N.J. doctor Amgad Hessein charged with M in health care insurance fraud | Healthquest | NewJerseyNewsroom.com -- Your State. Your News.

newjerseynewsroom.com

Sunday
Dec 21st
  • Login
  • Create an account
    Registration
    *
    *
    *
    *
    *
    REGISTER_REQUIRED
  • Search
  • Local Business Deals

N.J. doctor Amgad Hessein charged with $52M in health care insurance fraud

mousetrap_optOn Wednesday, law enforcement agencies arrested a Union County doctor and charged him with submitting nearly $52 million in fraudulent Medicare and private insurance health care claims, said Prosecutor Theodore J. Romankow.

During early morning raids, Dr. Amgad Hessein, 54, of Advanced Pain Management Specialists formerly headquartered in Union Township and currently located in Belleville and his brother were arrested. Hessein was charged with 2nd Degree Health Care Claims Fraud and Conspiracy. It is preliminarily estimated that Dr. Hessein and his brother Ashraf Sami, 56, netted up to roughly $5 million through their scheme, said Romankow.

The case began in April 2009 in Union Township when Sami, an office manager at Advanced Pain Management Specialists, reported a theft by an employee to the local police department, said Romankow. During that investigation by Union Township Police Department detective William Fuentes, "it became clear that Dr. Hessein and Advanced Pain Management Specialists were involved in a scheme of overbilling, upcoding and submitting fraudulent claims for treatments not rendered," said Romankow.

The Union County Prosecutor's Office Insurance Fraud Unit and the New York Regional office of the United States Department of Health and Human Services, Office of the Inspector General joined the investigation.

During the course of the investigation it was discovered that Advanced Pain Management Specialists billed the Medicare program nearly $52 million between January 2006 and July 2009, said Romankow.

"Bank records revealed that the doctor had billed for treatments for which he did not have the equipment to perform, would bill patients for higher level, more costly treatments than were actually performed and would bill for visits when patients were not even in the office," said Romankow. "Most brazenly on many occasions the doctor billed for treatments that he allegedly performed in his office while he was actually out of the country."

The investigation revealed that Dr. Hessein submitted claims for every day of the year in 2006 and 2007 and on multiple occasions his billable hours exceeded 24-hours on many days, said Romankow.

With the proceeds of this fraud, Dr. Hessein and Ashraf Sami purchased oceanfront real estate in New Jersey, commercial properties and several luxury vehicles. Those properties and vehicles, including a $1.59 million home in Belmar, N.J., as well as numerous bank accounts were seized by the authorities.

Sami is being held on $200,000 bail and Hessein on $300,000. Both are being lodged at the Union County Jail.

— NEWJERSEYNEWSROOM.COM

 
Comments (16)
16 Saturday, 17 December 2011 02:52
Johnny
As many of u already know, as of November 27, 2011 Doctor
Hesseins license 2 practice has been taken away until
The trial is over, meanwhile I need a Doctor that can prescribe me
My meds for now & inject my back.

CAN ANY1 TELL ME WHERE I CAN FIND A PAIN MANAGEMENT
DR. THAT WON'T GIVE ME A BIG HASSLE ON MY MEDS
CAUSE I HAVE MY PRESCRIPTION BOTTLES & MY APPT WITH HESSEIN WAS TODAY & SINCE HE IS NOT THERE I NEED MY REFILL FOR THE END OF THIS MONTH. MY CEL NUMBER IS 862-588-1553
15 Wednesday, 23 November 2011 13:36
Lucy R.
Doctor Hessein is a great doctor and was able to give me injections in my back , which in turn helped me walk again. Although he is charged with a crime, what happened to innocent until proven guilty. I am sure that he is not the one in charge of medical billing so we need to be looking at the person in his office that was in charge of billing. Nvertheless Dr. Hessein is a great doctor. And the way the healthcare companies only want to pay the doctors $19 dollars for an office visit is a disgrace. America needs to get it's health care system in order.
Free Dr. Hessein. He is truly a great doctor. Let not dwell on what he did wrong. Lets remember all the people like me he help walk again.
14 Thursday, 20 January 2011 17:12
Pisosho
Knew him years ago in ND. Always knew he was a low life snake. Send him back to his own country. What a dk5uuirt bag.
13 Monday, 20 December 2010 22:48
Loga
He is my healer . We all love u and support u . Union county are dangers and corrupt .
12 Monday, 06 December 2010 11:30
Laura trevino
Every body is envy of him . I agree the best in nj
11 Friday, 03 December 2010 08:51
Sabrina
The best . The best . The best . . He make me walk . The best doctor in nj
Md
10 Thursday, 02 December 2010 18:46
Gale
I'm back to work after 5 years . I agree the best in America
9 Thursday, 02 December 2010 18:44
Zonia
He save my life..... Thank u dr hessein
8 Thursday, 02 December 2010 18:42
Liliana
He is only doctor , who take care of my pain . The best in nj
7 Tuesday, 30 November 2010 18:05
Irma
The best doctor in america
6 Tuesday, 30 November 2010 18:03
Melissa brown
Praise him , praise him . He give my back my life nobody like him . God help him with the lies . Best doctor in united states
5 Monday, 29 November 2010 21:35
Oscar trevino
The best
4 Saturday, 27 November 2010 13:15
john l
DR H, HAS BEED TREATING ME FOR A FEW YEARS NOW. UP TILL THEN ALL THE OTHER DOCTORS THAT I SAW IN THE PAST JUST WANTED TO CUT ME OPEN. DR. H. HAS BEEN KEEPING ME GOING WERE I CAN HOLD DOWN A FULL TIME JOB AND A PART TIME ONE (THAT I HAVE TO STAND 8HRS AT A TIME). I WAS DOWN TO POINT WERE I WAS WALKING WITH A CANE AND COULD NOT EVENMAKE IT A BLOCK, NEVER MIND CRAWLING TO THE BATH ROOM IN THE MORNING!!! EVERY TIME I GET TO GO AND SEE HIM I GET SHOTS IN MY BACK UNDER EQUIPMENT I GUESS THAT DOESN'T EXSIST!!!!!!! THE OTHER DOCTORS WOULD MAKE ME LOSE A WHOLE DAY OF WORK FOR THE SAME PROCEDURE, BECAUSE OF THIS MAN I WOULD HAVE BEEN OUT ON PERMANENT DISABILITY YEARS AGO!!!!!!!! BACK OPERATIONS HAVE NOT BEEN SUSSESSFUL IN MY FAMILY! TO THE PEOPLE THAT READ THIS ARTICAL!!! THESE ARE ONLY ALLEGATIONS!!! HE IS A KIND AND CARING MAN WITH A GREAT STAFF.
3 Friday, 19 November 2010 11:59
Charles M
I have been seeing Dr Hessein on and off for years. He is the only doctor that was able to get my back pain under control. I now walk without a cane and I owe it all to him.

I am quite surprised!
2 Thursday, 18 November 2010 22:18
Jason Yousef
that was my back pain doctor, he used to work in Saint michael's in newark, and leftk it around january or february 2010
1 Thursday, 18 November 2010 11:08
claudiahoe
I have posted this already here before You guys should stop complaining because, one the health care we have now isnt as good as it was supposed to be. also the law has just been signed so give it some time. so if u want to say u have the right to choose tell that to ur congress men or state official. If you do not have insurance and need one You can find full medical coverage at the lowest price check http://ow.ly/3akSX If you have health insurance and do not care about cost just be happy about it and believe me you are not going to loose anything!

Add your comment

Your name:
Subject:
Comment:

Follow/join us

Twitter: njnewsroom Linked In Group: 2483509