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Date: 11-20-2019
Case Style:
Case Number: 4:18-cr-00307-AGF
Judge: Audrey G. Fleissig
Court: United States District Court for the Eastern District of Missouri (St. Louis County)
Plaintiff's Attorney: Amy E. Sestric and Andrew J. Lay
Defendant's Attorney:
Description: St. Louis, MO - The United States of America charged Naim Muhammad with Medicaid fraud.
Naim Muhammad, 56, of St. Charles, MO, pled guilty to one count of making a false claim to Medicaid. Mr. Muhammad appeared today before U.S. District Judge Audrey G. Fleissig who accepted his plea and set sentencing for February 28, 2020.
According to the plea agreement, Mr. Muhammad was the President of Community Behavioral Health (“CBH”). CBH maintained an office in the City of St. Louis, Missouri. Mr. Muhammed had no psychiatric training or license.
Mr. Muhammed billed the Missouri Medicaid program for mental health therapy services to a patient identified by initials W.W. Mr. Muhammad told Medicaid that a licensed provider with the initials D.P. had provided the therapy to W.W. on June 21, 2017. However, Mr. Muhammad’s statements were false and fraudulent in that patient W.W. was not treated by the licensed provider D.P. on June 21, 2017, the date of service shown in defendant’s therapy records for W.W. Mr. Muhammad’s statements were material to the Missouri Medicaid program because the program does not pay for services not actually provided to the patient and does not pay for mental health services provided by unlicensed individuals.
The Indictment in this case further alleges that Mr. Muhammad repeatedly billed the Missouri Medicaid program for therapy services allegedly provided on dates when the patient was actually deceased, and, therefore, unable to receive any services. For example, W.W. died on June 8, 2017, before the alleged June 21, 2017 session.
This charge carry a maximum possible penalty of five years imprisonment, a fine of $250,000 or both imprisonment and a fine. In determining the actual sentences, a judge is required to consider the U.S. Sentencing Guidelines, which provide recommended sentencing ranges.
The Office of Inspector General investigated this case for the U.S. Department of Health and Human Services and the Medicaid Fraud Control Unit of the Missouri Attorney General’s Office, with assistance from the Division of Professional Registration of the Missouri Department of Commerce and Insurance.
Outcome: Guilty
Plaintiff's Experts:
Defendant's Experts:
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