LAWFUEL – The Legal Newswire – A licensed physician pleaded guilty to committing health care fraud in United States District Court in Los Angeles today.
Mamdouh S. Bahna, M.D., who was indicted by a federal grand jury in Los Angeles in October 2005, owned and operated an outpatient surgery center in Los Angeles called Bel Air Surgical Institute (BASI). Bahna and his co-defendant, William W. Hampton, M.D., ran a “rent-a-patient” scam at BASI, where unnecessary medical procedures were performed on patients who were compensated with money or other benefits.
As set forth in the 17-count indictment, 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 discounted cosmetic surgery procedures. 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.
According to Bahna’s plea agreement, from prior to July 2003 to approximately October 2004, Bahna hired marketers to find individuals with health insurance that would pay for various surgical procedures, including EGD, colonoscopy, sinus surgery, sweaty palm surgery, and laparoscopy. After Bahna hired them, marketers and recruiters found insured patients willing to undergo unnecessary surgeries at BASI by offering the patients cash. After the patients’ insurance was verified, the agreed-upon surgeries were scheduled, and marketers often assisted the patients in getting to BASI.
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 to create the appearance that the surgeries were medically necessary. 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 over $2,000,000.
When sentenced, Bahna faces a statutory maximum of 10 years in federal prison and fines totaling $250,000. Bahna will also pay almost $1,000,000 in restitution to his victims. United States District Judge Audrey B. Collins ordered Bahna to appear for sentencing on November 5, 2007.
Hampton’s case is set for trial on October 9, 2007. Hampton also is facing state charges in Orange County where Hampton and two other doctors are alleged to have participated in a health care fraud scheme in which patients were recruited to undergo unnecessary procedures in exchange for money or low-cost cosmetic surgeries.
The Federal Bureau of Investigation investigated this case.
CONTACT: Assistant United States Attorney Consuelo S. Woodhead
Assistant United States Attorney Vince Farhat
Release No. 07-091