The Justice Department announced two cases of fraud involving orthopedic surgeons in the last month.
1. An orthopedic surgeon from Canton, Mass., faces 11 counts of healthcare fraud after allegedly "upcoding" patient visits. Olarewaju Oladipo, MD, allegedly executed his scheme from January 2016-December 2019, the Justice Department said. He allegedly used billing codes for more complex services that were not provided. Over four years, Dr. Oladipo allegedly billed for more than 60 patients daily and sometimes more than 90 in one day.
2. Elemer Raffai, MD, was indicted in connection with a $10 million scheme to defraud Medicare. He allegedly purported to practice with AffordADoc Network and other telemedicine companies that paid him for each consultation with a beneficiary. Between July 2016 and June 2017, he allegedly signed prescriptions and order forms for services that were not medically necessary. He and others involved in the scheme submitted about $10 million in false claims, and Medicare paid more than $4 million on them, according to the Justice Department.