An indictment unsealed today charges Dr. Vasso Godiali, age
56, vascular surgeon, with orchestrating a $60 million health care fraud
scheme. Dr. Godiali is also charged with
money laundering, for financial transactions involving approximately $49
million in proceeds he derived from the scheme.
The indictment was announced by United States Attorney Matthew
Schneider.
Schneider was joined in the announcement by Michigan
Attorney General Dana Nessel, Special Agent in Charge Timothy R. Slater of the
FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S.
Department of Health and Human Services Office of Inspector General’s (HHS-OIG)
Chicago Regional Office.
According to the Indictment, 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. The indictment further alleges Godiali
submitted false and fraudulent claims to Medicaid, Medicare, and Blue Cross for
services not rendered and that he “unbundled” claims by exploiting modifier-59
to falsely claim he was performing many separate and distinct procedures, when
in fact he was entitled to a single reimbursement for a single procedure.
The indictment further alleges that Godiali utilized six
corporations through which he laundered approximately $49 million, which he
ultimately used to fund investment accounts at multiple financial institutions.
In addition, the Indictment alleges that he engaged in money laundering by
using proceeds from his scheme to pay property taxes on a Houghton Lake,
Michigan, residence.
"This is a large, significant and important
prosecution. Health care fraud schemes, such as the one alleged to have been
committed by Dr. Godiali, divert millions of dollars from public programs
intended to help those in need for the sole purpose of lining the pockets of greedy
doctors,” stated United States Attorney
Matthew Schneider. “I salute Attorney General Dana Nessel and her staff, along
with the entire law enforcement team that labored so tirelessly on this case. The work that culminated in to today’s
indictment demonstrates cooperation and teamwork at its best.”
“Flagrant efforts to scam Medicare, Medicaid and Blue Cross
Blue Shield of Michigan are despicable in any degree—but particularly so when
tens of millions of dollars are involved.
Thanks to United States Attorney Matthew Schneider and his team along
with the efforts of our own Health Care Fraud Unit and the Michigan Department
of Health and Human Services Office of Inspector General staff, which initiated
the early investigation into this alleged health care fraud scheme, it has come
to a halt,” said Michigan Attorney General Dana Nessel. “Once it became clear that the potential
Medicare fraud exposure in this case was ten times what our own Medicaid fraud
exposure was, we reached out to the U.S. Attorney’s Office to increase the
depth and breadth of the investigation.
I am proud of the efforts of everyone involved and look forward to
making sure this doctor never sees another dime of taxpayer money.”
“Today’s indictment proves the collective resources of law
enforcement and the private sector can successfully combat fraud in our health
care system,” said Special Agent in Charge Slater. “Fraud schemes of this type
cost tax payers billions of dollars each year and remain a top investigative
priority of the FBI, HHS, and insurance companies across the country.”
“Healthcare fraud impacts everyone. The submission of false
and fraudulent claims drives up the cost of healthcare and wastes vital
taxpayer dollars”, said Lamont Pugh III, Special Agent in Charge, U.S.
Department of Health & Human Services, Office of Inspector General. “The
OIG will continue to work with our federal, state, and private sector partners
to identify fraud schemes and hold parties that execute these schemes
accountable.”
The United States Attorney’s Office also filed a related
civil lawsuit seeking the forfeiture of approximately $39.9 million seized from
accounts controlled by the defendant or related to four separate real estate
transactions.
An indictment is only a charge and is not evidence of guilt.
Each defendant is entitled to a fair trial in which it will be the government's
burden to prove guilt beyond a reasonable doubt.
If convicted of a health care fraud charge, the defendant
faces a maximum sentence of imprisonment of ten years, and a maximum fine of
$250,000 on each count. If convicted of money laundering, the defendant faces a
maximum sentence of twenty years of imprisonment, and a maximum fine of twice
the amount laundered.
The case was investigated by Special Agents of the HHS and
FBI, with cooperation and assistance from the Michigan Attorney General’s
Office, Michigan Department of Health and Human Services - Office of Inspector
General.
The case is being prosecuted by Assistant U.S. Attorneys
Craig F. Wininger and Philip A. Ross.
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