Matawan medic made millions in a health care fraud scheme

Dr. Fazal Panezai, 76, the owner, and sole medical provider of Matawan-Aberdeen Heart & Medical Center, admitted his involvement in a health care fraud scheme that resulted in fraudulent insurance reimbursements exceeding $1.9 million.

This development unfolded during a plea hearing before U.S. District Judge Georgette Castner at the Trenton federal court.

According to U.S. Attorney Philip R. Sellinger, documentation submitted in the case, and statements presented during the court proceedings, Panezai orchestrated a scheme involving false claims submitted to at least six health insurance benefit programs.

These claims purported office visits that either did not transpire or were inaccurately billed in terms of duration.

One glaring example highlighted during the proceedings detailed how Panezai submitted claims for office visits totaling approximately 1,675 minutes, equivalent to around 27.9 hours, for a single day’s purported office visits on May 27, 2022.

Authorities say he billed insurance providers over $80,000 for office visits during periods when he was absent from the country, conducting no consultations or medical services.

Panezai was also found to have submitted claims for office visits when patients merely picked up prescriptions from the front desk, without meeting with him personally.

These deceptive claims led to insurance plans issuing reimbursement checks to the medical center, with Panezai pocketing the fraudulent profits, totaling more than $1.9 million.

The charge of health care fraud carries a maximum penalty of 10 years in prison and a maximum fine of either $250,000 or twice the gain or loss resulting from the offense, whichever amount is greater. Sentencing for Panezai is set for Aug. 20, 2024.

Sellinger acknowledged the investigative efforts of special agents from the FBI, under the guidance of Special Agent in Charge James E. Dennehy in Newark, which led to the guilty plea. The Matawan Police Department also received appreciation for their assistance in the investigation.

Assistant U.S. Attorney DeNae Thomas, from the Health Care Fraud Unit in Newark, represents the government in this case.