Florida physician pleads guilty to $29M fraud


Ugly Case of Health Care Fraud - Pondera Solutions

Moses D. deGraft-Johnson, MD, pleaded guilty Dec. 18 to 56 counts of healthcare fraud, conspiracy to commit healthcare fraud and aggravated identity theft, according to the Department of Justice

Between late 2015 and his arrest in February of this year, Dr. deGraft-Johnson, who owned and operated the Heart and Vascular Institute of North Florida in Tallahassee, performed invasive surgical procedures on patients who didn’t need them or altered patients’ medical records to reflect procedures he didn’t perform. 

As part of his plea deal, Dr. deGraft-Johnson acknowledged consistently performing two invasive diagnostic angiography procedures on hundreds of patients, whether medically necessary or not. When the patients returned for follow-up office visits, Dr. deGraft-Johnson submitted fraudulent claims to their insurance companies stating he performed atherectomies during the appointments. Using this scheme, the physician admitted he claimed to have performed more than 3,000 of these surgical procedures to clear blockages in arteries in as many as 845 of his patients’ legs. 

In court documents released in February, prosecutors provided several examples of Dr. deGraft-Johnson’s fraud. In one case, he claimed to have done 14 procedures during a seven-hour period. Prosecutors said the procedures would have taken roughly 28 hours, according to The New York Times. In another example, he allegedly claimed to have performed 13 atherectomies on patients in Florida when he was traveling abroad.

Dr. deGraft-Johnson submitted false claims to insurers for the surgeries he didn’t perform and for the unnecessary procedures. As of Dec. 18, the investigation revealed he received at least $29 million through the fraud scheme. 

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