February 11, 2015

Jersey City, New Jersey Pediatrician Admits Making Nearly $200,000 Billing Medicaid for Bogus Treatments

TRENTON, NJ—A licensed pediatrician practicing in Jersey City, New Jersey, today admitted fraudulently billing Medicaid for more than 1,000 wound repair procedures that were never performed, U.S. Attorney Paul J. Fishman announced.

Badawy M. Badawy, 52, of Bayonne, New Jersey, pleaded guilty before U.S. District Judge Anne E. Thompson in Trenton federal court to Count One of an indictment charging him with health care fraud.

According to documents filed in the case and statements made in court:

Badawy owned and operated Sinai Medical Center of Jersey City LLC, a medical practice focusing on pediatric and family medicine. From January 2004 through December 2008, Badawy submitted thousands of claims to Medicaid for wound repair procedures related to the repair of superficial wounds over 30 centimeters in length on a patient’s face, ears, eyelids, nose or lips as well as the repair of previously closed wounds. Badawy claimed to have performed these treatments on his patients, most of whom were children.

During his plea hearing Badawy admitted that he regularly submitted claims for procedures that were never performed. As a result of his false claims, Badawy received $196,911 in Medicaid payments.

The charge of health care fraud carries a maximum penalty of up to 10 years in prison and a maximum fine of $250,000 or twice the gross gain or loss resulting from the crime. Sentencing is scheduled for May 20, 2015.

U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Richard M. Frankel in Newark and the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Scott J. Lampert, with the investigation leading to today’s guilty plea.

The government is represented by Danielle Alfonzo Walsman and Michael H. Robertson of the U.S. Attorney’s Health Care and Government Fraud Unit.

U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $635 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug and Cosmetic Act and other statutes.