HomeHealthShutting Down The U.S.’s Most Infamous Medicare Fraud Scam

Shutting Down The U.S.’s Most Infamous Medicare Fraud Scam

Many people have likely never heard of Farid Fata in their life, but there was a time when the former doctor’s name was trending for all the wrong reasons. Dr. Fata is a former hematologist/oncologist who masterminded one of the largest instances of healthcare fraud in United States history. In this article, we discuss Fata’s long-running scheme, how he was eventually caught, and the role that whistleblowers played in his downfall.

What Was Dr. Fata Known For?

Prior to the discovery of his medical malfeasance, Fata was regarded as an experienced hematologist/oncologist, or doctor that treats cancer. In 2003, the doctor opened his own practice, Michigan Hematology-Oncology (MHO). He quickly became known as a leading cancer specialist in Detroit, and his practice grew by an additional six locations over the following years.

Fata’s practice included a radiation treatment facility, pharmacy, and laboratory, so the majority of testing was done in-house. The doctor also employed a treatment technique that he called “European protocol.” This protocol was an aggressive cancer treatment that used chemotherapy drugs at a higher rate than other, more conservative, treatment plans.

Early Misgivings Regarding Fata’s Practice

Mere years after Fata opened his practice in 2003, significant concerns about his treatment methods and results surfaced. One of the doctor’s patients, Maggie Dorsey, sued him for medical malpractice in 2007 when she discovered that she did not have cancer. Fata diagnosed Dorsey with cancer in 2004, following up with seven months of unnecessary chemotherapy that made it difficult for her to walk. Unfortunately, the case was settled out of court in 2009, with no public acknowledgment of Fata’s significant error.

A year later, an oncology nurse named Angela Swantek interviewed for a job within Fata’s practice. Swantek was an experienced nurse who had worked in many of the region’s most prestigious cancer treatment facilities. As part of the interview process, she was allowed to shadow a nurse at Fata’s office. She noticed several egregious breaches of cancer treatment protocols, such as:

  • A drug normally administered as an injection provided via an IV drip over the course of an hour
  • Patients receiving the drug Neulasta on the same day as chemotherapy treatments, despite protocol being a 24-hour separation between the two,

Swantek was horrified by what she witnessed at Fata’s practice, stating that he was “doing his patients more harm than good.” She left the practice before the end of his scheduled visit in disgust and filed an official complaint against the clinic with state regulators. A year after she filed her case in 2010, the state investigation was closed without any action taken.

A Poorly-Timed Vacation Exposes Fata’s Scheme

In 2013, Fata made two critical mistakes that would bring his scheme crashing down around him. His first error was in diagnosing Monica Flagg with multiple myeloma. This form of cancer requires a lifetime of treatments for the patient to have a chance of survival — with the doctor billing the patient’s insurance company for every chemotherapy season provided. Hours after undergoing her first prescribed round of chemotherapy, Flagg broke her leg in an unrelated accident.

Flagg was seen by a physician at MHO after suffering an accident. Fata, critically, was out of the country in Lebanon at the time. Flagg’s treating physician, Soe Maunglay, reviewed her medical record and was shocked to discover that she was perfectly healthy, minus her broken leg. Over the following day, Maunglay continued to look into Flagg’s medical records and, after discovering nothing to indicate she required chemotherapy treatments, warned her to collect her medical records and see another doctor.

Maunglay had already decided to resign from Fata’s clinic but realized that he couldn’t move on without investigating further. The young doctor’s father had died of cancer, and he was determined that no one else should suffer unnecessary harm due to an intentional misdiagnosis. He discovered additional signs of medical malpractice:

  • Non-Hodgkin’s lymphoma was regularly treated with rituximab, a targeted cancer drug
  • Intravenous immunoglobulins (IVIG) were prescribed regularly without any apparent medical reasoning

Maunglay consulted with a nurse practitioner and an infusion nurse at Fata’s practice, convincing them to intervene and call for Fata to reduce his use of IVIG treatments. When Fata agreed, Maunglay was further convinced that Fata was intentionally disregarding medical procedures, as a doctor who was confident in his methods would not abruptly change them.

Justice Served Through the False Claims Act

Neither the lawsuit against Fata in 2007 nor the state investigation of his practice in 2010 resulted in no sanctions against the unethical doctor. However, in late 2013, Fata’s scheme was finally about to unravel. Maunglay met with George Karadsheh, the practice manager at MHO. Karadsheh had been growing suspicious over the number of physicians abruptly leaving the practice and proved more than willing to listen to Maunglay’s concerns. Karadsheh had previously found fraud at Detroit’s Lafayette Clinic and reported it under the False Claims Act, a government anti-fraud law.

Once again, Karadsheh filed a False Claims Act case, bringing forth concerns about Fata’s unethical treatment. Agents from the federal Department of Health and Human Services and the Federal Bureau of Investigation (FBI) visited Maunglay’s home just a few days after Karadsheh spoke with the FBI on August 2, 2013. They took notes on the evidence he had gathered at Fata’s practice. Less than 24 hours later, Fata’s practice was swarmed by federal agents, and the doctor was arrested.

Prosecuting Dr. Fata

With irrefutable evidence of Fata’s wrongdoing, the doctor knew that he had no defense against the serious charges he was facing. The maximum punishment for his actions was a 175-year prison sentence, with a high chance of being deported to his native country of Lebanon in the unlikely event he was released early. Deportation was a possible condition of Fata’s punishment since the doctor received naturalization while concealing evidence of illegal activities.

Fata chose to plead guilty to one count of conspiracy to pay and receive kickbacks, two counts of money laundering, and thirteen counts of health care fraud. In return for his guilty plea, charges relating to Fata’s immigration status were dropped. U.S. Attorney Barbara McQuade nevertheless sought the highest possible penalty for his actions, calling him “the most egregious fraudster in the history of this country.” Fata ended up being sentenced to 45 years in prison, which angered many of his former patients, who viewed the sentence as insufficient.

The Importance of the False Claims Act in Stopping Dr. Fata

At the end of the day, Fata was successfully stopped and prosecuted because of the bravery and willingness of his former employees to stand up to him and do what was right. Had Karadsheh not elected to file a False Claims Act when he did, it could have been many more years before Fata was caught, if he was ever discovered. Luckily, he was caught and stopped from harming patients ever again.

Abubakar is a writer and digital marketing expert. Who has founded multiple blogs and successful businesses in the fields of digital marketing, software development. A full-service digital media agency that partners with clients to boost their business outcomes.

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