What a Pain

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46466081 - back pain.

Pain doctors normally provide relief for those who are suffering from chronic conditions, but a neurologist in Fairhope, Alabama operated a clinic that caused a lot of pain for the insurance providers he fraudulently billed. He not only committed Medicaid fraud, but also submitted bogus bills to multiple private insurance companies over a 13-year period and used the payments to live a luxurious life.

The neurologist persuaded patients to visit his clinic so that he could bill a variety of healthcare benefit programs including Medicare, Medicaid, Blue Cross Blue Shield of Alabama, Humana, United Healthcare and other private insurance companies for medically unnecessary tests and procedures. (He may have convinced himself that insurance companies make too much money anyway, so, why not take a cut too.)

The pain doctor also got himself into more trouble by violating traditional standards of care in his medical practice. He failed to provide informed consent to patients about procedures. (Wouldn’t you like to know that you were going to get a shot of pain medication directly into your spinal column before it happens? Maybe it’s better not to know.) The physician also fraudulently documented patient records before submitting false claims to the insurance companies and issued prescriptions for schedule II controlled substances without a legitimate purpose. (Schedule II controlled substances have a high potential for addiction.)

During a Federal Bureau of Investigation (FBI) search of the neurologist’s home, approximately $287,983.25 was seized from a safe. Several days later, he opened a new joint account with his ex-wife and made an initial deposit of $576,005.55. (Just the fact that he opened an account with his ex-wife should be enough to signal that something was amiss.) Then, a month later, he contacted the financial institution and asked them to remove his name from the account. (You can run, but you can’t hide.)

A raid of his medical practice found that he had caused serious bodily injury to patients and routinely filed lawsuits and falsified documents against anyone who opposed him. The doctor relied on a former patient, who happened to be in law enforcement, to help him. The man provided surveillance of various people and other favors like running license plates, fixing tickets and investigating individuals in exchange for prescriptions for controlled substances.

After a grand jury returned a 22-count superseding indictment against him, charging him with healthcare fraud, making false statements relating to healthcare matters, lying to a federal agent, unlawfully distributing schedule II controlled substances and money laundering, he struck a plea deal. The 58-year-old neurologist pleaded guilty to one count of healthcare fraud and one count of unlawful distribution of a schedule II controlled substance. (And, he agreed to no longer practice medicine or prescribe controlled substances in the U.S.)

When sentenced, this fraudster faces up to 10 years in prison for healthcare fraud and up to 20 years in prison for unlawfully distributing a controlled substance. He also has state criminal charges pending in another county where a grand jury returned a two-count indictment against him charging him with Medicaid fraud and first-degree theft of property.

This Alabamian operated his healthcare fraud scheme with the sole purpose of making money for himself. As he awaits his sentence, he will have to come to the painful realization that he may have to kiss his boat, airplane and gun collection goodbye. To eliminate the painful situation that this doctor has caused, the government will seize all of his assets, which should serve as an important reminder to anyone thinking about committing a similar crime.

Today’s “Fraud of the Day” is based on an article entitled, Daphne pain doctor pleads guilty to healthcare fraud, money laundering,” posted on AL.com on August 31, 2017.

A former pain doctor, who operated in Baldwin County, that was facing federal charges for defrauding Medicaid pleaded guilty to on Thursday morning.

Acting United States Attorney Steve Butler of the Southern District of Alabama made the announcement that Dr. Rassan M. Tarabein, 58, a neurologist residing in Fairhope pled guilty before Chief United States District Judge Kristi K. DuBose to one count of health care fraud and one count of unlawful distribution of a schedule II controlled substance. 

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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.