WASHINGTON – Four Metro Detroit physicians were found guilty of health care fraud for their roles in a scheme to administer unnecessary back injections to patients in exchange for prescriptions of medically unnecessary opioids.
Officials said patients were required to get the injections in order to get the prescriptions. Some of the opioids were resold by drug dealers.
Spilios Pappas, 62, of Lucas County, Ohio, Joseph Betro, 59, of Oakland County, Michigan, Tariq Omar, 62, of Oakland County, Michigan, and Mohammed Zahoor, 53, of Oakland County, Michigan, were each found guilty of one count of conspiracy to commit health care fraud and wire fraud, and one count of health care fraud.
Sentencing has been scheduled for July 16 for Pappas, July 17 for Betro, July 24 for Zahoor and July 30 for Omar before Chief U.S. District Judge Denise Page Hood of the Eastern District of Michigan. Seventeen other defendants, including eight other doctors, previously pled guilty in connection with the investigation.
“These physicians subjected patients to medically unnecessary injections to reap millions in fraudulent billings. Worse still, they incentivized those treatments by offering opioid prescriptions in sky-high dosages meant for the terminally ill,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “Today’s verdict shows that the Department will root out physicians who let dollar signs rather than medical need drive their treatment of patients.”
Evidence at trial showed that from 2008 to 2016 Pappas, Betro, Omar and Zahoor worked at numerous medical clinics in Michigan and Ohio, which were operated under the name of the Tri-County Group (Tri-County) and owned by co-conspirator Mashiyat Rashid.
While working at Tri-County they engaged in a scheme to defraud Medicare of over $150 million by billing for medically unnecessary facet joint injections, unnecessary urinary drug screens, home health and more. Officials said they offered prescriptions of oxycodone 30 mg to patients who were in pain, drug dealers, or opioid addicts. Those patients were forced to submit to unnecessary facet injections for the prescription.
The four defendants were all ranked in the top 25 doctors for dollars paid by Medicare for facet joint injections, even though they only worked a few hours a week. The defendants practice was described during trial as an assembly line, where the four defendants earned anywhere from $1,100 to $3,500 an hour for performing the injections.
They also signed a standing order for urine tests for each patient and every visit was sent to National Laboratories, also owned by Rashid. This was in exchange for tens of thousands of dollars in illegal kickbacks.
Officials said they provided prescriptions for narcotics, including opioids and benzodiazepines, as an incentive to patients who received the injections. Officials said evidence from the Michigan Automated Prescription System showed that the four defendants were among some of the top prescribers of oxycodone 30mg in the state.