Physicians apparent victims of ID theft in $40 million fraud scheme

A California couple is charged with stealing identities of doctors and patients to conduct illegal billing.

By Tyler Chin, AMNews staff. Nov. 3, 2003.

A federal grand jury has indicted a couple in Los Angeles, charging they fraudulently billed more than $40 million to two insurance programs for low-income residents in California by stealing the identities of physicians and patients.

The fraud allegedly committed by Khaled Ahmed and his wife Sandra Cervantes is the largest of almost 360 health care fraud cases that the U.S. Attorney's Office in Sacramento has filed in the past several years.

The indictment, released in October, charges that Ahmed and Cervantes deployed a variety of schemes between 1996 and April 2000 to defraud Medi-Cal and the Family Planning, Access, Care and Treatment Program.

The alleged schemes included billing for services that never occurred, overbilling for medical services that were actually performed, and illegally billing for procedures performed by physicians not licensed to practice in California. The couple also was accused of billing the state for more contraceptives and family planning services than patients actually received.

Ahmed owned several medical clinics in the Los Angeles area, the indictment said. Under state law, however, only California-licensed physicians can own medical clinics and bill Medi-Cal.

In 1996, Ahmed and his wife, who was Ahmed's chief biller, obtained an unidentified physician's personal data. They used those data to misrepresent the true ownership of the clinics and to obtain Medi-Cal provider numbers without the physician's knowledge, the indictment said.