On Wednesday, the couple — Dr. Abdelrahman Mohamed, 64, and Cecilia Manacsa, 59 — were sentenced to 36 months and 16 months in federal prison respectively. Mohamed also paid $730,000 in restitution.
According to a press release, the pair pleaded guilty in U.S. District Court in Greeneville 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) in Morristown, a neurology and pain management facility. Manacsa worked at HNC as a supervisor of various employees, including ones responsible for submitting bills to Medicare and TennCare.
Prosecutors say that from January 2012 to September 2016, Mohamed and Manacsa scheduled far more patients per day than could be attended to. On average, the couple scheduled between 40 and 60 patients per day during the estimated six-hour period when 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 medication, which he signed and gave to the patient, the press release states.
Prosecutors say this process was repeated until all waiting patients had received a prescription. Each patient was then scheduled for another appointment the following month, at which time the process was repeated.
Mohamed admitted that during this time he issued thousands of prescriptions for opiates and frequently did so on a recurring monthly basis, often for years. Mohamed also admitted that when he issued these prescriptions he was doing so outside the scope of ordinary medical practice.
According to the press release, after these patient 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.
“Their actions risked the health and safety of patients by prescribing opioids without a comprehensive physical exam,” said Derrick Jackson, special agent in charge.