PROVIDENCE — Federal prosecutors are seeking $3 million from Dr. Tarek W. Wehbe, an internist with the Renaissance Medical Group in Providence, who the federal government accuses of fraudulently billing Medicare, Medicaid and private insurers for services he did not perform.
Wehbe, who had his license suspended last week by Rhode Island Health Director Dr. David R. Gifford, is accused of billing for services he didn’t perform, inflating the type of treatment he provided and billing for days consisting of more than 24 hours.
The complaint filed in U.S. District Court in Providence asserts that Wehbe billed for visits and treatments that, if performed properly, would have taken more than 24 hours in a single day. For example, Wehbe billed for 87 patient visits on March 7, 2006, according to the complaint. According to federal standards, the time needed to see that many patients would have been more than 30 hours.
On other days, the complaint alleges, Wehbe billed for 28, 27 and 23.6 hours of visits in a single day.
Federal prosecutors also say that Wehbe fraudulently billed for infusion of the drug Remicade, which is used to treat Crohn’s disease and rheumatoid arthritis, and for treatments with drugs such as Paclitaxel and Gemzar, which are used to treat cancer.
According to the affidavit, between November 2001 and December 2006, suppliers delivered 22,890 units of Remicade to the Renaissance Medical Group, which Wehbe owns. He billed insurers for 39,239 units, or about 16,000 more than he received. The complaint states that from 2002 to 2006, Medicaid, Medicare and private insurers overpaid Wehbe $2.99 million, of which $1.8 million went for infusion drug treatments and $1.1 million for fraudulent office visits and treatments.
Prosecutors are seeking forfeiture of Wehbe’s property and bank accounts. The affidavit states that Wehbe has an account at Citizens Bank and owns real estate at 1630 Mineral Spring Ave., North Providence; 566 East Shore Rd., Jamestown; 6 Pine Tree Lane, Lincoln, 15 Dennell Drive, Lincoln; and 78 Farnum Pike, Smithfield.
Along with the U.S. Attorney’s office, other agencies involved in the investigation include the U.S. Department of Health and Human Services, the Internal Revenue Service, the U.S. Food and Drug Administration and the Rhode Island attorney general’s Medicare fraud control and patient abuse unit.
Wehbe, 43, has been under investigation by state and federal agencies for alleged health-care fraud and medical negligence since a raid at his office in December 2006. When the state suspended Wehbe’s license on April 7, Gifford, state health director, used his power to pull a doctor’s license without a hearing if a physician is deemed to be an immediate danger to the public.
That suspension was prompted by the discovery that Wehbe’s records of purchases of chemotherapy drugs did not match the amount he billed insurance companies. “In reviewing the records, it doesn’t appear that he could have given what he billed for,” said Dr. Robert S. Crausman, chief administrative officer for the state Board of Medical Licensure. “That could be just billing fraud but it leaves open the possibility that patients didn’t get what they should have gotten.”
Most of the affected cancer patients left Wehbe’s practice in December 2006 after he agreed to stop offering infusion therapy at his office after the investigation started, Crausman said. At the time, investigators were concerned about his treatment of patients who had rheumatoid arthritis, hepatitis C and fibromyalgia. When the cancer treatment issue came to light, the medical board considered the matter more serious and recommended that Gifford immediately pull Wehbe’s license, according to Crausman.
The state attorney general’s office is following up to determine if there was abuse of patients, said spokesman Michael Healey.
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