Pill Mill Thrill

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Fraudsters get a thrill out of stealing from others. Otherwise, they wouldn’t keep doing it. (The constant source of illegitimate income is also attractive.) A very deceptive Dover, Massachusetts physician got his thrill from running a multi-million-dollar Medicare fraud scam involving a pill mill.

The term “pill mill” describes a physician, medical office, or pharmacy that prescribes or dispenses narcotic medications inappropriately. (You could say that definition accurately describes exactly what today’s fraudster was doing.)

The Dover doctor became criminally famous for prescribing more oxycodone than most hospitals in Massachusetts. Authorities took notice in 2012 when he was considered the eighth highest prescriber of oxycontin in the state. The next year, he was the second highest prescriber of the narcotic. (During that timeframe he basically doubled the number of oxycontin prescriptions per month, which is indicative of illegal drug distribution. He also prescribed other powerful narcotics such as methadone and fentanyl.)

 The doctor, who ran a group of pain management clinics in Massachusetts and Rhode Island, also employed a group of physicians in Cairo, Egypt. They staffed an administrative office overseas where they were responsible for falsely billing insurance agencies for services that were never provided.

The foreign doctors commonly claimed that the doctor saw each patient for 25 minutes or more, when he only spent about five minutes with them and did not provide an examination as claimed. (In reality, the patients waited for hours to see the physician in an overcrowded office, not in an exam room. Sometimes he arrived as much as four hours late to a very crowded waiting room.) The Dover physician also had his Cairo-based co-conspirators improperly bill Medicare for urine drug tests. (This is in spite of him failing to store the samples properly. He also used unreliable equipment to perform the lab tests, rendering the results useless.)

So, what did the doctor do with the more than $8 million he stole from the government healthcare program through Medicare fraud? His multi-million-dollar scheme enabled him to pay for expanding the size of his Dover home by building a movie theater, squash court and a carriage house. (Because everyone needs a carriage house these days. Oh, and by the way, he also purchased real estate in Florida.)

The 62-year-old doctor pleaded guilty to numerous charges of Medicare fraud and money laundering. He was sentenced to eight years in federal prison, three years of supervised release and must pay restitution of $8,725,120. (Somehow this sentence is supposed to compensate for some of his patients who died because they overdosed on large doses of powerful painkillers.) Let’s hope that the sobering reality of today’s case has made an impact on the Dover doctor, bringing his pill mill thrill to a decisive end.

Today’s “Fraud of the Day” is based on an article entitled, Dover doctor behind ‘pill mill’ gets 8 years in prison, $8.7M restitution order,” posted on MassLive.com on March 22, 2018.

A Dover doctor, who at one time was one of the state’s largest prescribers of opioids — second only to an entire hospital — was sentenced Thursday to eight years in federal prison.

Fathallah Mashali, 62, will also serve three years of supervised release and pay restitution in the amount of $8,725,120, federal prosecutors said in a statement.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.