A Dallas doctor and hospital chain operator is facing 20 years in prison for stealing roughly $18 million from government health care agencies. Dr. Tariq Mahmood was found guilty today of eight counts of health care fraud, including conspiracy, and seven counts of aggravated identity fraud.
Several of Dr. Mahmood’s employees at Renaissance Hospital Terrell testified that Mahmood regularly insisted on upcoding services in order to obtain higher reimbursements from Medicare. Upcoding is a fraudulent practice where a health care provider assigns a code for services that is worth more money than the service actually provided.
Norma Longley, a coder for Mahmood’s hospital chain, testified that she noticed her Medicare reimbursement codes had been altered at another of Mahmood’s facilities after she had refused to follow his upcode orders. Government auditors began informing Longley that her Medicare billings were “riddled with mistakes,” according to the Dallas News.
Another coder claimed that she was fired for refusing to obey Mahmood’s upcoding orders. In many cases, Dr. Mahmood actually billed for services on patients “he had never seen,” according to his indictment.
Dr. Mahmood’s case received attention at the national level after a government panel said the case “raises broader questions about CMS’ ability to detect fraud in its programs.” Put simply, this case demonstrates why we need whistleblowers; maybe now more than ever. If you have been asked to upcode or have witnessed health care fraud on any level, you should seek the advice of an experienced whistleblower attorney to help you navigate your best course of action.