United States Attorney's Office District of Connecticut
Press Release

WATERBURY DOCTOR PAYS $160,000 TO SETTLE CIVIL ALLEGATIONS UNDER THE FALSE CLAIMS ACT

The United States Attorney for the District of Connecticut today announced that JUAN FICA, of Waterbury, Connecticut, has entered into a civil settlement agreement with the Government to resolve allegations that he violated the False Claims Act by submitting false claims to the Medicare and Medicaid programs.

The Government alleged that, from 1996 through 2003, FICA employed an individual named Elie Nakouzi to work at FICA’s medical practice, located at 1389 West Main Street in Waterbury. Although Nakouzi was not licensed to practice medicine, Nakouzi treated patients in FICA’s medical practice. During this time, FICA and Nakouzi referred to Nakouzi as “Doctor Nakouzi,” and Nakouzi signed FICA’s initials on prescriptions and medical records that Nakouzi had written. FICA then billed insurance companies for services that were rendered by Nakouzi, representing them as services rendered by FICA.

Through this scheme, FICA defrauded the Medicare and Medicaid programs of approximately $80,000. To settle allegations under the False Claims Act, FICA agreed to pay double damages, in the amount of $160,000. The False Claims Act provides for treble damages and penalties of $5,500 to $11,000 per false claim submitted to the Government.

A complaint against FICA was filed in the United States District Court in Connecticut under the qui tam, or whistleblower, provisions of the False Claims Act. The complaint made a number of allegations about FICA’s billing practices, including that FICA charged Medicare and Medicaid for services rendered by Nakouzi. The relator (whistleblower) will receive a share of the proceeds of the settlement in the amount of $30,400.

On August 9, 2006, FICA was sentenced to 18 months of imprisonment, followed by two years of supervised release, for conspiring to commit health care fraud. The Court also ordered FICA to pay a fine in the amount of $4,000 and nearly $156,000 in criminal restitution. On December 13, Nakouzi was sentenced to two months of imprisonment, four months of home confinement and three years of supervised release. Nakouzi was also ordered to pay a fine in the amount of $4,000 and to perform 150 hours of community service during his term of supervised release.

The United States Attorney noted the collaborative investigative efforts of the Health Care Fraud Task Force in the case, including the work done by members of the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office and the Connecticut Attorney General’s Office.

The Health Care Fraud Task Force, which is coordinated by the Federal Bureau of Investigation and the Inspector General of the U.S. Department of Health and Human Services, addresses abuses of the health care system in Connecticut. Members of the Task Force who investigated this case include special agents from the FBI, HHS-OIG, the Food and Drug Administration, the U.S. Defense Criminal Investigative Service, and inspectors from the Chief State’s Attorney’s Office.

The U.S. Attorney’s Office stated that anyone with information concerning health care fraud is encouraged to contact the FBI Health Care Fraud hotline at (203) 785-9270, or 1-800-HHS-TIPS.

This case was prosecuted by Assistant United States Attorney Richard M. Molot and Auditor Susan Spiegel.

CONTACT:

U.S. ATTORNEY'S OFFICE
Tom Carson
(203) 821-3722
thomas.carson@usdoj.gov