Orthopedic Surgeon To Serve 16 Months for HealthCare Insurance Fraud
On May 21, 2024, Dr. Olarewaju James Oladipo, a 60-year-old orthopedic surgeon from Canton, Massachusetts, was sentenced in federal court in Boston for his role in a healthcare insurance 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 Court Judge Allison D. Burroughs sentenced Oladipo to 16 months in prison, followed by one year of supervised release. The court also imposed a special assessment of $1,000, with forfeiture and restitution to be determined at a later date.
Overview of the Health Care Fraud Scheme
Oladipo’s healthcare fraud scheme lasted from approximately January 2016 through December 2019. During this period, He falsely billed insurers and MassHealth for patient visits using more expensive billing codes despite not providing the corresponding complex services. He used codes for more intricate examinations and services that were not actually performed and falsified medical records to reflect these non-existent services.
Oladipo’s fraudulent billing practices were staggering in volume. He frequently billed for more than 60 patients per day and sometimes even exceeded 100 patients in a single day. Given the sheer number of patients, many visits could have only lasted five minutes or less. However, Oladipo used billing codes that typically corresponded to visits lasting 15, 25, 30, or even 45 minutes.
Oladipo’s Opioid Prescribing Practices
In addition to his fraudulent billing, Oladipo was also one of the top prescribers of opioids in Massachusetts. In 2017, he was the highest prescriber of an opioid pain reliever for MassHealth fee for service members, and in 2018, he was the second-highest prescriber in that category.
The scale of Oladipo’s opioid prescribing was massive. In 2018 alone, he issued more than 12,000 prescriptions for opioids, totaling nearly 900,000 pills to more than 1,100 patients. Following an audit in 2018, MassHealth terminated Oladipo as a participating provider.
Oladipo’s fraud is part of the huge problem in the health insurance industry
The financial impact of Oladipo’s healthcare fraud scheme was substantial. An insurance company representative, a victim of Oladipo’s crimes, testified at trial that such fraud is “a huge problem in our industry.” Taxpayer-funded health plans like MassHealth were also affected by Oladipo’s fraudulent activities.
Beyond the financial repercussions, Oladipo’s crimes contributed to the ongoing opioid epidemic in Massachusetts. His excessive opioid prescribing practices resulted in large quantities of oxycodone being introduced into the community, with prescriptions, in most cases, going to patients already suffering from opioid addiction.
Prosecution Team
The U.S. Attorney’s Office for the District of Massachusetts announced Dr. Olarewaju James Oladipo’s sentencing. The case was investigated by various federal and state law enforcement agencies, including the Federal Bureau of Investigation, Health and Human Services’ Office of Inspector General, and the United States Postal Service Office of Inspector General.
The prosecution team also received valuable assistance from the Massachusetts Attorney General’s Office, the National Insurance Crime Bureau, and the Drug Enforcement Administration. Assistant U.S. Attorneys Evan D. Panich and William B. Brady prosecuted the case.
