Dr. Spyros Panos, Multimillion Dollar Health Care Fraud Scheme, New York 2023

Dr. Spyros Panos, a 45-year-old orthopedic surgeon from Dutchess County, New York, has been sentenced to 54 months in prison for operating a long-running health care fraud scheme that defrauded Medicare, the New York State Insurance Fund, and numerous private health insurance providers out of over $2.5 million.

According to the United States Attorney for the Southern District of New York, Preet Bharara, Dr. Panos’s fraud was extensive, costing millions of dollars to federal, state, and private health insurance providers when he billed for thousands of surgical procedures that he falsely described or did not perform at all.

Dr. Panos, who was a board-certified orthopedic surgeon licensed to practice medicine in the State of New York, was part of a medical group with offices in Dutchess County, New York. He performed orthopedic surgical procedures at hospitals in Poughkeepsie, New York, and maintained a high-volume orthopedic practice that enabled him to carry out his fraud scheme on a large scale.

Between 2006 and July 2011, Dr. Panos performed thousands of surgical procedures, often as many as 20 or more in a single day, for which he and the medical group submitted claims in excess of $35 million to health insurance providers. Health insurance providers paid the medical group in excess of $13 million on these claims.

However, Dr. Panos furnished false information to health insurance providers, resulting in them paying the medical group at least $2.5 million more than they were entitled to receive based on the true nature and details of the surgical procedures Dr. Panos performed. Among Dr. Panos’s false representations were claims that he performed open surgeries when in fact he performed them arthroscopically, and that he used certain techniques and procedures during the course of the surgical procedures when in fact he did not.

As a result of his conviction, Dr. Panos is subject to mandatory exclusion from participation in any federal health care program, including Medicare and Medicaid. He also agreed to the entry of a $5 million order of forfeiture against him. Dr. Panos must surrender to start serving his prison term in 30 days.

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