Defendant pleaded guilty to health care fraud and money laundering
BOSTON - Fathalla Mashali, 62, of Dover, Mass., pleaded guilty on March 15, 2017, in U.S. District Court in Boston to 27 counts of health care fraud, one count of conspiracy to commit mail fraud, and 16 counts of money laundering. Sentencing is scheduled for June 21, 2017.
Insurance companies and patients who believe they may be potential victims of Mashali’s scheme to defraud Medicare and other health care insurers, will find additional information about this case on the U.S. Attorney’s Office website https://www.justice.gov/usao-ma and the U.S. Department of Justice website https://www.justice.gov/largecases. Potential victims who can document direct and proximate harm, including financial loss suffered as a result of the charged conduct, may complete the potential victim identification form and return it to the United States Attorney’s Office for determination of their crime victims’ rights status. Victims of this crime may be entitled to restitution.
Mashali was a licensed physician in Massachusetts and Rhode Island and operated New England Wellness & Pain Management, P.C., a/k/a New England Pain Associates, P.C., of Massachusetts and Rhode Island, a/k/a Greystone Pain Management, Inc., a/k/a New England Pain Institute, P.C. (NEPA). He also employed Egyptian doctors in Cairo, Egypt, who entered false information into U.S. patients’ medical records. Many of the patients at NEPA were Medicare beneficiaries.
From approximately October 2010 through March 2013, Mashali falsely billed Medicare and commercial insurers for extensive medical services that he did not provide. Mashali also routinely billed Medicare and private insurers for urine drug test results that were false and fraudulent. When Medicare began to inquire about Mashali’s unlawful billing practices and initiated an audit of Mashali’s medical services, requesting 40 patient medical files, Mashali caused his staff both in the United States and in Egypt to falsely alter patient records. This included falsifying patient encounters which had taken place sometimes one or more years earlier, and faking and backdating the results of patients’ urine drug tests. Mashali knew that his patient records would not pass muster with Medicare’s auditors and thus ordered his staff to make these changes.
Mashali used the proceeds derived from his fraudulent billing to fund a lavish lifestyle, spending money on his extravagant Dover, Mass., residence and a condominium in Florida.
Source: U.S. Department of Justice, Office of the United States Attorneys
