ROME — An orthopedic surgeon in Rome is accused of scheming with telemedicine companies to try to bilk $10 million in fake Medicare claims, according to the U.S. Department of Justice.
Dr. Elemer Raffai, 56, of Rome, pleaded not guilty in Federal Court to one count of healthcare fraud, authorities said. He was scheduled to reappear in court on Friday.
Raffai worked as an orthopedic surgeon at Rome Medical Practice Orthopedics & Sports Medicine on East Chestnut Street. Raffai was previously affiliated with Rome Health, but hospital officials said he has not been on staff since 2013. He was also known to practice in Franklin County.
Justice Department officials said Raffai was one part of a large scheme involving several doctors and telemedicine companies that sought to bilk $10 million from the federal government through false Medicare claims. Officials said Medicare paid out more than $4 million in claims.
Between July 2016 and June 2017, authorities said Raffai had repeated, short telephone conversations with potential patients, without ever physically examining them or evaluating their medical needs. Authorities said Raffai then submitted Medicare claims for these patients requesting medical braces that were unnecessary and not required.
Raffai made these unwarranted Medicare claims because he was getting paid in bribes of about $25 to $30 per patient by the telemedicine company AffordADoc Network, authorities said. AffordADoc was, in turn, getting kickbacks from the medical brace suppliers to have doctors make these claims.
Between July 2016 and June 2017, authorities said Raffai was paid $176,000 by AffordADoc.
Meanwhile, according to the Justice Department, the CEO of AffordADoc, Lester Stockett, 52, of Colombia, previously pleaded guilty in Federal Court in September 2019 for his role in “one of the largest health car fraud schemes ever investigated by the FBI.” As part of his plea deal, Stockett agreed to pay $200 million in restitution.
Dr. Raffai faces a maximum of 10 years in federal prison if convicted.
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