Here are 10 lawsuits or investigations involving physicians, beginning with the most recent.
1. Miami HIV Clinic Physician Convicted for $23M Medicare Scheme
Miami-area physician Rene De Los Rios, MD, has been convicted for his role in a $23 million HIV injection and infusion Medicare fraud scheme. Dr. De Los Rios practiced at Metro Med, which operated as an HIV infusion clinic for HIV-positive Medicare beneficiaries. From approximately April 2003 through Oct. 2005, Metro Med submitted nearly $23 million in claims to the Medicare program for injection and infusion treatments for Medicare beneficiaries that were not medically necessary and were not provided.
2. Connecticut Physician Charged With Hedge Fund Fraud
Joseph "Chip" Skowron III, MD, of Greenwich, Conn., was charged with conspiracy to commit securities fraud and conspiracy to obstruct justice in a criminal complaint unsealed in U.S. District Court in Manhattan. Dr. Skowron, a healthcare hedge fund portfolio manager, allegedly evaded $30 million in losses for his funds by paying a French physician for secrets on the progress of a liver disease drug. The secrets allowed Dr. Skowron to sell all his hedge fund's shares before the stock dropped following public announcements.
3. Ohio Physician Sues After State Decertifies Him
James E. Lundeen Sr., MD, a physician with offices in Plymouth and Portsmouth, Ohio, filed suit over the state's decision to decertify him following an investigation for workers' compensation fraud. Last month, investigators from the Bureau of Workers' Compensation and other state agencies investigated Dr. Lundeen's offices in connection with an ongoing probe. Two days after the raids, BWC decertified him but no charges have been filed.
4. 22-Count Indictment Accuses Texas Oral Surgeon of Conspiracy, Medicaid Fraud
A federal indictment has accused oral surgeon Gary Morgan Schwarz, DDS, of McAllen, Texas, of bilking Medicaid more than $4 million by billing certain dental procedures under more expensive medical procedure classes. The 22-count federal indictment alleges Dr. Schwarz billed the government for procedures, like sedating patients, which were performed by unqualified dental assistants in settings in which he was not licensed to operate.
5. Chicago Surgery Centers Searched, Surgeons Subpoenaed in Probe of ASC Owner, Political Fund-Raiser
Two Chicago surgery centers were served with search warrants and a federal grand jury has subpoenaed at least 30 Chicago-area physicians as part of an investigation into whether an ASC owner made improper payments to physicians to solicit them to perform procedures at his surgery centers. Raghuveer Nayak is accused of paying physicians hundreds of dollars for each surgery they brought to his ASCs in Illinois and Indiana. Many of physicians subpoenaed as part of the investigation have been offered or granted immunity for their testimony. Immunity would protect physicians who admit wrongdoing from criminal prosecution, but their medical licenses could still be at risk.
6. New York City Physician Sentenced to Prison For Involvement in Car Crash Clinic Scheme
Aron Goldman, MD, of New York City was sentenced to serve between 2.5 and 7.5 years in prison and pay $800,000 in fines for his participation in a no-fault insurance fraud ring where he and other providers would stage car accidents, deliver unnecessary care and submit false claims to insurance companies through an enterprise known as St. Nicholas Group, based in Manhattan.
7. Mississippi Family Practitioner Convicted of Bilking $6.9M From Medicaid, Medicare
Family practitioner Cassandra Faye Thomas, MD, of Jackson, Miss., was convicted of organizing a scheme that bilked $6.9 million in fraudulent Medicaid and Medicare claims. Dr. Thomas, the former owner of now-closed Central Mississippi Physical Medicine in Yazoo City and Flora, billed Medicaid and Medicare for in-home therapy sessions from 2002 to 2004 and was paid approximately $6.9 million in reimbursements.
8. New Jersey Oncologist Accused of Selling Prescriptions to Medicaid Patients From His Car
Hematologist and oncologist Ki I. Song, MD, of Matawan, N.J., has been accused of selling fraudulent drug prescriptions to Medicaid patients in a restaurant parking lot, receiving large sums of cash in exchange. The allegedly fraudulent prescriptions were for narcotics, including Percocet and Xanax, and were not medically necessary. Dr. Song would allegedly accept $100 in cash for each prescription, which were distributed without patient history or examination.
9. Physician to Serve 34 Months in Prison for Operating Philadelphia "Pill Mill"
Christopher Vassalluzzo, MD, pleaded guilty to operating a Philadelphia "pill mill" that distributed millions of prescription diet drugs. Dr. Vassalluzzo pleaded guilty to conspiracy to distribute controlled substances, mail fraud and tax evasion. He will serve 34 months in prison and forfeit $5.2 million along with valuable possessions.
10. Georgia Internist Charged With 21 Counts of Medicare, Tax Fraud
Internist Lawrence Eppelbaum, MD, of Roswell, Ga., has been indicted on charges healthcare fraud and tax fraud. Dr. Eppelbaum, owner and operator of the Atlanta Institute of Medicine and Rehabilitation and the Pain Clinic of AIMR in Atlanta, allegedly created a purported charitable organization called the Back Pain Fund in 2004. The fund was never incorporated as a charitable tax-exempt entity. Rather, it was allegedly used as a vehicle for Medicare fraud. Between 2004 and 2009, Dr. Eppelbaum billed Medicare approximately $15 million for the treatment of Back Pain Fund patients.
Read more coverage of physicians involved in lawsuits:
- 10 Physicians Accused or Convicted of Fraud
1. Miami HIV Clinic Physician Convicted for $23M Medicare Scheme
Miami-area physician Rene De Los Rios, MD, has been convicted for his role in a $23 million HIV injection and infusion Medicare fraud scheme. Dr. De Los Rios practiced at Metro Med, which operated as an HIV infusion clinic for HIV-positive Medicare beneficiaries. From approximately April 2003 through Oct. 2005, Metro Med submitted nearly $23 million in claims to the Medicare program for injection and infusion treatments for Medicare beneficiaries that were not medically necessary and were not provided.
2. Connecticut Physician Charged With Hedge Fund Fraud
Joseph "Chip" Skowron III, MD, of Greenwich, Conn., was charged with conspiracy to commit securities fraud and conspiracy to obstruct justice in a criminal complaint unsealed in U.S. District Court in Manhattan. Dr. Skowron, a healthcare hedge fund portfolio manager, allegedly evaded $30 million in losses for his funds by paying a French physician for secrets on the progress of a liver disease drug. The secrets allowed Dr. Skowron to sell all his hedge fund's shares before the stock dropped following public announcements.
3. Ohio Physician Sues After State Decertifies Him
James E. Lundeen Sr., MD, a physician with offices in Plymouth and Portsmouth, Ohio, filed suit over the state's decision to decertify him following an investigation for workers' compensation fraud. Last month, investigators from the Bureau of Workers' Compensation and other state agencies investigated Dr. Lundeen's offices in connection with an ongoing probe. Two days after the raids, BWC decertified him but no charges have been filed.
4. 22-Count Indictment Accuses Texas Oral Surgeon of Conspiracy, Medicaid Fraud
A federal indictment has accused oral surgeon Gary Morgan Schwarz, DDS, of McAllen, Texas, of bilking Medicaid more than $4 million by billing certain dental procedures under more expensive medical procedure classes. The 22-count federal indictment alleges Dr. Schwarz billed the government for procedures, like sedating patients, which were performed by unqualified dental assistants in settings in which he was not licensed to operate.
5. Chicago Surgery Centers Searched, Surgeons Subpoenaed in Probe of ASC Owner, Political Fund-Raiser
Two Chicago surgery centers were served with search warrants and a federal grand jury has subpoenaed at least 30 Chicago-area physicians as part of an investigation into whether an ASC owner made improper payments to physicians to solicit them to perform procedures at his surgery centers. Raghuveer Nayak is accused of paying physicians hundreds of dollars for each surgery they brought to his ASCs in Illinois and Indiana. Many of physicians subpoenaed as part of the investigation have been offered or granted immunity for their testimony. Immunity would protect physicians who admit wrongdoing from criminal prosecution, but their medical licenses could still be at risk.
6. New York City Physician Sentenced to Prison For Involvement in Car Crash Clinic Scheme
Aron Goldman, MD, of New York City was sentenced to serve between 2.5 and 7.5 years in prison and pay $800,000 in fines for his participation in a no-fault insurance fraud ring where he and other providers would stage car accidents, deliver unnecessary care and submit false claims to insurance companies through an enterprise known as St. Nicholas Group, based in Manhattan.
7. Mississippi Family Practitioner Convicted of Bilking $6.9M From Medicaid, Medicare
Family practitioner Cassandra Faye Thomas, MD, of Jackson, Miss., was convicted of organizing a scheme that bilked $6.9 million in fraudulent Medicaid and Medicare claims. Dr. Thomas, the former owner of now-closed Central Mississippi Physical Medicine in Yazoo City and Flora, billed Medicaid and Medicare for in-home therapy sessions from 2002 to 2004 and was paid approximately $6.9 million in reimbursements.
8. New Jersey Oncologist Accused of Selling Prescriptions to Medicaid Patients From His Car
Hematologist and oncologist Ki I. Song, MD, of Matawan, N.J., has been accused of selling fraudulent drug prescriptions to Medicaid patients in a restaurant parking lot, receiving large sums of cash in exchange. The allegedly fraudulent prescriptions were for narcotics, including Percocet and Xanax, and were not medically necessary. Dr. Song would allegedly accept $100 in cash for each prescription, which were distributed without patient history or examination.
9. Physician to Serve 34 Months in Prison for Operating Philadelphia "Pill Mill"
Christopher Vassalluzzo, MD, pleaded guilty to operating a Philadelphia "pill mill" that distributed millions of prescription diet drugs. Dr. Vassalluzzo pleaded guilty to conspiracy to distribute controlled substances, mail fraud and tax evasion. He will serve 34 months in prison and forfeit $5.2 million along with valuable possessions.
10. Georgia Internist Charged With 21 Counts of Medicare, Tax Fraud
Internist Lawrence Eppelbaum, MD, of Roswell, Ga., has been indicted on charges healthcare fraud and tax fraud. Dr. Eppelbaum, owner and operator of the Atlanta Institute of Medicine and Rehabilitation and the Pain Clinic of AIMR in Atlanta, allegedly created a purported charitable organization called the Back Pain Fund in 2004. The fund was never incorporated as a charitable tax-exempt entity. Rather, it was allegedly used as a vehicle for Medicare fraud. Between 2004 and 2009, Dr. Eppelbaum billed Medicare approximately $15 million for the treatment of Back Pain Fund patients.
Read more coverage of physicians involved in lawsuits:
- 10 Physicians Accused or Convicted of Fraud