At one time he had 6 hospitals, 4 closed and 2 are struggling with financial issues under new ownership. The news stated he was allowed to operate this way for years before it was finally addressed. There were a couple billing coders that were asked and told to change the codes and they refused so they found a way to work around them. One coder was fired 3 weeks after she refused to dummy up the billing codes.
In addition his former administrator also faces charges on falsifying documents to obtain $18 million in stimulus funds for converting to electronic medical records and EMRs were never done.
Dr. Mahmood’s defense was that he “suggested” changing the codes but any smart biller that has done this for years will catch on to what’s happening in a hurry. It would be pretty easy to see the stimulus money fraud as if you walk in and there’s no EMRs in use anywhere, well that would tell the story. BD
According to information presented in court, Mahmood, a general practitioner, owned and operated several hospitals in the state of Texas, including Cozby Germany Hospital in Grand Saline, Renaissance Terrell Hospital in Terrell, Central Texas Hospital in Cameron, Community General Hospital in Dilley, and Lake Whitney Medical Center in Whitney. From January 2010 to April 2013, Mahmood and others carried out a scheme to defraud Medicare and Medicaid through the submission of false and fraudulent claims.
Mahmood and others added, changed, deleted, and incorrectly sequenced diagnostic codes in a way that did not reflect the actual diagnoses and conditions of the patients. They submitted false and fraudulent claims to Medicare and Medicaid based on the added, changed, deleted, and incorrectly sequenced diagnostic codes. Mahmood and others also unlawfully used Medicare beneficiaries’ names and Medicare numbers in order to commit health care fraud. Mahmood was indicted by a federal grand jury on April 11, 2013.