This story made me sick to my stomach when I posted it. That takes a lot considering my earlier career as a cop in New Orleans. A Detroit hematologist-oncologist was convicted for a Medicare fraud scam involving giving patients dangerous and medically unnecessary chemotherapy. Prosecutors say the man, Dr. Faid Fata of Oakland, Michigan, performed the treatments simply so he could bill Medicare and private insurance companies.
According to court records, Dr. Fata was able to submit $225 million of bills to medicare just 6 years before being caught. He also was billing private insurers as well.
Chemotherapy is both painful and often is accompanied by many complications. In addition to hair loss and severe nausea, chemo drugs can cause heart problems, anemia and even infections.
Most Medicare fraud cases involve billing for services never performed. Dr. Fata took his criminal activity to a new low by actually endangering the safety of his patients. The indictment says that in some cases, Dr. Fata performed chemo on patients that didn’t even have cancer. Thankfully, Dr. Fata pleaded guilty and this avoided having patients having to testify. When sentenced he faces 175 years in prison.
Law enforcement officials were quick to announce Fata’s conviction. Assistant Attorney General Leslie Caldwell said, “At a time when they are most vulnerable and fearful, cancer patients put their lives in the hands of doctors and endure risky treatments at their recommendation. Dr. Fata today admitted he put greed before the health and safety of his patients, putting them through unnecessary chemotherapy and other treatments just so that he could collect additional millions from Medicare. The mere thought of what he did is chilling. Thanks to the quick action of our partners, he was arrested and has now admitted his guilt.”
A copy of Fata Medicare Fraud Indictment can be read here.
Not only was Fata charged with Medicare fraud charges. IRS special agents also charged him with money laundering. In addition, he was charged with lying on immigration papers. More and more we see IRS special agents lending their financial expertise in complex white collar fraud cases.
Although nothing can minimize the horrendous nature of Fata’s crimes against his patients, adding IRS agents to the investigation is often necessary because of the sheer volume of paper and documents in Medicare fraud cases. A spokesperson from the IRS said in a prepared statement, “It’s exceptionally distressing to see this kind of fraud committed by individuals in occupations that profess high ethical standards.. When doctors commit fraud through their profession, it is not only a violation of the public trust but also a complete renunciation of their Hippocratic oath. Those who commit Medicare fraud are pick-pocketing from every American taxpayer.”
What many people do not realize is that many of these Medicare fraud cases start because of a whistleblower. We have seen many of these cases originate with a tip from a billing clerk, nurse or back office staff. These folks are the true heroes.
Under the federal False Claims Act, whistleblowers who report fraud involving a federally funded program such as Medicare can get paid up to 30% of whatever the government collects. (The average award is closer to 20%).
Calling a Medicare tip line won’t earn you a big award, however. To qualify under the False Claims Act you must file a lawsuit in federal court in the name of the government. The suit is sealed meaning it is a secret filing and generally remains sealed while the government investigates the case.
Think you have inside information and qualify as a whistleblower? Give us a call. We have represented people in several, billion cases. Not every case is worth that much, of course, but awards can be huge because prosecutors can claim triple and other enhanced damages.