Dental Prof Faces Criminal Charges

An associate professor at the Harvard School of Dental Medicine (HSDM) was charged on Thursday with six counts of mail fraud, 14 counts of health care fraud, two counts of obstruction of criminal investigations, and two counts of money laundering.

These charges were made in connection to defrauding Medicare of approximately $5.4 million, according to a press release from the U.S. Attorney’s office in Boston.

Dr. Abdul Razzaque Ahmed, an associate professor of Oral Medicine, Infection, and Immunity at HSDM, specializes on dermatology and runs the Center for Blistering Diseases in Boston.

In particular, he works with the disfiguring diseases Pemphigus vulgaris and Pemphigoid. Pemphigus is a life-threatening skin disease while Pemphigoid is a less lethal, but still painful disease, according to the New England Journal of Medicine.

The Federal indictment unsealed in court on Thursday accuses Ahmed of correctly diagnosing patients with the Pemphigoid strain—and then falsifying their medical records to indicate that they had the rare Pemphigus, the treatment of which is covered by Medicare.

The treatment for Pemphigus uses intravenous immunoglobulin in place of steroids, the common treatment for Pemphigoid. Immunoglobulin is much gentler on patients, but it costs about $10,000 a month and has to be administered for up to a year.

Ahmed is a great proponent of immunoglobulin therapy; he has written many papers in the New England Journal of Medicine regarding its effectiveness and has conducted research on its uses at HSDM and at the Department of Dermatology at the Harvard Medical School.

He also petitioned Medicare to cover immunoglobulin treatment for Pemphigoid patients who failed to respond to steroid treatment or suffered serious side effects from that treatment.

In 2002, Medicare officials approved limited funding for cases where patients had not responded to treatment or were too sick to try the less effective steroid therapy.

The health care fraud charges stem from allegations that Ahmed mixed blood samples of patients who had the less lethal Pemphigoid strain with those who had the lethal Pemphigus, in order to obtain Medicare coverage for their treatment.

He would receive patients from all over the country at the height of his practice, his colleagues said.

“When we had patients who were having trouble with Medicare...we sent them to Dr. Ahmed, and he seemed to have the ability to do it,” Sal Capo, president and executive director of the California-based Pemphigus & Pemphigoid Society, told the Boston Globe on Thursday.

Ahmed’s lawyer paints him as a lifesaver, saying that he acted to save the lives of his patients, most of whom could otherwise not have afforded the therapy.

The prosecution, however, cites the fact that Medicare reimbursed him at a rate of $90 per gram of immunoglobulin while the actual cost of treatment was between one half and two thirds of that amount, according to the Boston Globe.

Ahmed is also charged with mail fraud for falsifying documents pertaining to patients’ diagnoses, including letters to other physicians and immunopathology reports.

He was further charged with mixing blood samples and sending them to the United States Attorney’s office—to prove that his patients had the covered disease—after the office started an investigation into his conduct.

Ahmed, his lawyer, and his associates at the Center for Blistering Diseases could not be reached for comment.

If found guilty, he faces a maximum sentence of 5 years in prison for each count of mail fraud and each obstruction count, 10 years in prison for each health care fraud count, and 20 years in prison on each money laundering count.

All of the charges also carry terms of up to 3 years of supervised release, and a $250,000 fine, except for the Money Laundering counts which carry a maximum $500,000 fine.