Former orthopedic surgeon allegedly fraudulently reviewed 2.5K records in medical, workers compensation claims


Five years after former orthopedic surgeon Spyros Panos pled guilty to making millions in a healthcare fraud scheme and surrendered his medical license in 2013, he was arrested again for alleged fraudulent behavior, according to Bloomberg

This time, Mr. Panos is accused of posing as another orthopedic surgeon to review medical and workers' compensation claims for several insurance companies, a scheme he began while awaiting sentencing in his original fraud case.

More than 2,500 individuals have been notified that Mr. Panos fraudulently reviewed their medical information, however Bloomberg notes the "full reach" of the fraud allegations isn't yet public information. The volume of claims Mr. Panos reviewed that were denied has not been revealed. However, his indictment shows that of the 200 Connecticut-based claims he reviewed, he recommended denial in most.

Since 2013, he collected $876,000 by reviewing medical and workers' compensation claims. Anthem, Health Care Services and The Hartford are examining the cases that Mr. Panos may have influenced during review. Other insurance companies have notified members their privacy was violated, but did not detail how.


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