Information for Victims in Large Cases
U.S. v. Fathallah Mashali
Fathallah 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. Mashali was a licensed physician in Massachusetts and Rhode Island. Mashali 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.
U.S. v. Moustafa Moataz Aboshady
Moustafa Moataz Aboshady, 33, an Egyptian national residing in Lake Forest, Calif., was indicted in September 2016, in U.S. District Court in Boston, on one count of conspiracy and two counts of making false statements in connection with health care benefit programs. As alleged in the indictment, Aboshady was a medical resident in Massachusetts and Rhode Island, employed at New England Wellness & Pain Management, P.C., which was also known as New England Pain Associates, P.C., Greystone Pain Management, Inc., and New England Pain Institute, P.C., or NEPA. NEPA had locations in Massachusetts and Rhode Island. The indictment alleges that Aboshady was part of a conspiracy involving other members of NEPA, including its owner and members of a satellite office in Cairo, Egypt, in connection with a scheme to falsify patient medical records in order to obtain payments from the Medicare program and commercial health insurance companies. The alleged conduct included submitting claims for payment to Medicare and commercial health insurance companies for services not rendered.
U.S. v. Warner Chilcott Sales (U.S.) L.L.C.
Pharmaceutical company Warner Chilcott has agreed to plead guilty to health care fraud and pay $125 million to resolve criminal and civil liability arising from the illegal promotion of various drugs. A portion of the illegal conduct related to the manipulation of “prior authorizations” for the osteoporosis medications Actonel® and Atelvia®. Insurance companies who paid for Actonel® and/or Atelvia®, or individuals who paid co-payments for these drugs, based on manipulated prior authorizations between June 2010 and February 2012, may be eligible for restitution. Potentially affected insurance companies and individuals have until March 31, 2016 to submit the restitution claim form.