Farid Fata
Farid T. Fata is a Lebanese-born former hematologist/oncologist and the admitted mastermind of one of the largest health care frauds in American history. He was the owner of Michigan Hematology-Oncology, one of the largest cancer practices in Michigan. He was arrested in 2013 on charges of prescribing chemotherapy to patients who were either perfectly healthy or whose condition did not warrant chemotherapy, then submitting $34 million in fraudulent charges to Medicare and private health insurance companies over a period of at least six years. He pleaded guilty in 2014 to charges of health care fraud, conspiring to pay and receive kickbacks, and money laundering. On July 10, 2015, he was sentenced to 45 years in federal prison.
Early life and career
Fata was born in Lebanon in 1965, to a Melkite Catholic family. After obtaining a medical degree there in 1992, he emigrated to the United States to begin his medical career. He served a residency at Maimonides Medical Center in Brooklyn from 1993 to 1996. From 1996 to 1999, he was a fellow in hematology-oncology at Memorial Sloan Kettering Cancer Center in Manhattan. He was an attending physician at Geisinger Medical Center in Danville, Pennsylvania from 2000 to 2003.He struck out on his own in 2003, opening Michigan Hematology-Oncology in Rochester Hills, Michigan. Over the next decade, it grew to seven locations throughout Metro Detroit—in Rochester Hills, Bloomfield Hills, Clarkston, Sterling Heights, Troy, Lapeer and Oak Park. He became a naturalized U.S. citizen in April 2009.
Fata specialized in treating blood cancer. He owned his own lab, pharmacy and radiation treatment facility. At his height, he was treating 17,000 patients at his clinics. He acquired a sterling reputation as one of the best cancer specialists in Metro Detroit. He was known for his aggressive approach, which gave higher doses of chemo drugs more frequently—a protocol he called "European protocol".
Fata's wife, Samar, helped run the business side of his practice as Chief Executive Officer and Chief Financial Officer of his companies. She moved back to Lebanon after her husband's arrest; they have since divorced.
Fraud
Concerns about Fata cropped up as early as 2007, when Maggie Dorsey sued Fata for malpractice. She had been diagnosed with cancer in 2004, and seven months of chemo had made it difficult for her to walk. She learned that she did not have cancer. The case was settled out of court in 2009. In 2010, veteran oncology nurse Angela Swantek went to MHO for an interview, but was stunned to see practices that her experience told her were "plain wrong". She believed that Fata was pumping patients with drugs specifically to bill their insurance for more money—a classic fraud scenario. She complained to state authorities, but got no response until 2011, when she got a form letter saying that there was no evidence to support an investigation.In 2013, Fata diagnosed 54-year-old Monica Flagg with multiple myeloma—a condition that required a lifetime of chemo for her to have any chance to survive. On July 1, hours after her first round of chemotherapy, she broke her leg in two places. Fata was on vacation in Lebanon at the time. One of the doctors at MHO, Soe Maunglay, saw her in the hospital that day, and was stunned to see that her readings were completely normal. As he put it, he could tell "just by looking at the chart" that Flagg's numbers were not consistent with an active cancer patient.
The next day, Maunglay went to Fata's clinic and reviewed Flagg's records, and could find nothing in Flagg's test results that could justify a chemo regimen. He later told The Detroit News that myeloma can start with minor changes in blood chemistry—minor enough that a dishonest doctor can use chemotherapy to avoid detection. He estimated that if another doctor had seen Flagg within two months, she would have appeared to be in remission. He also believed that since Flagg was far healthier on paper than a typical myeloma patient, the insurance payments would continue flowing to Fata for the rest of his life. Maunglay went to see Flagg the following day, and told her she did not have cancer. He further advised her to get her records right away and find another doctor, and that she should never go back to Fata again.
Maunglay was already due to leave MHO the following month after catching Fata red-handed lying about the clinic's enrollment in a professional quality program. However, after discovering that a perfectly healthy woman was being treated with chemotherapy, he felt that he needed to stop Fata. Knowing that Flagg's case, even as egregious as it was, would not be enough to shut Fata down, he needed to find more evidence of misconduct. Maunglay investigated MHO's patient records, and found numerous instances of unethical and potentially illegal behavior. For instance, Fata was treating several patients with IVIG, a drug intended to treat patients with specific immune deficiencies, when there was no apparent medical basis for it. Maunglay persuaded a nurse and a nurse practitioner to confront Fata. When Fata agreed to curb the use of IVIG, Maunglay believed that this was further evidence that Fata was a fraud. Later, he told the News that an honest doctor would never cut back on his own protocol solely because of staff and physician objections. Weeks later, the FBI stepped in on a tip from George Karadsheh, who was the office manager for Fata's network of clinics. Karadsheh grew suspicious after clinical staff and other doctors began giving their notice without explanation and leaving the practice. When Karadsheh asked Maunglay why he was leaving, he told him that Fata kept insisting on aggressive chemotherapy regimens, even for patients who didn’t need it.
Karadsheh did not believe Maunglay at first since he was aware of other clinical staff who provided care and oversight. However, Karadsheh recalled that many nurses and others had expressed concerns about Fata's aggressive regimen. Karadsheh then conducted his own investigation and interviewed several staff. The first thing he noticed was that Fata's treatment-to-consultation ratio was different from those of other doctors. Karadsheh went back to Maunglay, who suggested that Karadsheh check on Fata's use of IVIG. Karadsheh asked a nurse and she reported that she discovered that in one week, 38 out of 40 patients did not need or did not qualify for the drug. She took this information to Maunglay, who disclosed it to Karadsheh during his investigation. Karadsheh knew what health care fraud smelled like; he had exposed medical billing fraud at a Detroit area hospital in 1996. He took his findings to the Detroit office of the Federal Bureau of Investigation and sued Fata, MHO and several related entities under the False Claims Act on August 5; he was thus entitled to a significant financial reward. Maunglay said that Karadsheh had done "a great service" because of his past experience detecting fraud. Fata was arrested the next day for health care fraud.
Indictment
Fata was originally held on $170,000 bond. However, federal authorities found evidence that Fata and his wife had assets of $9 million not yet seized, and feared that the high liquidity of these assets could make him a high flight risk. They persuaded federal judge Sean Cox to raise his bond to $9 million. He was confined to jail pending trial; had he been released, he would have been confined to his home in Oakland Township and barred from practicing medicine.Federal investigators amassed evidence that Fata had bullied or deceived 553 people into getting chemotherapy treatments they did not need, causing the patients' insurance companies and Medicare to pay $34 million in fraudulent and unnecessary claims. They also found that Fata took kickbacks from two local hospices, and poured Medicare and private insurance proceeds into his own diagnostic testing facility, where he ordered unnecessary tests. On the basis of these findings, Barbara McQuade, the United States Attorney for the Eastern District of Michigan, obtained a series of superseding indictments against Fata. They culminated in a 23-count indictment charging Fata with health care fraud, conspiracy to take and receive kickbacks, money laundering, and unlawfully procuring naturalization. The last charge was added because McQuade contended Fata had concealed the extent of his fraud from immigration authorities when he applied for citizenship. If he had been convicted on all charges, Fata would have faced a maximum of 175 years in prison, plus the prospect of having his naturalization revoked.
Guilty plea
Facing the prospect of a lifetime in prison and possible deportation to Lebanon, Fata pleaded guilty before federal judge Paul Borman on September 20, 2014. He pleaded guilty to 13 counts of health care fraud, one count of conspiracy to pay and receive kickbacks, and two counts of money laundering. In return, the immigration charges were dropped. Nonetheless, McQuade sought the maximum possible sentence of 175 years in prison. Her office argued that the egregiousness of Fata's crimes far exceeded that of Bernard Madoff, and denounced him as "the most egregious fraudster in the history of this country".Sentencing
Fata's sentencing hearing began on July 3, 2015. At the hearing, dozens of Fata's victims revealed how the unnecessary chemo treatments had harmed them. For example, Robert Sobieray lost nearly all of his teeth after being falsely diagnosed with blood cancer, and still twitched uncontrollably. Patty Hester lost much of her hair after being falsely told she was terminally ill with myelodysplastic syndrome, and the stress of finding out about Fata's deceit gave her high blood pressure. Another patient, "C. C.", said that due to 177 unnecessary chemo treatments, she had problems with her bladder, bowel and kidneys so serious that she could no longer perform basic tasks.On July 10, 2015, Fata addressed the court for the first time. He said he was "horribly ashamed" at his behavior, and admitted giving in to a "self-destructive" quest for power and wealth. Borman was unmoved, and sentenced Fata to 45 years in prison, saying that Fata had committed "huge, horrific" crimes. The sentence Borman imposed is barely one-fourth of what prosecutors sought, and was deemed insufficient by many of Fata's victims. Nonetheless, at Fata's age, it is very likely that he will die in prison. McQuade publicly thanked Maunglay and Karadsheh for exposing what she described as "the most serious fraud case in the history of the country". Fata also faces myriad civil suits. Karadsheh announced in January 2016 that he had reached a $1.7 million settlement. Maunglay, who did not file a lawsuit, will not take any financial reward.
Fata, Federal Bureau of Prisons inmate number 48860-039, is serving his sentence at Federal Correctional Institution, Williamsburg in Salters, South Carolina. His earliest possible release will be October 19, 2052, when he will be 87 years old.
Fata requested that his guilty plea be tossed in May 2018. His claim is based on the assertion that he received poor legal advice that resulted in his guilty plea and that he has always maintained his innocence, despite his admission of guilt during his sentencing hearing. He stated in the filing, "My guilty pleas were not the result of my actually being guilty. From day one to the present, I have steadfastly maintained my innocence."