PHILADELPHIA – United States Attorney Jacqueline C. Romero announced that Muhamad Aly Rifai, 49, of Easton, PA, was charged by Indictment with four counts of healthcare fraud stemming from his alleged scheme to improperly and fraudulently bill the federal Medicare program for services not provided, or not provided at the level which was claimed.
According to the Indictment, the defendant was a licensed psychiatrist who was the sole owner of Blue Mountain Psychiatry, a psychiatry practice with offices located in Easton, Palmerton, and Stroudsburg, Pennsylvania. The Indictment alleges that for several years, Rifai routinely and improperly billed Medicare for services which he did not provide to Medicare beneficiaries and nursing home patients, including billing for treating dead beneficiaries; billing for treating the same patient at the same time at different nursing homes; and billing for providing more than 24 hours’ worth of services to patients on a single day.
The Indictment further alleges that the defendant routinely billed for higher levels of care than he or his staff provided to nursing home patients. According to the Indictment, despite not having actually seen the patient, Rifai added a pre-printed stamp to medical progress notes to support billing for psychological and add-on services which were not provided by his staff. From about January 2015 until October 2022, Rifai, through Blue Mountain, obtained Medicare payments of at least approximately $1.36 million based on fraudulent claims.
The defendant made an initial appearance in federal court on these charges before U.S. Magistrate Judge Richard Lloret.
If the public has any information regarding Blue Mountain Psychiatry or any other health care fraud allegation, individuals should contact the HHS-OIG hotline at 800-HHS-TIPS.
If convicted, the defendant faces a maximum possible sentence of 40 years in prison, and a fine of up to $1 million.
The case was investigated by the Office of Inspector General, U.S. Department of Health and Human Services, and is being prosecuted by Assistant United States Attorney Joan E. Burnes.