Healthcare Fraud So Shocking You Won't Believe Me That It Happened

 

According to a criminal complaint filed by the U.S. Attorney for the Eastern District of Michigan, a Detroit doctor has been falsely diagnosing patients with cancer, just so he can give them chemotherapy and make money from doing that.

I am a whistleblower lawyer, and I had so much to do today that I had decided I would skip blogging today. But then I read about this case, and was so shocked and infuriated that I just had to write.

The accusation is so bizarre that I'll say it again. https://askcompetentlawyer.com/medicare-medicaid-fraud/ The Complaint says that Dr. Fata of Michigan diagnosed patients with cancer, even though they did not have cancer, because he decided he would like to make more money. Apparently he couldn't drum up enough cancer patients who needed chemotherapy, so he invented a few.

The Complaint is filed as a healthcare fraud indictment. The doctor is accused of defrauding Medicare because he billed for chemotherapy, PET scans and other cancer treatments for patients who did not have cancer. The Complaint talks about how much money the U.S. has lost to the fraud. I represent whistleblowers who file False Claims Act lawsuits, so I am curious as to whether a whistleblower told the Government about the fraud. I could not tell from the Complaint, but the Complaint did give the dates on which Dr. Fata's employees were interviewed, and I noted that one of Dr. Fata's employees was interviewed three days before the others. The Complaint gave less information about this employee than it did about the others.

The doctor also is accused of giving people more chemotherapy and more drugs than they needed - a lot more. For example, an oncologist who had worked with the doctor said that over a two-year period, Dr. Fata ordered 56 doses of Rituximab for a non-Hodgins lymphoma patient - even though the correct dosage would have been 12. The doctor also treated patients who had Idiopathic Thrombocytopenic Purpura (ITP). These patients were to be given Rituximab for 5-6 weeks before they had surgery to remove their spleens. Allegedly the drug was so profitable for Dr. Fata that he kept patients on it for years and never mentioned the surgery option.

For two patients, Dr. Fata allegedly ordered a "maintenance dose" of chemotherapy - even though the patients were in remission. Fortunately, the Complaint says these two patients sought second opinions.

The doctor also is accused of hiring three foreign doctors and letting them treat patients even though the foreign doctors were not licensed in the U.S.

Yes, Dr. Fata's actions would have defrauded Medicare and Medicaid. But can you imagine the agony that these patients and their families went through? The Complaint notes that the doctor generally did not tell patients they had been diagnosed with cancer, but he did falsify their records. It seems very likely that some of these patients "learned" that they had cancer when they talked to their insurance carriers or their other doctors.

And then the Government says that the doctor intentionally gave chemotherapy to the patients knowing they did not need it! These patients became desperately ill from chemotherapy - for nothing! I can imagine that a dad was so sick he couldn't travel to see his son's graduation from college. A mom couldn't snuggle her child to sleep at night because she was in the bathroom throwing up. Somebody lost a job because he or she didn't have the strength to go to work.

As a lawyer, I've generally got a lot to say, but words fail me here.

Yes, Dr. Fata made a large profit. According to the Complaint, his company billed Medicare $35 million in just two years, and $25 million of that was for Dr. Fata's services. But how can you even plumb the depths of the misery that this man must have caused, allegedly just to make more money?