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Healthcare Fraud Is Occurring State To State And “Head To Toe”

A few weeks ago, we blogged about the fact that medical malpractice occurs in every division of the medical field. This unfortunate reality is worsened by the fact that healthcare fraud also occurs within every discipline. And, as readers of the Allegiant Experts Blog are well aware, healthcare fraud is a problem all across America. The United States Department of Justice has certainly kept us abreast of that.

A couple of weeks ago, their Northern District of Georgia division reported that Dr. Oluwatoyin Solarin had been sentenced to one year and six months in federal prison for filing false claims with the Georgia Medicaid program. The Atlanta-based dentist defrauded the health insurance program of nearly $1 million. As part of her ruse, Solarin submitted bills for procedures that she claimed to have performed during times when she was actually out of the country.

Operating her dental care practice known as “Care Dental”, Solarin submitted false claims to both the Georgia Medicaid Program and the Peach State Health Plan of Georgia Medicaid between 2009 and 2013. Among those false claims where ones submitted for patients who were ineligible for Medicaid services. For patients whose Medicaid services were expired, Solarin would have her employees “backdate” the claims to false dates so that she could be reimbursed.

The money made by Solarin’s fraud scheme was put towards the purchases of real estate throughout the Atlanta area. However, as explained by U.S. Attorney John Horn, “the wealth she amassed through her scheme will now be forfeited and paid back to the government.” As part of her plea agreement, the disgraced dentist will repay the money and forfeit her interest in her many real estate properties.

The Georgia-based dentist was outdone by a Pennsylvania-based podiatrist, however. Early last month, The Department of Justice’s Eastern District of Pennsylvania branch reported that Stephen A. Monaco was sentenced to a whopping 97 months in prison for defrauding Medicare, Medicaid and private victim insurance companies. Operating “A Foot Above Podiatry” in Havertown, Monaco submitted fraudulent bills to Medicare totalling upwards of $5 million.

The bills represented podiatric procedures that Monaco never performed. As well, bills were submitted for procedures that weren’t even medically necessary. He even went so far as billing for medication that was supposedly requested by his patients even though the meds were unnecessary and potentially dangerous.

“Monaco provided ‘pill seeking’ patients with prescriptions for oxycodone, a dangerous and addictive opioid medication, in exchange for payments from health insurance providers,” reads the Department of Justice’s report, “Individuals seeking oxycodone from Monaco received painful injections in their toes and feet, for which Monaco submitted fraudulent claims to the patients’ insurance providers. Monaco administered these medically unnecessary injections to create the appearance of legitimacy for his prescription of opioids.”

Monaco will have three years of supervised release following the completion of his prison term. He is also required to pay restitution in the amount of $4,960,295 and forfeit any assets that are traceable to his offense.

From Georgia to Pennsylvania and from dentistry to podiatry – healthcare fraud really does occur from state to state and “head to toe”. At Allegiant Experts, we expose such healthcare fraud cases in our blog to highlight the fact that the taking advantage of our insurance programs is a major problem in America. Our team of clinical experts, therefore, is dedicated to assisting attorneys who try cases against perpetrators of such fraud.

For more information about our experience, expertise and how we may be able help your case, please don’t hesitate to call us at 407-217-5831 or email us at info@allegiantexperts.com.

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