Dentist

Three Health Care Fraud Cases That Will Make You Cringe

It’s a given: all health care fraud and abuse is bad. But some health care fraud is beyond bad and gets your blood boiling. These cringe-worthy health care fraud cases often involve a greedy, reckless and corrupt doctor that puts patients at risk simply because he or she wants to bill the government for more money by providing medically unnecessary care. Sadly, patients are being harmed in the name of greed.

Below are three health care fraud stories that are sure to raise your blood pressure:

Florida Dentist Needlessly Pulls Children’s Teeth to Bilk Money From Medicaid

If the title didn’t get you upset, just give it a second…this one gets a whole lot worse. Earlier this week (Sept. 1), Dr. Howard Schneider of Jacksonville, Florida was served with over 50 notices of intent to sue by patients who accuse the 78-year-old dentist of performing unnecessary tooth extractions, many of which were performed on children. Worse yet, the dentist reportedly preyed on poor families.

Medicaid paid Schneider for extraction procedures on a “per tooth” basis. The dentist allegedly took this to the extreme by needlessly performing these extractions again and again on children and adults alike.

An investigation into the alleged fraud began shortly after Brandi Mosley posted pictures of her six-year-old daughter on Facebook after the little girl underwent dental surgery in May at Schneider’s practice. He removed seven of the little girl’s teeth. You read that right…seven teeth removed at one time from the mouth of a six-year-old.

Now, you might think that surely there has to be an explanation for this. According to Mosley, Schneider’s nurse told her before the extraction that kids typically behave better during the procedure if parents leave the room. ‘We don’t like parents back here for the procedures,’ Mosley was told.

When the procedure was over, the nurse told Mosley that her young daughter had been involved in an ‘incident.’ She took the gauze out of her daughter’s mouth and saw just how many teeth were missing.

Once other people got wind of Mosley’s story, protestors began to rally outside of Dr. Schneider’s Jacksonville practice for weeks. Finally, the Florida Attorney General’s Office decided to open a case against the dentist, alleging that he has been committing health care fraud for many years.

Over the last five years, Dr. Schneider has received roughly $4 million in Medicaid payments for his handiwork. According to Raw Story, Schneider maintains that he is innocent, though the evidence at present speaks to the contrary.

Detroit Doctor Gets 45 Years in Prison For Treating Cancer Patients With Needless Chemotherapy

This isn’t the first time that Dr. Farid Fata has been discussed in this blog. His story caught the public’s attention when the media reported that he had received over $17 million from bogus health care billings while running his Oakland, Michigan-based oncology practice. But nothing could have prepared us for the stories some of his patients would tell at Fata’s sentencing hearing.

One patient, Robert Sobieray, said he came to see Dr. Fata because he was experiencing lower back pain. After examining Sobieray and administering a series of tests, the doctor told him that he had metastatic bone cancer. The patient was given a chemotherapy drug called Zometa and radiation treatment. But tests showed that Sobieray didn’t actually have cancer, and now Zometa has a serious side effect of bone death, specifically in the jaw.

It’s pretty easy to feel sick about this case and even worse because the Michigan doctor had over 500 other victims.

Dr. David Steensma, an associate professor at Harvard Medical School, as well as a cancer physician at Dana-Farber Cancer Institute in Boston, provided expert testimony for the prosecution. Dr. Steensma reviewed the medical records of over 100 of Fata’s patients. In them, he found 2,770 incidents of unnecessary chemotherapy along with hundreds of other dangerous treatments. He told the court that he’d never seen anything like this before.

Steensma told the court that five of Dr. Fata’s patients were treated unnecessarily with Velcade, a drug with the dangerous side effect of permanent peripheral neuropathy—numbness and/or pain in the hands or feet. Dr. Fata reportedly told one of his patients who were experiencing numbness that moving their feet and toes would make the numbness better.

“I think he’s guilty of the most cruel thing a human being can do to another human being,” said Dr. Soe Maunglay, who was actually the person that exposed Dr. Fata’s highly-questionable practice. Maunglay brought the practice to the attention of a superior and Fata was arrested days later.

In the end, Fata was sentenced to 45 years in prison for health care fraud (among other crimes), which some of his patients felt simply wasn’t enough. The federal prosecutor on the case asked for 175 years.

Kentucky Hospital Settles Whistleblower Lawsuit Claiming Doctors Cracked Chests in Unnecessary Heart Surgeries

That case also sounds unbelievably painful and shocking. Chests cracked unnecessarily.

Sadly, this story from 2014 is all too true. Saint Joseph Health System of Louisville, Kentucky agreed to pay state and federal governments $16.5 million to settle health care fraud allegations claiming it paid kickbacks to cardiologists for patient referrals for unnecessary chest-cracking bypass surgeries and other procedures.

According to the whistleblower lawsuit originally filed in 2011, three cardiologists falsified medical records in order to justify sending patients to Saint Joseph facilities for bypass surgeries and stent procedures. The cardiologists—Satyabrata Chatterjee, Ashwini Anand, and Sandesh Patil—allegedly received kickbacks via medical companies and partnerships. None of the aforementioned doctors was a party in this particular health care fraud settlement, though a spokesperson for the U.S. Attorney’s Office in Kentucky said other defendants in the case are still the subject of investigation.

Bloomberg Business reported that at least eight unnecessary bypass surgeries were conducted. In these procedures, a patient’s rib cage is forcibly cracked open, which often results in a very lengthy recovery process.

The three whistleblowers—cardiologists Paula Hollingsworth, Michael Jones and Michael Rukavina—came to learn about the alleged Saint Joseph fraud after treating several patients who had been the victims of these unnecessary procedures. They ended up sharing a whistleblower reward of $2.5 million.

Aside from the whistleblower settlement, Saint Joseph remains in the process of defending around 250 civil health care fraud cases filed by patients claiming to have had unnecessary stents or other cardiac procedures. Many of the patients in these cases name Anand, Chatterjee or Patil as defendants.

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