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Psychiatrist found guilty in $110 million fraud scheme


 

N.J. doc charged on 34 counts of illegally prescribing controlled substances

A N.J. orthopedic surgeon has been charged with 34 counts of illegally prescribing controlled substances.

According to documents filed in the case, from November 2016 to February 2018 Evangelos Megariotis, MD, 68, of Passaic County, N.J., prescribed opiates — including oxycodone, alprazolam (Xanax), and cough syrup with codeine — as well as stimulants without a legitimate medical purpose and outside the usual course of his practice.

Before the State of New Jersey permanently banned him from practicing medicine, Dr. Megariotis owned and operated Clifton Orthopedic Associates, in Clifton, N.J.

According to The Bergin Record, the state alleges that Dr. Megariotis prescribed thousands of doses of painkillers even though he knew his patients were abusing them and in some cases were getting similar drugs from other doctors. In addition, Dr. Megariotis failed to diagnose or treat these patients’ underlying conditions, treated illnesses outside his scope of practice, and performed surgery in the absence of medical need.

If convicted, Dr. Megariotis could face a lengthy prison sentence as well as substantial fines. The counts of illegally prescribing Schedule II opioids and stimulants are punishable by a maximum of 20 years in prison and a $1 million fine. Illegally prescribing Schedule IV controlled substances brings a maximum of 5 years in prison and a $250,000 fine. The counts of illegally prescribing cough syrup with codeine, a Schedule V controlled substance, are punishable by a maximum of 1 year in prison and a $100,000 fine.

Michigan surgeon pleads guilty to fraud scheme

A Bay City, Mich., vascular surgeon has pleaded guilty to engaging in a scheme to defraud Medicare, Medicaid, and Blue Cross/Blue Shield of Michigan out of approximately $19.5 million

According to the plea agreement, in 2009, Vasso Godiali, MD, 59, began false and fraudulent billing to the three insurers. False claims included billing for the placement of stents in dialysis patients and for the treatment of arterial blood clots. The surgeon admitted to billing for the placement of multiple stents in the same vessel and preparing medical records to support the necessity of placing those stents. However, he never placed the stents.

In the plea document, Dr. Godiali also admitted that his medical records would describe occluded arteries that would justify arterial thrombectomies. However, in many cases, there were no occluded arteries, and no thrombectomies were performed, even though Dr. Godiali billed insurers for them.

“When Dr Godiali submitted claims for medical services that were never provided, he violated the trust of his patients and defrauded taxpayer-funded health care programs,” Mario M. Pinto, special agent in charge, said in a statement announcing the plea.

In 2014, The Bay City Times interviewed Dr. Godiali after he was featured by USA Today as one of seven physicians in the United States to receive more than $10 million for Medicare reimbursements in 2012. He told The Times he was a workaholic. “I work a lot — I work probably more than surgeons that you meet,” he told the paper.

Dr. Godiali faces up to 10 years in prison. In addition, he will be required to pay $19.5 million in restitution to the three insurers. A civil forfeiture case against approximately $39.9 million seized from accounts controlled by Dr. Godiali is pending. Sentencing is scheduled for September 15.

A version of this article first appeared on Medscape.com.

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