On Could 21, 2024, Dr. Olarewaju James Oladipo, a 60-year-old orthopedic surgeon from Canton, Massachusetts, was sentenced in federal courtroom in Boston for his function in a healthcare insurance coverage fraud scheme. Oladipo was convicted by a federal jury in December 2023 on ten counts of healthcare fraud.
Sixteen months to serve
U.S. District Courtroom Decide Allison D. Burroughs sentenced Oladipo to 16 months in jail, adopted by one yr of supervised launch. The courtroom additionally imposed a particular evaluation of $1,000, with forfeiture and restitution to be decided at a later date.
Overview of the Well being Care Fraud Scheme
Oladipo’s healthcare fraud scheme lasted from roughly January 2016 by means of December 2019. Throughout this era, he falsely billed insurers and MassHealth for affected person visits utilizing costlier billing codes regardless of not offering the corresponding complicated providers. He used codes for extra intricate examinations and providers that weren’t really carried out and falsified medical data to replicate these non-existent providers.
Oladipo’s fraudulent billing practices had been staggering in quantity. He continuously billed for greater than 60 sufferers per day and typically even exceeded 100 sufferers in a single day. Given the sheer variety of sufferers, many visits might have solely lasted 5 minutes or much less. Nevertheless, Oladipo used billing codes that usually corresponded to visits lasting 15, 25, 30, and even 45 minutes.
Oladipo’s Opioid Prescribing Practices
Along with his fraudulent billing, Oladipo was additionally one of many prime prescribers of opioids in Massachusetts. In 2017, he was the best prescriber of an opioid ache reliever for MassHealth payment for service members, and in 2018, he was the second-highest prescriber in that class.
The size of Oladipo’s opioid prescribing was large. In 2018 alone, he issued greater than 12,000 prescriptions for opioids, totaling practically 900,000 tablets to greater than 1,100 sufferers. Following an audit in 2018, MassHealth terminated Oladipo as a taking part supplier.
Oladipo’s fraud is a part of the large drawback within the medical insurance business
The monetary affect of Oladipo’s healthcare fraud scheme was substantial. An insurance coverage firm consultant, a sufferer of Oladipo’s crimes, testified at trial that such fraud is “an enormous drawback in our business.” Taxpayer-funded well being plans like MassHealth had been additionally affected by Oladipo’s fraudulent actions.
Past the monetary repercussions, Oladipo’s crimes contributed to the continued opioid epidemic in Massachusetts. His extreme opioid prescribing practices resulted in massive portions of oxycodone being launched into the neighborhood, with prescriptions, usually, going to sufferers already affected by opioid dependancy.
Prosecution Workforce
The U.S. Legal professional’s Workplace for the District of Massachusetts introduced Dr. Olarewaju James Oladipo’s sentencing. The case was investigated by varied federal and state legislation enforcement businesses, together with the Federal Bureau of Investigation, Well being and Human Providers’ Workplace of Inspector Common, and the USA Postal Service Workplace of Inspector Common.
The prosecution staff additionally acquired worthwhile help from the Massachusetts Legal professional Common’s Workplace, the Nationwide Insurance coverage Crime Bureau, and the Drug Enforcement Administration. Assistant U.S. Attorneys Evan D. Panich and William B. Brady prosecuted the case.
