Shutting Down The U.S.’s Most Notorious Medicare Fraud Rip-off

Previous to the invention of his medical malfeasance, Fata was considered an skilled hematologist/oncologist, or physician that treats most cancers. In 2003, the physician opened his personal apply, Michigan Hematology-Oncology (MHO). He shortly grew to become referred to as a number one most cancers specialist in Detroit, and his apply grew by an extra six places over the next years.

Fata’s apply included a radiation therapy facility, pharmacy, and laboratory, so nearly all of testing was accomplished in-house. The physician additionally employed a therapy approach that he known as “European protocol.” This protocol was an aggressive most cancers therapy that used chemotherapy medicine at a better price than different, extra conservative, therapy plans.

Mere years after Fata opened his apply in 2003, important issues about his therapy strategies and outcomes surfaced. One of many physician’s sufferers, Maggie Dorsey, sued him for medical malpractice in 2007 when she found that she didn’t have most cancers. Fata recognized Dorsey with most cancers in 2004, following up with seven months of pointless chemotherapy that made it tough for her to stroll. Sadly, the case was settled out of court docket in 2009, with no public acknowledgment of Fata’s important error.

A yr later, an oncology nurse named Angela Swantek interviewed for a job inside Fata’s apply. Swantek was an skilled nurse who had labored in most of the area’s most prestigious most cancers therapy services. As a part of the interview course of, she was allowed to shadow a nurse at Fata’s workplace. She seen a number of egregious breaches of most cancers therapy protocols, reminiscent of:

• A drug usually administered as an injection supplied through an IV drip over the course of an hour
• Sufferers receiving the drug Neulasta on the identical day as chemotherapy remedies, regardless of protocol being a 24-hour separation between the 2,

Swantek was horrified by what she witnessed at Fata’s apply, stating that he was “doing his sufferers extra hurt than good.” She left the apply earlier than the tip of his scheduled go to in disgust and filed an official grievance in opposition to the clinic with state regulators. A yr after she filed her case in 2010, the state investigation was closed with none motion taken.

In 2013, Fata made two crucial errors that might deliver his scheme crashing down round him. His first error was in diagnosing Monica Flagg with a number of myeloma. This type of most cancers requires a lifetime of remedies for the affected person to have an opportunity of survival — with the physician billing the affected person’s insurance coverage firm for each chemotherapy season supplied. Hours after present process her first prescribed spherical of chemotherapy, Flagg broke her leg in an unrelated accident.

Flagg was seen by a doctor at MHO after struggling an accident. Fata, critically, was in a foreign country in Lebanon on the time. Flagg’s treating doctor, Soe Maunglay, reviewed her medical report and was shocked to find that she was completely wholesome, minus her damaged leg. Over the next day, Maunglay continued to look into Flagg’s medical information and, after discovering nothing to point she required chemotherapy remedies, warned her to gather her medical information and see one other physician.

Maunglay had already determined to resign from Fata’s clinic however realized that he couldn’t transfer on with out investigating additional. The younger physician’s father had died of most cancers, and he was decided that nobody else ought to endure pointless hurt as a consequence of an intentional misdiagnosis. He found extra indicators of medical malpractice:

• Non-Hodgkin’s lymphoma was commonly handled with rituximab, a focused most cancers drug
• Intravenous immunoglobulins (IVIG) had been prescribed commonly with none obvious medical reasoning

Maunglay consulted with a nurse practitioner and an infusion nurse at Fata’s apply, convincing them to intervene and name for Fata to cut back his use of IVIG remedies. When Fata agreed, Maunglay was additional satisfied that Fata was deliberately disregarding medical procedures, as a physician who was assured in his strategies wouldn’t abruptly change them.

Neither the lawsuit in opposition to Fata in 2007 nor the state investigation of his apply in 2010 resulted in no sanctions in opposition to the unethical physician. Nonetheless, in late 2013, Fata’s scheme was lastly about to unravel. Maunglay met with George Karadsheh, the apply supervisor at MHO. Karadsheh had been rising suspicious over the variety of physicians abruptly leaving the apply and proved greater than prepared to take heed to Maunglay’s issues. Karadsheh had beforehand discovered fraud at Detroit’s Lafayette Clinic and reported it beneath the False Claims Act, a authorities anti-fraud legislation.

As soon as once more, Karadsheh filed a False Claims Act case, bringing forth issues about Fata’s unethical therapy. Brokers from the federal Division of Well being and Human Providers and the Federal Bureau of Investigation (FBI) visited Maunglay’s residence only a few days after Karadsheh spoke with the FBI on August 2, 2013. They took notes on the proof he had gathered at Fata’s apply. Lower than 24 hours later, Fata’s apply was swarmed by federal brokers, and the physician was arrested.

With irrefutable proof of Fata’s wrongdoing, the physician knew that he had no protection in opposition to the intense prices he was going through. The utmost punishment for his actions was a 175-year jail sentence, with a excessive probability of being deported to his native nation of Lebanon within the unlikely occasion he was launched early. Deportation was a doable situation of Fata’s punishment because the physician acquired naturalization whereas concealing proof of unlawful actions.

Fata selected to plead responsible to 1 depend of conspiracy to pay and obtain kickbacks, two counts of cash laundering, and 13 counts of well being care fraud. In return for his responsible plea, prices referring to Fata’s immigration standing had been dropped. U.S. Legal professional Barbara McQuade nonetheless sought the best doable penalty for his actions, calling him “probably the most egregious fraudster within the historical past of this nation.” Fata ended up being sentenced to 45 years in jail, which angered lots of his former sufferers, who considered the sentence as inadequate.

On the finish of the day, Fata was efficiently stopped and prosecuted due to the bravery and willingness of his former staff to face as much as him and do what was proper. Had Karadsheh not elected to file a False Claims Act when he did, it might have been many extra years earlier than Fata was caught, if he was ever found. Fortunately, he was caught and stopped from harming sufferers ever once more.