New York Doctor Sentenced to 13 Years in Prison for Multi-Million Dollar Health Care Fraud

[Princess Turandot]

2. He appears to have been caught because one of his patients carefully reviewed...

...their explanation of benefits (EOB) from both Medicare and their supplemental insurance (AKA Senior-care) plan that covered any required coinsurance payments. They saw billings for numerous wound debridement procedures that had never occurred, and called the fraud hotline number on the EOB.

According to one court document, during the period in question, Ahmed submitted bills for 2,143 procedures under one specific procedure code (CPT code 27301). The 2nd highest submissions from one physician for this code? All of 127 of them.