It’s almost as if there is some sort of underground ring of physicians and other medical professionals who are in competition with each other for pulling off the biggest health care fraud schemes possible. The crazy idea isn’t so far-fetched when you consider the litany of charges being levied on fraudsters from the medical profession all over this country. Not to mention, some members of this “ring” really seem to want to win it all.
If there were such an unscrupulous organization, we imagine that Dr. Vasso G. Godiali of Bay City, Michigan would be a front runner for title of “top fraudster”. As reported by the Eastern District of Michigan branch of the United States Department of Justice this week, the 56 year-old has been charged in connection with his orchestration of a $60 million health care fraud scheme.
Godiali is also being charged with laundering more than $49 million.
According to the DoJ, the indictment states that “Godiali submitted false and fraudulent claims for the placement of stents in dialysis patients and for the treatment of arterial blood clots. The indictment further alleges that Godiali exploited medical billing software to improperly maximize payments from Medicare, Medicaid, and Blue Cross Blue Shield of Michigan”.
In addition, he submitted false and fraudulent claims to said insurance programs for services that were not rendered. The vascular surgeon also “unbundled” claims by falsely claiming he was performing many separate and distinct procedures. In actuality, Godiali was only entitled to a single reimbursement for a single procedure.
Godiali faces up to 30 years in prison.
Covering this story on Mlive.com, Cole Waterman reveals that money laundering is a 20-year felony and fraud is punishable by up to 10 years in prison. He also offers further details about the indictment which reveals that from 2009 to 2015, Godiali defrauded Medicare, Medicaid and Blue Cross Blue Shield of Michigan by making numerous claims of placing vascular stents in his patients.
“In 2009, Medicare paid the doctor $73,896 for placing 41 vascular stents, the indictment states,” writes Waterman, “In subsequent years, Godiali increased the number of stents for which he was paid by Medicare. In 2013, he reported having placed 250 stents and received $792,789 from Medicare; the following year, he reported having placed 245 stents and received $713,356.11, the indictment reads.”
Godiali seemed to get greedier over time.
Over the course of the following years, Godiali continued to raise the number of patients on whom he claimed to perform procedures. In 2014, for example, the surgeon reported that he performed no less than 815 blood-clot-removal procedures (known as “mechanical thrombectomies”). For these alleged procedures, Godiali was paid more than $1.1 million by Medicare.
To launder the money he was earning through his fraudulent billings, Godiali also used six different corporations. Laundering approximately $49 million, the doctor both funded investment accounts at multiple financial institutions and paid property taxes on a Houghton Lake residence. Godiali’s next court date is pending.
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