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Pontiac General Hospital and doctor face lawsuit alleging fraud

Posted at 5:52 PM, Oct 01, 2018
and last updated 2018-10-02 08:31:57-04

Oakland County’s oldest hospital is now facing serious accusations of fraud in another legal battle playing out in federal court. For months, we’ve been telling you about issues being raised at Pontiac General Hospital. Now, one of their doctors is also under fire in part of a civil lawsuit. 

“It’s good. I’m building the business. We are doing the work and we’re bringing a lot of patients. I’m seeing patients and doing surgeries. Everything,” Dr. Muhammad Awaisi told 7 Action News in a recent interview, despite being accused of serious wrongdoing. 

Later, Awaisi would refuse to talk about why he lost his medical license, prior to working there. In fact, no one from Pontiac General Hospital has been willing to speak with us for months. A brief interview with Awaisi would prove to be the only exception. 

“I’ve seen the change in the last 2 1/2 years. This hospital was bankrupt three times. It’s out of bankruptcy and this is big progress itself” he said.

However, according to documents filed by Allstate Insurance against him, the hospital and others, there have committed serious abuses, forged fake medical records and conducted illegal schemes to bill for unnecessary services or services never performed. 

The civil lawsuit also labels the alleged schemes as part of a RICO conspiracy, a charge typically reserved for criminals prosecution. Yet, Awaisi says the hospital is making major improvements and providing quality care. 

“I’ve seen the growth coming up. It is a slow and steady process that has to be done. It cannot happen overnight,” says Awaisi.

Public records also show after graduating from medical school in Pakistan, Dr. Awaisi lost his medical license in Massachusetts in September 2008 after an investigation showed he improperly accessed other doctors' patient info and directed them to have unnecessary treatments at his own rehab clinic for profit. 

Former FBI Asst. Director Dan Roberts who spent years investigating health care fraud, and agreed to offer his insight, told us, “The first thing I thought of after 36 years in law enforcement is somebody needs to investigate that from a criminal perspective if there’s some fraud that’s been alleged.”

He added that hospitals have a duty to investigate doctors they hire. 

“That certainly is a red flag for someone to take a look at and do a deep dive into their background check. I would encourage that any patient do some due diligence and check up on their doctor before they go," Roberts said.

Documents also show the doctor's medical license was suspended in Michigan in November 2009 for using an expired pad to prescribe drugs. But he got his license back.

He now operates on patients at Pontiac General Hospital. Attorneys for Allstate declined to comment for our story. An attorney for Pontiac General has not returned our calls.

To file a complaint online about a hospital, click here