There are few felons who can top the pain caused by so many victims as Dr. Farid Fata, who is facing a demand by prosecutors for a 175-year sentence for sending hundreds of healthy patients into unnecessary cancer treatments.
Some 553 patients were given the unnecessary cancer treatments to 553 patients before Fata was arrested in 2013. He was accused of $35 million in Medicare fraud. He pleaded guilty in the fall to fraud, money laundering and conspiracy charges.
Absent the plea, some of the cases might have produced some challenging evidentiary burdens. Some of the patients had cancer but were over treated while some received the wrong treatment for their type of cancer. Those could be defended as malpractice but not fraud. However, there appeared to be enough evidence of knowing fraud to force Fata to throw in the towel on trial.
The trial itself would have allowed patients to recount how they suffered organ damage as a result of unnecessary treatment. Moreover, these victims had to tell their loved ones that they had cancer and prepare their families for their possible deaths. One man lost a testicle and came close to kidney failure due to the unnecessary treatment.
What most concerns me are accounts of people complaining as early as 2010 with no action taken to shutdown this doctor.
In the meantime, the defense counsel is seeking a limit on victim’s statements for sentencing — a difficult proposition for a court in cutting off the right of victims to speak about their loss and pain.
Another interesting aspect of this case is how to handle the civil liability. He presumably had insurance coverage but the sheer number of cases presents a daunting problem for courts. This would seem a good case for special management like a mass tort situation where a court can administer the claims while reducing the litigation costs. Since liability is obvious, it would be unfair to see these victims paying either full contingency fees or high hourly rates for victims of 30 percent or more. Ideally, these claims can be administered through a single court. However, the insurance company may wish to contest some cases as properly diagnosed. That could lead to litigation in those marginal cases.
@Ninian
You are right about the American doctors. Doctors are people just like everybody else on the planet. If there is a chance to make extra money, they tend to go for it, too. Not many will go as far as Fata. It might just be an unnecessary MRI, at their clinic, or a friend’s clinic, or a few extra tests so those pesky lawyers won’t sue them, but they’ll do it.
After Texas passed its draconian medmal tort reform, the medical costs in South Texas did not go down, A Dr. Gawande went to South Texas to find out why:
http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum
Squeeky Fromm
Girl Reporter
Medicare fraud from providers much more common than Medicare fraud from individuals.
100% agree with Annie here. Since my husband and I became Medicare eligible and also have a supplemental policy, the Doctors offices seem to think that we need to have all the medical procedures available. They keep pushing us and sending us request for appointments. Worse than telemarketers. We feel like Medicare pinatas.
For years my husband paid cash for all procedures, blood tests, medicines etc. because he had a pre-existing condition that precluded private insurance. Minimal amounts really and because he paid cash he got a great discount. I had a high deductible HSA plan which was perfectly adequate because I have no medical conditions and take no medications. I rarely ever went to the doctor….rarely. It was merely to cover in case something catastrophic happened or I was in an accident……..which is the purpose of insurance. Catastrophic only and not to cover every band aid or pimple on your butt. That nice plan got canceled by Obamacare’s/Scotuscare’s new rules and new plans. My deductible was still high…. but the premium was sky HIGH, compared to the little amount that I was paying previously.
Since both of us being on Medicare, amazingly the cost of the routine procedures for my husband have doubled……likely so they can still get paid the same amount from the piddly Medicare reimbursement amounts.
However, they keep trying to get us to do all sorts of medical procedures, tests and are pushing medications harder than the drug dealer on the corner. It is just so they can puff up their volume and try to make some money on the ridiculously low reimbursement.
No. Thanks. We. Are. Fine. I’m educated enough to know when to say NO. Unfortunately there are Doctors who are unethical and people who are scared into unnecessary and harmful procedures and pushed into unnecessary costs.
Dust Bunny Queen
But this is wrong…..
No its WRONG
It doesn’t have to be like this. I don’t understand why the general public put up with these standards of probity. What you are describing is fraud.
It’s clear that your current system can never work.
But I think it will only be solved by an American……
Not an alien
The solution lies in acceptable care for all Americans not for just the few and as far as I can tell Americans don’t think like this.
Our health system worked well when there was no Medicare and no health insurance. Medicare started in 1965, and health insurance started in the 1930’s. Now we have Obamacare mucking up the system, taking a few thousand dollars more from me every year as a penalty for not believing in their system and giving me nothing back in return. Instead they give my hard earned money to guys like this fraud. Our system needs to change in the direction of getting government out of the health care business.
Be on the lookout for triple bypass fraud doctors. Tip, they live in mansions.
$18.8 million settlement resolving allegations of unnecessary cardiac procedures has raised patient safety concerns, along with questions about the potential for fraud and abuse among cardiology providers.
Payment data surrounding cardiac care is also leading investigators toward the potential fraud and abuse hotspot. Medicare spends $583 billion annually on cardiac procedures.
Give him chemo 24/7 until death.
Glad he was caught but this isn’t new. G R E E D Y physicians are everywhere. One doctor I was seeing diagnose with something I didn’t have so she can milk my insurance out of six grand for medication I wasn;t taking and didn’t need. I know she needed the $$ for her bi-weekly travel to Russia. Not only did I report her to my insurance co, but I dropped her immediately.
When it comes to health care or anything else, you must be pro-active, otherwise, people will step over you.
Here is an organization with information on victims’ rights:
http://www.nvcap.org/
While the criminal trial here is federal, a list by states is available at this link:
http://www.nvcap.org/states/stvras.html
Darren Smith
Victims rights must be protected.
But to stop this abuse will require change. Persisting with the current system won’t achieve this, it will just promote further damage to more patients,
Prevention is better than cure
Salaried physicians face huge pressure from hospitals to produce revenue for services, procedures, hospitalizations.
Was this doc salaried or in a private practice? If he was employed by a hospital, the hospital is also responsible.
To doctoryes
This is true but only with a fee for service system. That’s why the system can’t work.
It is the American public who pays for this in the end through a levy on already high insurance premiums
If he has typical insurance limits, the insurance company won’t worry about saving money. They will give it up at the first opportunity, though when that will be can be complicated by the insurer’s obligation to protect his interests. The litigation will get messy as to how the available funds will be apportioned between those injured since a million dollars could be a drop in the bucket given these allegations. Liability may be clear as to him, but attorneys for those injured will presumably try to bring in ancillary defendants if possible to make up the difference. Allegations that a primary care physician should have observed something inconsistent with the treatment being given, or reviewed a test result instead of relying on him, or a covering doctor should have recognized something inappropriate, or hospital or emergency room staff should have identified an issue, or a referring doctor should have known of his misconduct, etc.
I agree with Isaac’s comment. I gotta ask: how many cases like this would or do arise in a socialized medical nation such as Great Britain or France? None. I also want to know what this guy’s ethnicity is. Where did he go to high school? College? Med School? Was he in a frat? Does he have offspring who are doctors? What hospital allowed him in? Why not the death penalty on his criminal case? How many did he kill? Can the victims retrieve money from him personally as in taking his home, cars, furniture, doctor gowns? This is why God made rifles.
I like the 100, 200, and 300 year sentences. They make a statement as well as guarantee that the scumbag never gets out of prison. Bernie Madoff is the prime example. He gets life in prison with no parole and also gets and idea of what an incredible scumbag he is. That is to say, if science could make it so that he could life longer, he would live longer in prison. I suppose the stronger statement would be to whack em.
ninianpeckett:
“I have never understood the thinking behind a 175 year sentence. Why is such a sentence not “Life” without parole for example. I’m sure there must be a reason, but I don’t know of anyone even in the American Healthcare System that has lived to 175 years. I’m sure it must be to express public outrage etc but it is a bit odd….”
This is actually why I oppose parole. We should not be forced to sentence someone to consecutive life sentences just to ensure he serves a long sentence. Here in CA, they have emptied out the prisons to make moor room, and crime has increased 400% in some areas.
A sentence should be just. The time should be hard enough to serve that people don’t view jail time as an admirable quality, or a “high school reunion.” Good behavior in jail might net you perks like some TV time, but it should not lessen your sentence. The sentence is justice for the victims, and gives the public a break from the perpetrator. Why would I care if a rapist, thief, or pedophile behaves himself in jail? It’s how he acts in the real world that matters.
From what little I know of Sheriff Arpaio, he may be on to something making the prisoners wear bright pink and otherwise taking the “macho” right out of jail time.
Harder jail time but shorter sentences might, possibly, hopefully address the problem of young people being in a hurry to get in to jail, as well as the overcrowding of people while they’re there.
Ninianpeckitt
There is no system that is perfect. However, the American system is the most imperfect. The reason is that the system is governed by the first sacred tenet of capitalism, or ‘what the market can bear’. After this fundamental there follows the benefits of competition which are typically and transparently in the case of insurance and more in the case of health care insurance, nullified by the reality of monopoly and oligarchy. The industry is governed privately through a handful of ‘re insurance’ corporations. There are no benefits arriving from competition as there is no competition. There is simply the illusion of competition disguised and obscured by the unnecessary myriad of ‘plans, options, custom fits, etc’.
The American health care system has as its foundation the oligarchical organization of global re insurance corporations. This system sets the free enterprise absolute. This creates the areas of fraud and excess costs. The government is, to the ignorant, the bad guy. The ignorant, for lack of the ability to understand, call them selves libertarian and squirrel their heads where the sun don’t shine. The government is forced to plug into the system developed and maintained by the private sector which proceeds to the max of what the public can bear.
The rest of the more evolved nations, America’s peer nations, removed this primary capitalist tenet from the equation to a greater rather than lesser degree decades ago. These more advanced societies chose to adjust this primary tenet in a socialistic manner from ‘what the market can bear’ to ‘what the market chooses to bear’. The greatest illusion under which America functions is that it is actually performing under some umbrella of freedoms afforded by the free market system, when it comes to health care and health care insurance. There could not be anything more dictatorial than America’s present health care system.
This is true with other aspects of American society. Guns and irresponsibility come to mind.
The fact of the matter, and one which the degree of socialism America has embraced for the better of all people, is that some aspects of society must be governed and some must be left alone to prosper. The proof is there to be reviewed at any time and the proof points to a superior condition of health care at lower costs under a socialist based system where everyone pays into the system through monthly payments based on income with the availability of a second tier of insurance if one so desires, the perfect coupling of need and choice. The only positive examples one can draw from the US system are those of profit for a very, very, few, shareholders dividends, and redundant jobs in the hundreds of thousands. So, after all the US is subsidizing itself, but in a perverse way, at a cost to those who cannot afford it, and to the benefit of a very few.
The preponderance of the facets of American society are exemplary and admired around the world. They are to be held high, saluted, and waved about with pride. This is the greatest country in history given it’s size and complexity. However, it could be greater and this is the core value of everything that is great about America, to be greater, not, ‘If it ain’t broke, why fix it?’ or, ‘Well, if you like their system so much, why don’t you move there?’ or, ‘You just don’t understand, love, or respect the Constitution.’ and so on.
The American health care system us built upon great success and anchored by great failures. Experiencing failure is inevitable for most sometime or another. It makes one stronger if one spends a little time with the experience. The obvious benefit is that it illustrates what not to do and guides to how to do it better. However, deluding oneself that failure does not exist where and why it does is the most dangerous thing to do.
To Isaac:
I agree with much of what you say but…
“The preponderance of the facets of American society are exemplary and admired around the world. They are to be held high, saluted, and waved about with pride. This is the greatest country in history given it’s size and complexity”.
But this really isn’t how people around the World see America. It really isn’t.
It is how America sees itself and this can lead to complacency with regard to solving internal problems.
You are witnessing this in all sorts of ways and you can see from bloggers how difficult it is to discuss these issues if minds are closed and victims of historical rhetoric.
It is not possible to change unless there is insight.
It’s hard for me to think of anything printable I can say. A beloved member of my family just recently achieved remission. The thought of a man like this abusing her, or giving her the wrong cancer treatment for her cancer, weakening her and damaging her organs without helping her at all, makes me think very bad thoughts.
I pray for the recovery of his many victims, and that those who really had cancer have not lost their window to achieve remission.
This is a good example of why the criminal justice system’s prime directive is not rehabilitation of the perpetrators. It’s about justice, punishment, a deterrent to others, and keeping dangerous people like him away from the public.
Whenever someone in authority abuses the public trust, it’s a terrible betrayal. A doctor harming his patients is among the worst of those.
To Karen S
You are absolutely right
They say “ignorance is bliss” unless of course you have cancer and then the only option in medicine is usually dicing and slicing then chemo-therapy and radiation. There are millions of dollars at stake for using this barbaric, antiquated cure. A cure where many people die after a few years, but it makes doctors rich. Yet cancer is one of the most easiest ailments to cure. Medical science knows of these simple cures but greed keeps them from the public in lieu of the almighty dollar. So I ask, is ignorance truly bliss?
http://www.forbes.com/sites/elaineschattner/2014/12/24/a-gift-health-care-without-the-business/
“The ideal system would lack all the paperwork, except for medical records. Your health information, including past x-ray and MRI results, pathology reports and images, doctors’ notes, lab tests for Lyme disease and your blood type – basically everything – would be accessible to all doctors who have your consent to look at them, and to you, the patient.
There would be no bills, and no billers, and no insurance companies to choose from. That whole industry – and the amount of dollars, computers, Cloud-space and workers – could be put to other use. Yes, I’m dreaming…
Nurses and doctors and others who work in health care should receive fair, even generous, compensation for what they do, of course. People or companies who supply needed goods, such as machines and medicines, should be paid for what they provide, reasonably. But hospital networks (and the patients who populate those) as investment opportunities?
Profit as a healthcare endpoint? No. I reject that. Because we – people with breast cancer, scoliosis, diverticulosis, depression, whatever it is that you might have or had, or might develop in the future – are not commodities.
The insurance industry, in itself, accounts for over 20 percent of U.S. health spending, and administration of care (including insurance) 30 percent, according to this 2013 Bloomberg piece. Our complicated plans feed on resources that might, instead, be used to cover the costs of preventive care for people who are well, and better treatment for those who have illness and wish to receive it.”
I.Annie
I worked in a system very much like the one you described for most of my life. There was paperwork but certainly no billing and no way to commit fraud.
Plus, salaries mean that come 5 PM, the day is done.
No need to stay and see any extra patients, no benefit to taking care of that last person in the lobby.
What’s the point?
They can come back tomorrow, or go elsewhere. Like the ER.
What’s more, salaries make it harder to get sacked for anything but sex or theft.
Rude to patients? No matter. What choice do they have?
I love salaried single payer.
Forward!
To CCPGI
A doctor isn’t a 9-5 job although it has become this in some systems.
This is what is wrong. I have never worked less than 100 hrs/week and that’s not unusual.
http://www.hhs.gov/news/press/2015pres/06/20150618a.html
“WASHINGTON – Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell and Attorney General Loretta E. Lynch announced today a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount.
The defendants are charged with various health care fraud-related crimes, including conspiracy to commit health care fraud, violations of the anti-kickback statutes, money laundering and aggravated identity theft. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services, including home health care, psychotherapy, physical and occupational therapy, durable medical equipment (DME) and pharmacy fraud. More than 44 of the defendants arrested are charged with fraud related to the Medicare prescription drug benefit program known as Part D, which is the fastest-growing component of the Medicare program overall.”
I.Annie
This is fantastic….. how can you put up with these things?
The best part about salaries is that no matter how much work you do, you don’t get paid any more than the least productive worker, no more than the lazy and shirkers and those spending more time on office politics than on patients.
But laziness and shirking never happen in salaried single payer systems.
Everyone works hard in Utopia.
Forward!
To CCPGI
I never met a salaried doctor who didn’t work really hard – almost to the point of collapse and what’s more we all loved it.
You appear have no conception what it was like nor to understand the notion of vocation, which is very sad.
I come from a world where doctors gave up their lives to practice medicine without one thought for themselves and we have been forced to sit back and seen the whole thing wrecked by political commercialisation.
I don’t expect you to understand. You had to live through it to understand it.
When “hospital management” was created effectively replacing Matron in the UK in the 1980s, “patients” became “customers” and the Health Service became Health Care.
It all changed.
These people had no idea what we were talking about and their understanding of empathy noticeable by its total absence.
There was a change in thinking. Courses became necessary to tell us how to behave, perform, relate lead and everything else. The eye was taken off the ball and the System became more important than the patient.
The youngsters of today have been programmed with this current mind set. In fact they are now preselected for Medical School so that the required correctness is achieved.
It has been a total disaster for Medicine and I am proud to say that if I applied for medical school in todays world I would certainly be rejected.
We are all saddled with the system that we voted for, and if it isn’t working there is only one way to change it.
A good model for deal with this jerk and the insurance industry is the case of The Texas Litigation. A full collection of pleadings, class action motions, joint settlement agreement and order of judgment can be found at Michigan Law School Civil Rights Litigation website. In that case the numerous plaintiff attorneys agreed on a three tier class and had a magistrate hear some individual claims to determine exact damages. Lawyers for plaintiffs include Sly James the present Mayor of Kansas City, Steve Ryals, Michael Bastian and others. I just found this on the internet after reading this topic.