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Perhaps he meant "world leading in health care fraud"

A former neurologist who has billed himself as a "world leading physician" is heading to prison, the Department of Justice (DOJ) announced in a June 8 press release.

Rassan Tarabein, who operated a pain management clinic in Daphne, Ala, admitted that for more than 10 years “he induced patients to visit his clinic so that he could bill health care benefit programs for medically unnecessary tests and procedures.”

That sounds bad enough, but a look at the details reveals that it was much, much worse. Tarabein admitted that he:

  • Administered unnecessary pain injections.

  • Told patients that they had to receive therapeutic and diagnostic procedures in order to receive prescriptions for opioids.

  • Used improper medical techniques and equipment to perform procedures.

  • Did not provide informed consent to patients about procedures.

  • Falsified his patients’ electronic signatures onto forms that indicated that waived their right to monitoring “against medical advice.”

  • Failed to monitor his patients’ vital signs during and after procedures, putting them at risk for complications.

  • Spent little time with patients to maximize billings.

  • Discriminated against Alabama Medicaid patients, including by singling out those patients to receive spinal injections in regular exam rooms -- without imaging guidance if he was behind schedule. (Image guidance has been required for most spine injections for several years; failing to use image guidance put patients at risk and constituted improper billing.)

  • Created fraudulent documentation, which included falsifying records to describe procedures that were anatomically impossible, and falsely stating he had used image guidance.

  • Submitted false claims to insurance companies and inflated billing codes.

  • Failed to properly train his clinic’s employees about best medical practices, such as sterility and accurate record keeping.

  • Issued prescriptions for controlled substances without a legitimate medical purpose and outside the usual course of professional practice, including by relying on pre-signed blank prescriptions when outside the United States to prescribe opioids.

  • Disregarded audits and regulatory actions. (Tarabein received, and ignored, multiple warnings from the Alabama Board of Medical Examiners and several health care plans.)

At his sentencing hearing several patients described the emotional and mental trauma they experienced as a result of Tarabein’s treatments.

Why did he do it? Money, says DOJ: “The purpose of Tarabein’s admitted scheme was to maximize personal financial gain by fraudulently seeking payments from health care benefit programs such as Medicare, Medicaid, Blue Cross Blue Shield of Alabama, Humana, UnitedHealthcare, Cigna HealthSpring, and other private insurers."

Tarabein was sentenced to five years in prison and one year of supervised release. He’ll also pay more than more than $15 million in restitution to six health care plans, including Medicare and Medicaid.

And that’s not the end of his legal troubles. On June 28 he’ll be sentenced for one count of Medicaid fraud.

Blog Tags: anti-fraud, compliance
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