One Count of Careless Physician

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Medicare enrollment form and glasses

Physician Grigoriy Rodonaia, 45, of Port Neches, Tex., has been convicted of committing federal healthcare fraud after using patient identities to issue prescriptions without their knowledge. The fraudulent plan involved stealing the identities of military service members and their families to collect money from TRICARE, the health care program for uniformed service members, retirees, and their families around the globe.

While running his medical practice, Rodanaia Family Medicine and Aesthetics, the physician abused his patient’s trust in him by issuing prescriptions for specially compounded scar creams using the personal information of TRICARE beneficiaries. (Rodonaia should try-to-care about more than just himself.) Such information included names, birth dates, and Health Insurance Claim Numbers belonging to the TRICARE beneficiaries.

The prescriptions were forwarded to and filled by Memorial Compounding Pharmacy in Houston. All the prescriptions were issued without consulting the patients and without their knowledge. (Even with medical school under his belt, Rodonaia wasn’t wise enough follow the law.)

Each prescription’s bill ranged between $9,000 and $13,000 and multiple refills were authorized for each prescription. Since January 2015, over 600 prescriptions have been issued for 140 beneficiaries. (That totals up to a small fortune.)

As a result of this scheme, Rodanaia inflicted significant financial harm on the TRICARE healthcare system. Before Rodonaia was caught carrying out his scheme, TRICARE paid $6.7 million in funds to Memorial Compounding Pharmacy.

Rodanaia forged patient records to strengthen his fraudulent claims by creating the illusion that he examined the patients. (He should try examining and adjusting his morals instead.) False records were then submitted to the Defense Health Agency.

Rodonaia was indicted in March 2020 and a jury convicted him in November 2020. The convictions included 12 counts of health care fraud, three counts of aggravated identity theft, and one count of making a false statement. He was sentenced to 84 months in prison and must also pay $195,607.76 in restitution.

Today’s Fraud of the Day comes from a Department of Justice press release, “Jefferson County Doctor Sentenced to Federal Prison for Health Care Fraud Violations,” dated June 24, 2021.

BEAUMONT, Texas – A physician practicing in Beaumont has been sentenced to prison for federal health care fraud violations in the Eastern District of Texas, announced Acting U.S. Attorney Nicholas J. Ganjei today.

Grigoriy T. Rodonaia, 45, of Port Neches, Texas, was convicted by a jury on Nov. 17, 2020, of 12 counts of health care fraud, three counts of aggravated identity theft, and one count of making a false statement.  Rodonaia was sentenced to 84 months in federal prison today by U.S. District Judge Marcia Crone.  Rodonaia was additionally ordered to pay $195,607.76 in restitution.

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.