients, according to the report, which said other insurers and Medicare may also be victims of the alleged fraud.
Fadul and Al-Attar are also believed to have billed insurance companies from clinics that have yet to opened, according to the federal court documents, including one in Alexandria, Va. The informant told investigators that many claims originated from that clinic, but when an FBI agent visited the location, it was boarded up.
Both the doctors’ attorneys and an FBI spokesman declined to comment on the allegations.


Regional news: 









