New Jersey cardiologist admits defrauding health insurers of $1.9M

The owner and sole medical provider of a New Jersey medical practice admitted his role in a health care fraud scheme causing over $1.9 million in insurance reimbursements for false claims, U.S. Attorney Philip R. Sellinger announced today.

Dr. Fazal Panezai, 76, of Morganville, New Jersey, pleaded guilty before U.S. District Judge Georgette Castner in Trenton federal court to an information charging him with participating in a health care fraud scheme.

According to documents filed in the case and statements made in court:

Panezai, who owned and operated Matawan-Aberdeen Heart & Medical Center, for years submitted false claims to at least six health insurance benefit programs for office visits that either never occurred or did not take place for the length of time that he claimed.

For example, Panezai submitted claims for office visits lasting approximately 1,675 minutes - approximately 27.9 hours - for one day's worth of office visits on May 27, 2022. Panezai also billed health insurance providers over $80,000 for office visits when he was out of the country and not conducting any office visits. Panezai also submitted claims for office visits when patients only picked up a prescription for a controlled substance from the front desk and never met with him. The false claims caused insurance plans to issue reimbursement checks to the center. Panezai kept the illicit profits, which totaled more than $1.9 million.

The charge of health care fraud is punishable by a maximum of 10 years in prison and a maximum fine of either $250,000 or twice the gain or loss from the offense, whichever is greatest. Sentencing is scheduled for Aug. 20, 2024.

U.S. Attorney Sellinger credited special agents of the FBI, under the direction of Special Agent in Charge James E. Dennehy in Newark, with the investigation leading to the guilty plea. He also thanked the Matawan Police Department.

The government is represented by Assistant U.S. Attorney DeNae Thomas of the Health Care Fraud Unit in Newark.

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Original text here: https://www.justice.gov/usao-nj/pr/matawan-cardiologist-admits-defrauding-health-insurance-companies-more-19-million