United States Attorney's Office District of Connecticut
Press Release

Operation Free Shot: NORWALK DOCTOR WHO DEFRAUDED MEDICAID PROGRAM AND INSURANCE COMPANIES SENTENCED

Kevin J. O'Connor, United States Attorney for the District of Connecticut, announced that JORGE ELIAS, M.D., age 69, of 131 Musket Ridge Road, Norwalk, Connecticut, was sentenced today by Senior United States District Judge Ellen Bree Burns in New Haven to two years of probation and was ordered to pay a $30,000 fine for defrauding the Medicaid program and private health insurance companies. ELIAS had previously entered into a civil settlement agreement in which he agreed to pay $222,990.04 to the United States and the State of Connecticut, and had restitution in the amount of $108,000 to private insurance companies.

U.S. Attorney O'Connor noted that as a result of ELIAS's conviction, ELIAS will be barred from billing the Medicare and Medicaid programs. "This Office has a zero-tolerance policy when it comes to those who defraud government health care programs like Medicare and Medicaid," U.S. Attorney O'Connor stated.

In imposing a sentence of probation, Judge Burns noted that ELIAS is elderly and suffers from a serious heart condition. Before today's hearing, ELIAS had submitted evidence that he had suffered a heart attack 10 days after entering his guilty plea in May. Judge Burns also noted that ELIAS had promptly taken responsibility for his criminal conduct, and had voluntarily provided the Government with a list of insurance companies ELIAS had billed and provided other information that saved Government resources in determining the amount of loss caused by ELIAS's fraud. Judge Burns also noted that ELIAS had devoted his medical practice to caring for low-income patients.

U.S. Attorney O'Connor explained that this case is part of "Operation Free Shot," a continuing investigation by the Health Care Fraud Task Force. Operation Free Shot focuses on Connecticut health care providers who bill Medicaid and other insurance programs for childhood vaccines the providers received free-of-charge from the Vaccines For Children (VFC) program, a joint federal/state program that provides childhood immunizations. Under the VFC Program, doctors and other health care providers receive free vaccines distributed by the Department of Public Health, and agree not to bill Medicaid or any other third-party for the cost of the vaccines. The provider may recover a minimal fee for administrative costs associated with inoculating a child. In violation of these rules, ELIAS billed Medicaid and other insurance plans for the vaccine doses he received free from the VFC Program.

U.S. Attorney O'Connor noted that Operation Free Shot involved coordination among various federal and state authorities and agencies, and praised in the cooperation and assistance from all involved. "An integrated approach to fighting health care fraud is a powerful deterrent," said O'Connor. "And Connecticut intends to lead the nation in aggressively investigating and prosecuting such cases."

The Health Care Fraud Task Force, 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. Participants in the Task Force include the Connecticut Department of Public Health, the Connecticut Chief States Attorneys Office – Medicaid Fraud Control Unit, the U.S. Food and Drug Administration, the U.S. Postal Inspection Service, the Connecticut Department of Social Services, the Connecticut Attorney General's Office, the U.S. Internal Revenue Service, the U.S. Drug Enforcement Administration and the U.S. Defense Criminal Investigative Service. People who suspect health care fraud are encouraged to report it by calling the Task Force at (203) 785-9270.

The case was prosecuted by Assistant United States Attorneys David J. Sheldon of the Criminal Division, and Richard M. Molot of the Civil Division, along with Auditor Susan Spiegel.

CONTACT:

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