LAWFUEL – The Legal Newswire – A physician who pleaded guilty to defrauding insurance companies out of approximately $1 million by billing for unnecessary surgical procedures – including “sweaty palm” surgery – has been sentenced to 58 months in federal prison.
Mamdouh S. Bahna, 60, of Bel Air, was sentenced late Monday by United States District Judge Audrey B. Collins. Bahna pleaded guilty in July to health care fraud, admitting that he used his Bel Air Surgical Institute (BASI) to fraudulently bill insurance companies more than $2.4 million for improper procedures.
A second doctor involved in the case, William W. Hampton, was recently convicted of health care fraud and is scheduled to be sentenced in March.
Bahna ran a “rent-a-patient” scam at BASI, where unnecessary medical procedures were performed on patients who were compensated with money or other benefits. Bahna hired “marketers” who oversaw the recruitment of people who had private health insurance and were willing to undergo unnecessary surgical procedures in exchange for cash or discounts on cosmetic surgery. The procedures performed by the doctors at BASI included Esophagogastroduodenscopy (EGD), colonoscopy, sinus surgeries, laparoscopy and thoracic sympathectomy, which is commonly called “sweaty palm surgery.” Those willing to undergo the unneeded procedures were promised $300 for EGDs and colonoscopies and up to $1,200 for sweaty palm surgery. Patients were instructed by marketers and recruiters to describe false and exaggerated symptoms which were used to create medical charts used to make the surgical procedures appear to be justified.
In his plea agreement, Bahna admitted that treating physicians at BASI performed unnecessary surgeries on the recruited patients and created false medical records, which described false and exaggerated symptoms. After the surgeries were performed, Bahna paid the marketers, and the marketers in turn paid the recruiters and patients. The surgeries were billed to the patients’ health insurance providers, which paid for many of them. Bahna admitted the intended loss to the health insurance companies for the “rent-a-patient” scheme was more than $2.4 million.
Bahna has paid almost $1 million in restitution to his victims. In addition to the prison term and the restitution, Judge Collins ordered Bahna to pay a $150,000 fine.
Hampton, who also faces state charges in Orange County, was found guilty on November 27 of health care fraud. He faces up to 10 years in federal prison when he is sentenced by Judge Collins on March 8, 2008.
The Federal Bureau of Investigation investigated this case.
CONTACT: Assistant United States Attorney Consuelo S. Woodhead
Healthcare Fraud Coordinator
Assistant United States Attorney Vince Farhat