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Red Flag

Medicare enrollment form and glasses
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

In 2014, Dr. Vasso G. Godiali bragged to a news reporter that he was one of seven physicians in the country who received more than $10 million for Medicare reimbursements in 2012. Red flag? Maybe. Godiali went on to say he was a workaholic. “I work a lot – I work probably more than surgeons that you meet,” he said at the time. “And people that I meet, my colleagues, they know it.” Godiali claimed he worked eighteen to twenty hours per day, seven days a week, and saw patients every day, adding up to more than 1,600 visits per year. Red flag? Not yet!

Godiali had a lucrative practice right from the very beginning. In 2008, Medicare paid Godiali more than $3.5 million in legitimate claims. But that wasn’t enough for him. Once Godiali discovered how easy it was for him to submit bogus Medicare claims, it was no longer patient care that consumed his time but fraud. Godiali in 2009 began defrauding Medicare, Medicaid, and Blue Cross/Blue Shield of Michigan by submitting false billings to all three insurers for services never rendered and if they were rendered, the patient was probably not aware of it. Because he could have been dead. In 2011, Bay Regional Medical Center reported Godiali to the Michigan State Licensing Board for fraud after he allegedly placed a catheter in a deceased man. Maybe a red flag? By 2014, nearly every bill submitted by Godiali for payment was touched with fraud.

More than twenty years later, a red flag was finally raised. On May 3, 2023, Godiali was sentenced for Medicare and Medicaid fraud, to six and a half years in prison during which he must participate in the Inmate Financial Responsibility Program. What is the success rate of that program to reform a fraudster?  Don’t put any money on it. Put your money towards Godiali’s bills.  Godiali was ordered to pay restitution of $19.5 million with no fees added on for court or prison expenses. The court found that Godiali apparently does not have the ability to pay it. So the next six years are on the US. Taxpayer.

Good job by the Department of Health and Human Services for stopping Godiali.

Today’s Fraud Of The Day is based on article “Bay City surgeon sent to prison, must repay $19.5 million for years-long healthcare fraud” published by Saginaw News on May 5, 2023

Four years ago, a federal grand jury indicted a Bay City vascular surgeon on charges that he was running a multimillion-dollar healthcare fraud scheme. Freshly sentenced to prison, the doctor must also repay the colossal sum he spent years bilking.

Dr. Vasso G. Godiali, 60, on May 3 appeared before U.S. District Judge Thomas L. Ludington for sentencing. The judge ordered Godiali to spend 80 months in prison, during which he is to participate in the Inmate Financial Responsibility Program.

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