BEAUMONT, Texas — A Beaumont doctor who was indicted in March on healthcare fraud charges alleging he created more than 600 fake prescriptions costing taxpayers more than $6 million entered a not guilty plea on Wednesday.
Dr. Grigoriy T. Rodonaia, 43, of Port Neches, was indicted on March 18, 2020, on 35 charges of healthcare fraud according to a Wednesday news release from the U.S. Attorney’s Office.
He faces up to 10 years in prison for each charge.
Dr.Rodonaia's Beaumont offices at Rodonaia Family Medicine and Aesthetics were raided in April 2018 by agents with the DEA and Port Arthur and Beaumont Police officers according to file stories.
Officers could be seen loading up boxes of evidence as well as a computer from the practice at the time.
Dr.Rodonaia earned his medical degree from St. George’s University in the Caribbean in 2004 and has been a licensed physician since 2007.
Dr. Rodonaia told 12News at the time that he was innocent and said he really didn't know why he was being investigated but mentioned that the DEA was investigating how his office runs.
He is accused of creating more than 600 fake prescriptions for “specially compounded scar creams” for about 140 patients without their knowledge the release said.
Rodonaia used the patient’s personal information and TriCare health insurance information and sent the prescriptions, which authorized multiple refills and were valued at $9,000 - $13,000 each, to the Memorial Compounding Pharmacy in Houston the release said.
The release also alleged that Rodonaia had never examined or consulted with the patients.
TriCare, which is the health care program for service members, retirees and their families, ended up paying out more than $6.7 million to the pharmacy the release said.
He also created false records for the patients which he then submitted to the health agency according to the release.
Rodonaia is also accused of requiring Medicare and Medicaid patients seeking “opioid treatment” to pay cash for office visits in excess of what would be reimbursed to them.
The indictment also alleges that Rodonaia dispensed the weight control drug Adipex-P or Phentermine, a schedule IV controlled substance, “outside the course of standard medical practice.”
The Defense Criminal Investigative Service, Drug Enforcement Administration, Health and Human Services – Office of Inspector General and the Texas Medicaid Fraud Control Unit are investigating the case. Assistant U.S. Attorney Robert L. Rawls is prosecuting.
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From a U.S. Attorney’s Office news release…
A 43-year-old physician practicing in Beaumont has been indicted on federal health care fraud violations in the Eastern District of Texas, announced U.S. Attorney Stephen J. Cox today.
Grigoriy T. Rodonaia, of Port Neches, Texas, was indicted on March 18, 2020 and charged with 35 counts of health care fraud and other related violations. Rodonaia appeared before U.S. Magistrate Judge Keith Giblin today for an initial appearance.
According to the indictment, beginning in January 2015, Rodonaia is alleged to have participated in a health care fraud scheme by issuing prescriptions for specially compounded scar creams using the names, dates of birth, and Health Insurance Claim Numbers of TRICARE beneficiaries and caused the prescriptions to be forwarded directly to Memorial Compounding Pharmacy in Houston, Texas without the specific knowledge of the beneficiary and without having examined or consulted with the beneficiary. The prescriptions were billed to the military health care program, TRICARE, by the pharmacy at the approximate cost of $9,000 - $13,000 per prescription and the prescriptions authorized multiple refills. Over 600 prescriptions in the names of approximately 140 beneficiaries were issued by Rodonaia in this manner outside the usual course of professional practice and without medical necessity. Before the scheme could be detected, TRICARE paid approximately $6.7 million in TRICARE funds to Memorial Compounding Pharmacy. The indictment also alleges Rodonaia created patient files and records of the TRICARE beneficiaries as though he had examined or consulted with those patients and submitted those false records to the Defense Health Agency as part of an audit of the prescription scheme.
The indictment also alleges the defendant violated the Anti-kickback statute by requiring Medicare and Medicaid beneficiaries seeking opioid treatment to pay cash for an office visit in excess of the amount which would have been reimbursed by the Medicare and Medicaid programs. The indictment further alleges that Rodonaia dispensed a Schedule IV controlled substance, Adipex-P or Phentermine, a weight control drug, outside the course of standard medical practice.
If convicted, Rodonaia faces up to 10 years in prison for each count of health care fraud and a mandatory 2 years in prison for each count of aggravated identity theft. A grand jury indictment is not evidence of guilt.
This case is being investigated by the Defense Criminal Investigative Service, the Drug Enforcement Administration, Health and Human Services – Office of Inspector General, and the Texas Medicaid Fraud Control Unit. Assistant U.S. Attorney Robert L. Rawls is prosecuting this case.
