Jefferson County Doctor Sentenced to Federal Prison for Health Care Fraud Violations

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BEAUMONT, Texas – A physician practicing in Beaumont has been sentenced to prison for federal health care fraud violations in the Eastern District of Texas, announced Acting U.S. Attorney Nicholas J. Ganjei today.

Grigoriy T. Rodonaia, 45, of Port Neches, Texas, was convicted by a jury on Nov. 17, 2020, of 12 counts of health care fraud, three counts of aggravated identity theft, and one count of making a false statement.  Rodonaia was sentenced to 84 months in federal prison today by U.S. District Judge Marcia Crone.  Rodonaia was additionally ordered to pay $195,607.76 in restitution.

“Mr. Rodonaia’s sentence is well deserved. His criminal acts inflicted significant financial harm on the TRICARE system and involved identity theft from military service members and their families,” said Acting U.S. Attorney Nicholas J. Ganjei. “Targeting health care fraud in all its forms remains a top priority for the U.S. Attorney’s Office for the Eastern District of Texas.”

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Rodonaia, a physician practicing in Beaumont with Rodonaia Family Medicine and Aesthetics, was indicted on March 18, 2020.  According to information presented in court, beginning in January 2015, Rodonaia participated in a health care fraud scheme by issuing prescriptions for specially compounded scar creams using the names, dates of birth, and Health Insurance Claim Numbers of TRICARE beneficiaries, and caused the prescriptions to be forwarded directly to Memorial Compounding Pharmacy in Houston, Texas.  These prescriptions were issued without consultation with the patient and without the patient’s knowledge.  The pharmacy billed the prescriptions to the military health care program, TRICARE, at approximately $9,000 to $13,000 per prescription, with multiple refills authorized per prescription. Rodonaia issued over 600 prescriptions in the names of approximately 140 beneficiaries in furtherance of this scheme.  Before the scheme could be detected, TRICARE paid approximately $6.7 million in TRICARE funds to Memorial Compounding Pharmacy.  Further, to conceal his criminal activity, Rodonaia forged patient records to create the false appearance that he had examined those patients, and he submitted the fraudulent records to the Defense Health Agency in response to an audit.

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This case was investigated by the Defense Criminal Investigative Service, the Drug Enforcement Administration, Health and Human Services – Office of Inspector General, and the Texas Medicaid Fraud Control Unit. Assistant U.S. Attorneys John B. Ross and Robert A. Wells prosecuted this case.

 

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