Michigan surgeon sentenced to 80 months in prison for health care fraud
A Bay City vascular surgeon was sentenced to 80 months in prison for orchestrating a multimillion-dollar scheme to defraud health care programs, the U.S. Department of Justice announced on Thursday.
Vasso Godiali was ordered to pay $19.5 million in restitution to Medicare, Medicaid and Blue Cross Blue Shield of Michigan. He was sentenced on May 3, according to the release Thursday.
Godiali began defrauding medical insurers, including Medicare and Medicaid, in 2009, Justice officials said, citing a plea agreement reached on Feb. 8, 2022. Godiali billed for the placement of multiple vascular stents in the same blood vessel and prepared medical records claiming to document the necessity to collect payment.
"In fact, however, Godiali did not place those stents and admitted to billing for services never rendered while preparing materially inaccurate medical records to justify the fraudulent billings," the Justice Department said.
The scheme resulted in $14,473,000 in damages to the federal government and $19.5 million in losses to Medicare, Medicaid and Blue Cross. Part of the plea included restitution.
“We will not tolerate the use of federal health care programs as a source of personal enrichment,” said Brian M. Boynton, principal deputy assistant attorney general , head of the Justice Department’s Civil Division.
Godiali agreed to pay the U.S. government up to $43.4 million to resolve related civil allegations that his fraudulent billings to federal health care programs violated the False Claims Act, according to the release.
A civil settlement includes the resolution of claims brought under the whistleblower provisions of the False Claims Act by Innovative Solutions Consulting, LLC, the Justice Department said. Under those provisions, a private party can receive a portion of any recovery. Innovative Solutions will receive up to $4,341,900.
A civil forfeiture case resulted in the seizure of almost $40 million from financial accounts controlled by Godiali, except for $7.5 million, which will be released to Godiali’s wife pursuant to an agreement with the government.
All of the seized funds will be used to pay the criminal judgment or the False Claims Act settlement, officials said.
“This provider egregiously stole millions of dollars from taxpayers by billing federal health care programs for services that were neither medically necessary nor rendered to his patients,” said Special Agent Mario M. Pinto of the Department of Health and Human Services Office of Inspector General.
In addition to inaccurate medical records to justify fraudulent billings, officials said Godiali billed for arterial thrombectomies and created medical records that stated he encountered occluded arteries that would justify the performance of the procedures.
He admitted that he often encountered no such occlusions and performed no such thrombectomies, and billed insurers for services never rendered while preparing false medical records to justify the fraudulent claims, according to the release.
“A priority of my office is protecting our district against unscrupulous health care providers.” said U.S. Attorney Dawn N. Ison for the Eastern District of Michigan.
"We hope that today’s sentence and substantial civil recovery deter any other physicians likewise inclined to line their pockets at the expense of the public," Ison said.