Ali Rashan, CEO and founder of ClearMD arrested on charges of committing $24 million health care fraud

Ali Rashan, CEO and founder of ClearMD arrested on charges of committing $24 million health care fraud: “Ali Rashan allegedly facilitated an elaborate scheme using fabricated medical records to steal more than $24 million,” said FBI Assistant Director in Charge Christopher G. Raia. “This defendant allegedly violated his dual authorities as a medical doctor and CEO to receive reimbursement from thousands of illegitimate claims, says a press release by The Attorney for the United States, Sean Buckley. From at least 2021 until in or about 2023, RASHAN, the founder and owner of ClearMD, a provider of medical testing services, agreed to submit and caused to be submitted to insurers fraudulent claims that billed for unperformed and unrequested services purportedly provided to patients who sought testing for COVID-19 and fraudulent medical records in support of these fraudulent claims. For example, RASHAN directed ClearMD to submit or cause the submission of thousands of claims that billed for evaluation and management (“E/M”) services that were never performed. Furthermore, at times during the relevant period, RASHAN directed ClearMD to submit claims to insurers billing for two to four COVID-19 testing codes, even though ClearMD had administered only a single COVID-19 test to patients. Thereafter, in response to requests from insurers for documentation supporting its claims for reimbursement, RASHAN instructed ClearMD staff to write a software program to generate false medical records to support ClearMD’s fraudulent billings. RASHAN directed ClearMD to submit these fabricated medical records to insurers to deceive them about the services that ClearMD had provided and to justify ClearMD’s retention of amounts paid to ClearMD in response to fraudulent claims. This scheme resulted in losses of at least approximately $24 million. RASHAN, 41, of New York, New York, is charged with one count of conspiracy to commit health care fraud, which carries a maximum sentence of 20 years in prison; one count of health care fraud, which carries a maximum sentence of 10 years in prison; one count of wire fraud, which carries a maximum sentence of 20 years in prison; one count of conspiracy to make false statements, which carries a maximum sentence of five years in prison; and one count of false statements relating to health care matters, which carries a maximum sentence of five years in prison.