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September 18, 2014

Doctor admits to 'deplorable' fraud scheme involving fake cancer diagnoses

Daily Briefing

    A Michigan doctor has pleaded guilty to a fraud scheme that involved telling people who did not have cancer that they had the disease and giving them unnecessary chemotherapy, the Department of Justice (DOJ) announced on Tuesday.

    Farid Fata, founder of the Rochester Hill-based Michigan Hematology Centers, was charged with 29 counts of health care fraud, conspiracy, and other crimes. He pleaded guilty to 13 counts of health care fraud, two counts of money laundering, and one count of conspiracy to pay and receive kickbacks.

    "Dr. Fata's utter disregard for his patients' welfare was quite simply deplorable," says Special Agent in Charge Lamont Pugh of the HHS's Office of Inspector General.

    Background on the case

    In August 2013, Fata was charged with health care fraud as part of a Medicare fraud scheme that was worth as much as $35 million. In one case, prosecutors say that his actions may have contributed to a patient's death.

    Specifically, Fata was accused of submitting fraudulent claims for chemotherapy treatments, PET scans, and several cancer and hematology treatments on behalf of cancer patients who did not require them.

    Over a two-year period, Fata oversaw about $35 million in Medicare billings, and prosecutors allege that he falsified documents and ordered others to do the same. Fata was personally responsible for about $25 million of the Medicare claims submitted by the centers. According to FBI agent Brian Fairweather, that's "more than any hematologist/oncologist in the state of Michigan during that time period."

    Arrests, sanctions didn't stop doctors from getting Medicare dollars

    To justify the false claims, the FBI alleges that Fata misdiagnosed patients with cancer to justify cancer treatment, administered chemo to patients who had gone into remission, and ordered chemo for end-of-life patients who would not benefit from the drugs.

    Authorities also contend that Fata required patients who had other serious medical conditions that required immediate medical treatment to receive their chemotherapy before going to the hospital. In one case, a patient fell and hit his head, but Fata allegedly pushed him to receive his chemotherapy treatment before leaving for the hospital. The patient subsequently died from the head injury.

    How one nurse tried to stop him

    Chemotherapy nurse Angela Swantek interviewed for a job at Fata's oncology center in 2010 when she saw patients receiving chemotherapy in an incorrect manner.

    "I left after an hour and half. I thought this is insane," she told the Detroit Free Press, adding that she wrote a letter immediately to state authorities to investigate Fata. The state notified her in 2011 that Fata was committing no wrongdoing.

    "I handed them Dr. Fata on a platter in 2010 and they did absolutely nothing," Swantek says. She adds that she was elated when she heard that the federal government had finally charged him in 2013.

    Commenting on Fata's plea, she says, "I'm not surprised though; I wondered how his team was going to defend him. The charts don't lie."

    Which states are toughest on doctors?

    Sentencing ahead

    Delivering his guilty plea in court, Fata admitted, "It is my choice. I knew that it was medically unnecessary."

    He is scheduled to be sentenced in February, and U.S. Attorney Barbara McQuade told the Free Press she plans to seek life in prison for him.

    McQuade says, "The idea that a doctor would lie to a patient just to make money is shocking ... Dr. Fata was unique in that he saw patients not as people to heal, but as commodities to exploit." McQuade has called the scheme "the most egregious" one that her office has investigated (Baldas, Detroit Free Press, 9/17; AP/Crain's Detroit Business, 9/16; AlHajal, Michigan Live, 9/16; DOJ release, 9/16).

    Make sense of the changing fraud and abuse landscape

    The Obama Administration has taken several steps to intensify its enforcement activities, including recent amendments to the False Claims Act and unprecedented coordination between the Department of Justice and the Department of Health and Human Services.

    In this webconference, we help you make sense of the changing fraud and abuse landscape.

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