The ignorant encroachment on the practice of Psychiatry:
The Case of the United States of America v Muhamad Aly Rifai, MD
On November 8, 2022, the government of the United States of America indicted me on four counts of healthcare fraud. The counts involved four services of psychotherapy that the government alleged were not provided in late 2017. The government extrapolated those four services each worth $43.59 to 7 years (2015-2022) and demanded forfeiture of 1.3 million dollars. These charges stemmed from the care of hundreds of poor Medicare beneficiaries, living in the underserved rural areas of Pennsylvania that no other provider wanted to see but I willingly agreed to care for.
On the face of it, these charges were overwhelming and calamitous. The government prosecutor added a litany of erroneous, misleading but scandalous and headline-grabbing analytics suggesting that on some days in 2015 services were billed for more than 24 hours of work and that my practice sent bills on deceased Medicare beneficiaries after the date of death. The government investigators and prosecutor believed that this minority Muslim physician of Syrian origin who is solo practicing, will quickly relent and submit to a plea agreement.
In United States vs Muhamad Aly Rifai, MD, those representing the government met a conscientious, law-abiding physician, but also a tenacious advocate who believed in his profession, morality, and innocence. I was educated in the United States in top tear training institutions such as the University of Virginia and the National Institute of Mental Health. I am the president of the local psychiatric society and hold five active board certifications in Internal Medicine, Psychiatry, Consultation Psychiatry, and two in Addiction Medicine. None of these credentials or public health service really mattered to the government, but calling on my legal experience and prior expert witness familiarity with the legal system I assembled an experienced trial team. I resolved to go to trial which was delayed till May 2024.
During the protracted investigation that yielded only four charges over seven years (2015-2022), the prosecutor misunderstood the practice of psychiatry. She wantonly and benightedly mischaracterized the services of psychotherapy as “15 minutes med checks”—a term eliminated from the American Medical Association Current Procedural Terminology (CPT) in 2013.
During this six-day trial ordeal the government failed to produce a certified coder to support the veracity of the four charges. Instead, the government relied on the uninformed and uneducated opinions of a few disgruntled former employees who were quickly discredited. A high school graduate representing the government contracted auditor quickly retracted his testimony when confronted about the flawed and erroneous analytics he presented. A registered nurse also representing the government contracted auditor conceded while being reduced to tears that her integrity did not allow her to support the government charges and audit results.
As part of investigation, the prosecutor involved the Drug Enforcement Agency, to portray, as diversion, the legitimate prescribing of controlled medications for attention deficit disorder to children under eighteen. During the trial the jury heard, but quickly disregarded, the testimony of an undercover police officer. She had failed to illicit any diversion activities and alleged that forms she had completed several years earlier but forgotten about, were forgeries.
My brilliant attorney, law professor Paul Hetznecker, defended my rights and presented my case in an intelligent and compassionate manner to those twelve courageous Pennsylvanian men and women who heard my case. Our extraordinary coder/ auditor David Klein presented a simplified primer on psychotherapy coding to an attentive jury, he also debunked the flawed audits and analytics. Our expert psychiatrist, who practices in the rural areas of Georgia explained how psychotherapy was the bread and butter of psychiatry, cementing to the jury that our billing practices were legitimate and lawful.
The jury had no faith in the case presented by the prosecutor on behalf of the government of the United States of America, while being sympathetic to the fact that what we provided were medically appropriate psychotherapy services. The jury quickly and unanimously returned a not-guilty verdict after only a few hours of deliberations.
Prosecutors from the United States Department of Justice are still seeking a mulligan after the not guilty jury verdict, trying to administratively effect damage to my ability to practice the field of psychiatry. I will continue to defend my rights and the rights of my physician colleagues to be of service to our fellow Americans.
Addendum
Dr. Rifai is an advocate for all doctors. He wants other doctors to understand that government attack does not have to be the end of your life and practice. You CAN WIN! You just need to understand the basics of defense, do the homework, make sure you are compliant, use the tools, and go to trial! To that end, he wants to explain these basic tools to all interested medical professionals. His interview with Doctorsofcourage is at the end of the post. Also, he has permission to give out the contact information for the organizations that have the tools to help you win. These are:
Attorneys in my case
Paul Hetznecker Esq https://www.pauljhetznecker.com
Roanld Chapman II https://www.chapmanlawgroup.com/attorney/ronald_chapmanii/
Mitigation Specialists
Sam Mangel https://sam-mangel.com/about-us/
Justin Paperny https://www.whitecollaradvice.com/about-the-company/
Medical Experts Healthcare Fraud
Sean Weiss the Doctors Group https://www.doctorsmanagement.com/team-members/sean-m-weiss/
David Klein DK coding and Compliance https://dkcoding.com/
Discovery/ trial Presentation Corner Stone Discovery https://cornerstonediscovery.com/
Also Defendants should be fluent in signing up with Pacer https://pacer.login.uscourts.gov/csologin/login.jsf
What a sad day that these people can go after a legitimate Dr. I’m only one person I wish I could help more. All the Drs who took a plea cause they didn’t have money to fight. Congratulations on winning your case 🎉🎊
You want names of some people who deserve to face repercussions for their attempt at criminalizing medicine?
AUSA John Mulcahy – brought a case and sought decades in jail as a plea bargain for accusations that he still to this day doesn’t understand (and a case in which he lost on 70% of the charges). Tried to accuse the doctor of causing the overdose death of a patient who, in reality, injected crack into her neck and died of an acute opiate and fentanyl overdose.
AUSA Kaitlin O’Donnell – likewise failed to conduct any research into the very subject matter, and specialty, they were prosecuting and followed Mulcahy’s lead in treating this like an opioid doctor prosecution.
DEA Diversion Investigator Lisa Fernandes harassed patients, texted them without consent, ignored the very existence of any patient NOT being prescribed a controlled substance (which was half of the doctor’s caseload) and refused to listen to, let alone document any exculpatory evidence given by interviewees contradicting her pre-determined conclusion that this doctor was operating a “pill mill”.
She also proved to be the primary, and perhaps only, barrier to settlement discussions over the course of 6 years, telling multiple superiors and individuals from other agencies (i.e. DOJ) that she refused to consider any settlement, thereby preventing any ability to settle what should have never been a criminal matter.
All of these people made decisions which were in their OWN SELF-INTEREST and not in the interest of ensuring justice. They were all concerned about their career advancement rather than getting it right. Their actions post-verdict have continued to be indicative of people whose goal is to get the most jail time possible because that is the only measure they have of success in their field.
Special Agent in Charge Jodi Cohen (made inflammatory and boisterous statements in press release(s) / newspaper)
Acting US Attorney Joshua Levy (made inflammatory and boisterous statements in press release / newspaper)
Paul Callahan as Undercover, Burlington Police Department – lied on the stand just like he did in a previous setting and failed to clearly raise red flags which would prove the doctor’s intent stating that they didn’t offer him cash because they “knew he wouldnt go for that”
“Expert Witness” Dr. Philip Candilis who under oath endorsed the ludicrous suggestion that psychiatrists are expected to conduct a PHYSICAL examination at each visit and, as a term of treatment, automatically drug test patients solely on the basis that they are being prescribed a controlled substance, even when there are no pain medications being prescribed, rather than if there is an indication to do so.
Similar to this doctor, the government representatives failed to conduct ANY due diligence on the accusations they made within the specialty of Psychiatry, utilizing the framework of a pain doctor prosecution even though no opioids were involved and failed to research even the most obvious and accessible clinical guidelines to the practice of Psychiatry which likely would have resulted in no charges ever being filed.
Surprise surprise, the doctor is foreign born, has an obvious foreign last name and no history of complaints whether with the BORIM, malpractice and any local, state or federal law enforcement agencies.
Thanks. I’ll add these names to the Tags list.
Our government is totally out of control. I am so happy the doctor won on appeal. But I’m sure he had to spend a LOT of money and time in the process. I’m sure many medical professionals could not afford to appeal. I appreciate Doctor Rifai fighting back for himself and all medical professionals currently under attack in the US.
I want to know when the DEA is going to prosecute the White House doctors and pharmacy staff under the Trump administration for handing out serious medications like candy.
Why go there? Why not recognize the fact that I teach and help get the CSA repealed? Hitting the ball back and forth doesn’t do a thing. You’ve been around a long time in this fight. Are we better off? How about getting on board what will do the job. Join my ecourse starting July 1, and get more to join so we can go to Washington, explain the truth to Congress, and people at home can communicate the same to their legislators. It is only through this education that change will happen. Be a spark for change.
Name names for the Government. No longer can these people remain lurking in the shadows. Name names. Please.
DEA Agents
FBI if any involved
Federal Prosecutors
Board Investigator pharm/med/psych.
congrats! im glad you beat the feds