HOUSTON (CN) – A South Texas doctor billed Medicare for urology services that supposedly occurred when he was out of state, prosecutors say, charging the doctor and his attorney wife with fraud.
Dr. Hossein Lahiji, of McAllen, and wife Najmeh Vahid Lahiji, of San Antonio, were charged with conspiracy to commit health care fraud, and health care fraud in a three-count indictment announced Thursday by the Justice Department.
The charges are based on phony claims the Lahijis allegedly submitted to Medicare, Medicaid, Aetna, Blue Cross Blue Shield, Humana and United Healthcare from January 2003 through Feb. 24, 2012, prosecutors said.
“The Lahijis allegedly submitted claims to these health care benefit programs for urology services performed by Dr. Lahiji when, in fact, he was actually traveling outside the state of Texas and outside the United States,” prosecutors said in the statement. “Individuals who actually performed these ‘urology services, ‘ according to the indictment, were only licensed as medical assistants and did so without any supervision from any physician or other qualified, licensed personal. This is in violation of protocols established by Medicare, Medicaid, private health insurance as well as the state of Texas.”
The couple also allegedly “upcoded” his claims by saying that he performed a consultation on another physician’s patient, when in fact he had performed routine medical services for his own patient.
Lahiji is a co-owner of Doctor’s Hospital at Renaissance in Edinburg, Texas, prosecutors said.
If convicted the Lahijis each face up to 10 years in federal prison, and a $250,000 fine.
They are out on bond, and will appear in court soon on these charges, prosecutors said.
The couple also faces unrelated, federal charges in Oregon.