A Michigan hematologist will likely spend the rest of his life in prison after defrauding Medicare and private insurers, and violating the first tenet of medicine, "Do no harm."
Farid Fata, a hematologist-oncologist from the wealthy northern Detroit suburbs, was sentenced July 10 to 45 years in prison. As head of Michigan Hematology Oncology, until recently the state's largest private cancer network, Fata was accused of running a fraud scheme that involved administering unnecessary chemotherapy to 553 patients--including some who were intentionally misdiagnosed with cancer--and illegally billing Medicare and private insurers some $34 million in false claims.
In 2010, warning signs came from an oncology nurse, Angela Swantek, who considered taking a job with Fata's practice and observed what she later called a "chemo mill." Swantek saw more than dozen patients getting chemotherapy at any given time and apparently not in compliance with best practices for infusion. She declined the job and filed a complaint with Michigan professional licensing regulators, but the state later determined that nothing was out of compliance.
Three years later, the FBI stepped in on a tip from George Karadsheh, who managed the office of Crittenton Cancer Center in Rochester Hills. Karadsheh grew suspicious after clinical staff and other doctors were leaving the practice; one doctor told him Fata kept insisting on aggressive chemotherapy regimens, even for patients who didn't need it. In August, 2013 Fata was arrested.
"Healthcare fraud has been a serious problem in Michigan, but no case has been as egregious as the conduct of Dr. Farid Fata," said U.S. Attorney Barbara McQuade of the Eastern District of Michigan. "Dr. Fata did not care for patients; he exploited them as commodities. He over-treated, under-treated and outright lied to patients about whether they had cancer so that he could maximize his own profits."
Last September, Fata plead guilty to 13 counts of healthcare fraud, one count of conspiracy involving kickbacks and two counts of money laundering. He also admitted to soliciting kickbacks from Guardian Angel Hospice and Guardian Angel Home Health Care in exchange for patient referrals. U.S. District Judge Paul Borman of the Eastern District of Michigan imposed the sentence of 45 years in prison for the 50-year-old Fata and ordered him to forfeit $17.6 million.
Originally from Lebanon, Fata came to the U.S. in the 1990s to complete a hematology-oncology fellowship at Memorial Sloan-Kettering Cancer Center--training at a prestigious institution that he used to manipulate patients and family members questioning treatment decisions.
Michelle Mannarino said in a patient impact statement that Fata diagnosed her mom with breast cancer, and convinced her that she "had a very aggressive cancer that would become untreatable if she stopped chemo," including at one point 24-hour-drip with a drug more commonly used in colon cancers.
"Several times when I had researched and questioned his treatment, he asked if I had fellowshipped at Sloan Kettering like he had," Mannarino said.
One patient, according to the FBI, fell and hit his head during an office visit. Fata insisted that the patient complete a chemotherapy infusion before going to the hospital, and the man later died with a head injury.
Another patient, whose family testified anonymously, was diagnosed with advanced breast cancer and then urged by Fata to pursue an aggressive treatment strategy at the expense of her personal finances and her quality of life.
"Fata had instilled so much false hope of a cure over the months of seeing him," they wrote in a statement to the court. "Farid reminded [her] that she would die without him. We were wondering if there was any reason to file bankruptcy, questioning her life expectancy. He indicated again that he was trying a new therapy and we should definitely file bankruptcy on her behalf."
When the family asked about hospice, Fata apparently told them the end-of-life palliative option was unnecessary and their mother "would be around for a long time," they wrote. "He then held her hand, looked straight into her eyes and gently said, 'Don't worry, I will not let them stop the treatments you need.' She was very angry at us for the discussion that had just taken place… She was never able to accept that she was dying because Fata convinced her she was not. We never had the benefit of the final conversation we should have been able to have, to say the things we wanted to say."