Middlesex Cardiologist Charged With Insurance Fraud

A cardiologist with offices in Monmouth and Middlesex counties has been indicted for allegedly stealing more than $52,000 by billing insurance companies for services that he could not have performed because he was out of the country at the time.

Ahmad Mossavi, aka Seyed A. Mossavizadeh, 52, of Wayside, was charged with 48 counts of second-degree health care claims fraud and one count of third-degree theft by deception on Sept. 17.

At the time of the alleged crime, Mossavi was a cardiologist who an office in Ocean Township and another in South Plainfield. The state grand jury indictment alleges that between Jan. 20, 2008 and Oct. 9, 2009, Mossavi falsely submitted, or caused to be submitted, claims which purported that he was providing patient care. 

“When licensed professionals unlawfully bill for services they do not provide, the cost of the fraud is passed onto the rest of us, the consumers,” Acting Attorney General Hoffman said in a release. “We are doing our part to aggressively control rising health care costs.” 

It is alleged that, through this scheme, Mossavi fraudulently billed Aetna, CIGNA, Emblem Health, Horizon Blue Cross/Blue Shield and QualCare for a total of $52,717.  Mossavi allegedly billed for services under his own name and also under the name of his limited liability corporation, Nari Medical Association, LLC.   

An investigation by the Office of the Insurance Fraud Prosecutor determined that, during the times for which Mossavi was supposedly treating patients, he allegedly was out of the country, and not treating patients. 

Mossavi's medical license was suspended by the New Jersey Board of Medical Examiners on Sept. 23, 2011.

His second-degree crimes carry a maximum sentence of ten years in state prison and a criminal fine of up to $150,000 and third-degree crimes carry a maximum sentence of five years in state prison and a criminal fine of up to $15,000.