A Monmouth County, New Jersey, Cardiologist may be feeling a sudden tightness in his own chest after having been indicted on charges that he allegedly stole more than $52,000 by billing insurance companies for services that he did not perform. The announcement was made by Acting Attorney General John J. Hoffman on September 18, 2013.
Ahmad Mossavi, aka Seyed A. Mossavizadeh, 52, of Wayside, Monmouth County, was charged with 48 counts of second-degree health care claims fraud and one count of third-degree theft by deception. Hoffman stated that there was no way Mossavi could have performed the services he billed for because he was out of the country during the actual time of the supposed procedures.
At the time of the alleged crime, Mossavi was a cardiologist who had two offices in New Jersey – one in Ocean Township, Monmouth County, and one in South Plainfield. The state grand jury indictment alleges that between Jan. 20, 2008 and Oct. 9, 2009, Mossavi falsely submitted, or caused to be submitted, claims which purported that he was providing patient care.
It is alleged that, through this scheme, Mossavi fraudulently billed Aetna, CIGNA, Emblem Health, Horizon Blue Cross/Blue Shield and QualCare for a total of $52,717. Mossavi allegedly billed for services under his own name and also under the name of his limited liability corporation, Nari Medical Association, LLC. An investigation by the Office of the Insurance Fraud Prosecutor determined that, during the times for which Mossavi was purportedly treating patients, he allegedly was out of the country, and not treating patients.
“When licensed professionals unlawfully bill for services they do not provide, the cost of the fraud is passed onto the rest of us, the consumers,” said Acting Attorney General Hoffman “We are doing our part to aggressively control rising health care costs.”
“This indictment is another demonstration that this office has zero tolerance for fraud committed by health care providers,” Acting Insurance Fraud Prosecutor Ronald Chillemi said.
The indictment is merely an accusation and the defendant is presumed innocent until proven guilty. Second-degree crimes carry a maximum sentence of ten years in state prison and a criminal fine of up to $150,000 and third-degree crimes carry a maximum sentence of five years in state prison and a criminal fine of up to $15,000.
The New Jersey Board of Medical Examiners suspended Mossavi’s medical license on Sept. 23, 2011.