As freestanding surgery centers welcome an ever-growing number of hopeful total joints patients, core components of successful programs have enabled various surgery centers to capitalize on the surge.
A New York City surgeon pleaded guilty to financial crimes in connection with an extensive trip-and-fall scheme that authorities say included performing unnecessary back surgeries on patients who were recruited from homeless shelters or in the midst of active drug addictions.
Sady Ribeiro, MD, was charged with conspiracy to commit mail fraud and conspiracy to commit wire fraud, each of which carries a maximum sentence of five years in prison. Dr. Ribeiro forfeited more than $513,000 to the federal government and agreed to make restitution payments of nearly $4 million.
U.S. Attorney Damian Williams says Dr. Ribeiro and Adrian Alexander, the owner of a litigation funding company who was part of the scheme and who pleaded guilty to a wire-fraud conspiracy charge, obtained fraudulent insurance reimbursements and other compensation from bogus trip-and-fall cases from about January 2013 to April 2018. Both men are awaiting their sentences.
The patients involved in the scheme were referred to specific attorneys, who would file personal injury lawsuits against the owners of the accident sites and their insurers, and were instructed to receive ongoing chiropractic and medical treatments, says the U.S. Attorney’s Office. Patients were allegedly told they had to undergo surgery — in many cases two procedures — to receive payments that ranged from $1,000 to $1,500.
“As alleged, Dr. Ribeiro abused his professional license and position of trust by performing medically unnecessary surgeries to increase the value of fraudulent trip-and-fall lawsuits,” says Mr. Williams in a press release. “In carrying out the scheme, Mr. Alexander, who funded many of the fraudulent lawsuits, Dr. Ribeiro and their co-conspirators preyed upon the most vulnerable members of society in order to enrich themselves.”
Court documents say many of the patients were desperate enough to undergo surgeries in exchange for cash. “For example, it was common for patients to ask for food when they would appear for their intake meetings with the lawyers. Many of the patients did not have sufficient clothing to keep them warm during the wintertime and had poor-quality shoes,” says the U.S. Attorney’s Office.
The patients either falsely claimed they fell after tripping in cellar doorways, on cracked sidewalks or in potholes, or staged falls at those locations. The attempts to defraud property owners and insurance companies from subsequent personal injury lawsuits totaled $31 million. Medical treatment included unnecessary surgery and chiropractic work on nearly 200 patients. Most of the money from the lawsuits went to Mr. Alexander’s litigation funding company, not the fake patients, contends the U.S. Attorney’s Office.
Dr. Ribeiro and Mr. Alexander could not be reached for comment. In the New York Daily News, Dr. Ribeiro’s attorney Kenneth Abell said the procedures referred to as surgeries by prosecutors were minimally invasive, took less than 10 minutes to perform and presented no risks to the patients.Adam Taylor