Meriden Pediatrician Arrested on Charges He Defrauded Medicaid of $25,000

MERIDEN, CT — A pediatric and family medicine physician with offices in East Hartford and Meriden was arrested Tuesday on Medicaid fraud charges, accused of allegedly billing the government health care program more than $25,000 for services he did not perform.

Rocky Hill resident Sheikh Irfan Ahmed, 53, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney and charged with one count each of Larceny in the First Degree by Defrauding a Public Community, Identity Theft in the First Degree, Health Insurance Fraud, and Forgery in the Second Degree.

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According to the arrest warrant affidavit:

Between 2011 and 2012, Ahmed and his facilities were investigated on multiple occasions for a variety of complaints, including unsatisfactory patient treatment, lack of proper authorization to perform certain medical procedures, lack of proper medical recordkeeping and fraudulent Medicaid billing activity. As a result, Ahmed was terminated as an authorized performing provider in the Medicaid program, which immediately revoked his ability to both treat Medicaid patients and submit claims for payment.

Investigation disclosed that Ahmed nevertheless continued to bill Medicaid using the identification information of other professionals associated with his practice who were authorized to submit claims. Between April 2013 and April 2015, Ahmed submitted more than $25,000 in false claims for services never rendered by him or the other professionals, the warrant states.

Investigation also disclosed that Ahmed caused the creation of false entries to make it appear that services billed to Medicaid had been performed, when in fact they had not. These included entries by a provider who was not even employed by Ahmed on the date of service and someone who was on vacation or not at work when the alleged services were rendered.

Ahmed was released after posting a $25,000 non-surety bond and is scheduled to appear in Hartford Superior Court on August 23.

The charges are merely accusations and he is presumed innocent until and unless proven guilty, prosecutors said, but Larceny in the First Degree by Defrauding a Public Community, Identity Theft in the First Degree, and Health Insurance Fraud are class B felonies punishable by up to 20 years in prison. Forgery in the Second Degree is a class D felony punishable by up to 5 years in prison.

The case is being prosecuted by the Medicaid Fraud Control Unit.

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