DOCTORS BEHIND BARS: MY NEIGHBOR, THE VASCULAR SURGEON, SENTENCED TO 80 MONTHS IN FEDERAL PRISON FOR $60 MILLION HEALTH-CARE FRAUD…& LAUNDERING MORE THAN $49 MILLION!

There goes the neighborhood!

Dr. Vasso Godiali, shown above, was sentenced May 2, 2023 in the Bay City courtroom of U. S. District Judge Thomas L. Ludington.

While federal prosecutors requested a 108 month term, Ludington sentenced Godiali to 80 months.

Godiali, a vascular surgeon, was indicted in July 2019 and charged with orchestrating a $60 million health care fraud scheme. In addition, he was also charged with money laundering, for financial transactions involving approximately $49 million in proceeds he derived from the scheme.

His massive home, just steps from my own, was featured in the Bay City Garden Club’s 2013 “Secret Spaces, Incredible Places” Garden Walk. I can tell you from my own experience it’s not so impressive, having been been seized by the feds nearly four years ago. (Yes, the property was secured and is regularly inspected.)

Vasso Godiali, a vascular surgeon, was an established and successful
physician with a busy medical office in Bay City, Michigan. Godiali had a large patient base and enjoyed a lucrative and successful practice.

However, professional success and a comfortable living were not enough for Godiali.

Beginning in approximately 2009, Godiali chose to “pad” his already substantial income with fraudulent billings to health insurers. As Godiali discovered the ease with which these fraudulent claims could be submitted, he began to submit them on a more regular basis.

By 2014, Godiali’s fraud consumed him, with the majority of his
claims to health insurers reflecting fraudulent representations of some sort. The end result was a massive multi-year scheme to defraud involving at least $19.5 million in false claims to Medicare, Medicaid, and Blue Cross-Blue Shield of Michigan.

Excerpts from the government’s March 16, 2023 sentencing memo:

BACKGROUND
Dr. Vasso Godiali is a vascular surgeon who practiced in Bay City,
Michigan. For more than a decade, he had a busy practice which consisted, in large part, of hemodialysis patients who needed frequent surgical interventions.
Godiali’s practice was important to the community because vascular surgeons specializing in these patients were uncommon in mid-Michigan. And his practice was lucrative: in 2008, Medicare paid Godiali more than $3.5 million.

But that wasn’t enough. So Godiali devised and implemented a scheme to steal money from health insurers. He stole from Medicare mainly and he started out slowly. But the early successes of his fraud scheme emboldened him. By 2014, fraud touched almost every bill Godiali submitted to Medicare, Medicaid, and Blue Cross.

Godiali’s fraud came in two main categories: first, he lied to get paid for
procedures he did not perform, and second, he used overrides in the insurance coding system — what are called edits — to unbundle his claims and bill for each part of a procedure rather than for the procedure as a whole. In total, he stole at least $19.5 million dollars.

During the period of his fraud, Medicare, Medicaid, and Blue Cross paid
Godiali’s claims into his Bay City Vascular account at First Merit Bank. Godiali,
or his representatives, then directed the transfer of the insurance money into a
cascade of accounts held in the names of fictive businesses he created like
Essexville Auto Rental and Essexville Office and Medical Supplies. From these second-tier accounts, Godiali commonly had his money moved
into a third level account held in the name of Metro Medical, another non existent business entity. He created invoices which purported to document payment to Metro Medical for things like “Custom Surgical Kit” and “Wound Med Pac.”

Once money pooled in the tier three Metro-Medical account, Godiali moved
it into a fourth layer of accounts, these in his name and his wife’s. And from there, money was moved into a fifth tier of bank, insurance, and investment accounts, some held in his name, some in his business’s name, some in the name of other businesses.

Godiali’s attempts to conceal the fruits of his crimes also involved moving
funds to Switzerland while failing to file Foreign Bank Account Reports (FBARS).
In 2012, he ultimately repatriated the funds to the United States entering into the United States Treasury Department’s Offshore Voluntary Disclosure Program
(OVDP) in 2012. He eventually filed FBARS for tax years 2008, 2009, 2010,
2011, 2012, and 2013.

You know I’ll be there when Chez Godiali hits the market!