One Count of Careless Physician

219
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.

 

SHARE
Previous articleA Gentle Nudge
Next articleIt’s Downhill from Here

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.