NEW YORK – Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced on April 10 that Spyros Panos, a former orthopedic surgeon, who was previously convicted of health care fraud, was charged with wire fraud, health care fraud, and aggravated identity theft, in connection with a scheme in which he assumed the identity of a licensed orthopedic surgeon and obtained over $860,000 in payments for reviewing patient files in Workers Compensation cases. Panos was arrested this morning at his home in Hopewell Junction, New York, and was presented before U.S. Magistrate Judge Paul E. Davison in White Plains federal court this morning.
According to the allegations contained in the Complaint unsealed:
Spyros Panos, the defendant, was an orthopedic surgeon practicing in Dutchess County and residing in Hopewell Junction (the “Panos Residence”). In or about August 2013, Panos surrendered his license to practice medicine, and on or about October 31, 2013, he pled guilty, in United States District Court for the Southern District of New York, to a health care fraud charge (the “Health Care Fraud Charge”). In or about April 2014, Panos began serving a 54-month sentence. On or about September 16, 2016, Panos was released to a halfway house and then, about a month later, to home confinement. Since March 2017, he has been serving a two-year term of supervised release.
In connection with medical treatment relating to Workers’ Compensation claims, a peer review may be conducted when a treating physician requests a variance in treatment. The doctor performing the peer review is a licensed independent doctor who reviews the patient file but does not examine the patient, and writes a report opining whether the variance is appropriate. There are companies that supply doctors who conduct such peer reviews. Prior to being assigned to perform peer reviews, the doctor must establish that he/she has the proper credentials by providing, among other things: the schools from which the doctor earned his/her degrees and other educational credentials, the states in which he/she is licensed to practice medicine, and other pedigree and background information such as birth date and social security number.
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