Wael Bakry is a physical therapist who — according to Medicare data — operated on his own out of a modest storefront on Ocean Avenue in Brooklyn.
Yet he billed Medicare for $US4.1 million dollars in 2012, according to federal data released earlier this month — vastly more than the national average for physical therapists of $US32,341.
As noted by Julie Creswell and Robert Gebeloff in
The New York Times, Bakry apparently treated 1,950 Medicare patients that year, providing about 94 separate procedures for each one, a total of around 183,000 separate treatments or 21 per hour.
“I’m not Superman,” Bakry, who did not contest the numbers, told The Times. Instead, he argued that the raw data could be “deceiving,” saying that he employed 24 physical therapists and assistants in four separate offices who all billed under his name. (He also said he no longer worked out of the Ocean Avenue address.)
“While Medicare has encouraged providers to bill under their own numbers,” The Times notes, “the agency acknowledges that data for some providers covers multiple practitioners.”
It’s true: While practitioners billing Medicare what seem like exorbitant amounts warrant a closer look, a sky-high charge is not, in itself, evidence of wrongdoing. Multiple providers may bill under one number, as Bakry claimed explains his account, and while Medicare patients make up a small percentage of all patients at some practices, they may make up the majority of patients at others.
Furthermore, Medicare payouts — like the $US4.1 million to Bakry — should not be interpreted as a salary. “The money often must be split amongst other physicians, nurses, and specialised support staff in addition to paying for actual drugs and medical devices,” Brandon Turner explains at The Atlantic. “Think of it like paying for a meal at a restaurant — even though the waiter serves you the food, he’s not taking home the whole bill for himself.”
Bakry told The Times that Medicare “had never questioned his billing practices.”
Yet his high charges and high number of treatments per patient make him an outlier. Indeed, as The Times notes, “the 94 treatments Mr. Bakry’s average patient received during the year were more than three times the national average.”
These findings point to irregular, if not necessarily illegal, practices — and things got even stranger when we saw what we could learn from Bakry’s various places of business.
Following a trail of addresses
In the Times article, Bakry says he is operating out of four offices. Through some digging, we found five different addresses associated with him (including the 2518 Ocean Avenue address he claims he no longer uses).
Some addresses may be outdated, but each offers clues about Bakry’s operation.
Bakry’s National Provider Identifier, a unique ID assigned to all healthcare providers by the federal government, is associated with another address in Brooklyn, 1218 Neptune Avenue.
Another practitioner at that address, an occupational therapist named Victor Genkin, has already caught the eye of state regulators.
On June 14, 2012, New York’s Office of the Medicaid Inspector General sent a letter to Genkin announcing the results of an audit report. Inspectors concluded that Genkin double-charged Medicaid and Medicare for the same patients and consequently owes the state more than $US15,000. (This may have been a billing error or something else.)
Genkin, whose $2.3 million payout from Medicare was the second-highest occupational therapist reimbursement in the country, seems to have close ties to Bakry. They frequently refer patients to each other, and Amerigroup’s 2014 directory of providers lists them both at a practice called Priority Medical Group at 16204 Jamaica Avenue in Queens.
Something close in name, Priority Care Rehab & Physical Therapy, is also listed at that address, with Bakry as the president.
Priority Medical Group’s one review on Yelp — which, like all unverified Yelp reviews, should be taken with a grain of salt — a ccuses the practice of focusing on money, not care. “This is the most unprofessional medical office I have ever been to,” Jonathon P. writes. “The urologist is … more concerned with insurance information being correct as opposed to the patient’s well-being.”
Bakry is also listed as the owner of Cure Touch Rehab, which has a separate provider ID and is located at 2911 Surf Avenue in Brooklyn. (That address is also listed elsewhere as the home of Priority Care Rehab & Physical Therapy as well as Victor’s Occupational Therapy Solutions, which is owned by Victor Genkin.)
Cure Touch, meanwhile, is also registered with the New York Department of State, using what appears to be a residential address on Staten Island. Bakry’s licence to practice physical therapy, which is currently in good standing, is also registered to Staten Island.
A web of high payouts
Victor Genkin is one of several practioners who referred patients to Bakry while receiving high payouts themselves.
The highest Medicare biller among all occupational therapists, meanwhile, was Mayura Kanekar, who received more $US2.9 million in 2012 and was also a top referrer for Bakry. The average for occupational therapists in New York is $40,000 (nationwide, it’s even less: $US17,232).
Another top source of referrals for Bakry was Abraham Demoz, a doctor at Sunshine Medical who was among the top 25 Medicare billers in internal medicine. He received $2.6 million from Medicare in 2012, including more than $US1 million for 15,581 intravenous injections.
We reached out to Bakry, Genkin, Kanekar, and Demoz for comment and will update the post if we hear back.
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