The three biggest fraud cases involving ASCs so far this year amounted to $29,180,000 altogether.
Here are the top three, listed in order by dollar amount:
1. Two Italians and five Americans were charged in a fraud and drug trafficking conspiracy to distribute opioids in Tennessee and Florida "pill mills." The alleged conspirators ran the Knoxville, Tenn.-based Urgent Care & Surgery Center Enterprise, which operated opioid based pain management clinics that led to the death of approximately 700 patients. The superseding indictment alleges the defendants distributed oxycodone, oxymorphone and morphine in sufficient quantities to generate clinic revenue of at least $21 million.
2. Babar Iqbal, MD, who heads Riverside (Calif.) Regional Surgery Center, and three others were arrested March 8 on felony charges alleging they were involved in an $8 million healthcare fraud scheme. The co-conspirators allegedly devised a scheme to bill insurance for care given under false pretenses.
3. Sanjoy Banerjee, MD, a pain physician in Corona, Calif., was charged with workers compensation insurance fraud and perjury. Dr. Banerjee allegedly billed for urine toxicology testing as well as epidural injections through an ASC and lab he owned for workers' compensation cases. He allegedly billed for $180,000 worth of services, although self-referral is illegal in California. He pled not guilty in July.