Health Care Fraud—Unlicensed Physician

Two men in Connecticut have been indicted on nine counts of health care fraud and one count of conspiracy.^[1] Juan Fica and Elie Nakouzi are accused of running a scheme wherein Mr. Fica hired Mr. Nakouzi, who does not hold a medical license, to work in Mr. Fica’s medical practice.^[2] Mr. Nakouzi allegedly performed medical services on Mr. Fica’s patients with his knowledge, and then billed insurance companies for those services.^[3]

Health Care Fraud
Under 18 U.S.C. § 1347, it is a crime for a person to execute a scheme or artifice to defraud a health care benefit program^[4] or to obtain money from a health care program by false pretenses.^[5]

The punishment for a violation of section 1347 is a fine, imprisonment for up to 10 years, or both. If the violation results in substantial bodily injury, the person can be imprisoned for up to twenty years, and if death results, he can be sentenced to life in prison.

Conspiracy
We have previously discussed conspiracy here.

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[1] US Attorneys Office, Press Release: Waterbury Doctor and Hamden Man Charged with Health Care Fraud, Oct. 7, 2005, available here.
[2] Id.
[3] Id.
[4] 18 U.S.C. § 1347(1).
[5] Id. § 1347(2).