Don't believe the myth that enforcers only keep the big fish in health care fraud schemes — hospitals, diagnostic providers, pharmaceutical companies and so on — and let the small fry such as doctors and medical practices go.
The continuing saga of Parsippany, N.J.-based lab, Biodiagnostic Laboratory Services LLC (BLS), shows that enforcement is using a fine seine and keeping whatever they catch. For example, three doctors with practices in nearby Staten Island and Yonkers, N.Y., are set to spend time behind bars for accepting bribes from the lab, and in the case of two doctors, demanding that the lab pay for additional services.
George Roussis, a pediatrician, and his brother, Nicholas Roussis, an obstetrician-gynecologist, both with practices in Staten Island, accepted cash payments totaling approximately $175,000 from BLS employees and associates between October 2010 and April 2013. In addition, at the request of the Roussis brothers, BLS paid for strip club trips, including paying women to perform lap dances and engage in sex acts with George and Nicholas Roussis. In exchange, George and Nicholas Roussis referred their patients’ blood specimens to BLS, generating more than $1,450,000 and $250,000 of lab business for BLS, respectively.
Ricky Sayegh, an internal medicine specialist with a practice in Yonkers, was more of a traditionalist. He settled for cash bribes in return for referrals.
From February 2010 through April 2013, Sayegh received bribes totaling approximately $400,000 from BLS employees and associates. Sayegh’s referrals generated more than $1.4 million in lab business for BLS. Sayegh received a three-year sentence.
The trio aren't the first doctors to be convicted in relation to the BLS cash-for-corpuscle scheme.
The investigation has thus far resulted in 50 convictions — 36 of them doctors — in connection with the bribery scheme, which its organizers have admitted involved millions of dollars in bribes and resulted in more than $100 million in payments to BLS from Medicare and various private insurance companies. It is believed to be the largest number of medical professionals ever prosecuted in a bribery case.
The case also demonstrates that prosecutors aren't restricted to laws related directly to health care fraud when they set out to convict suspects. The brothers Roussis and Sayegh were charged with violating the
anti-racketeering Travel Act, which prohibits "interstate and foreign travel or transportation in aid of racketeering enterprises."