Criminal Doctor Redux: Two Years Ago Today . . .

“Doctor Ajemian corrupted the license publicly granted to him to practice medicine, and betrayed the public trust embodied in that privilege. By his fraudulent actions, he not only distorted his professional duties, but flipped the physician’s medical function on its head and made health care a mockery.” (U.S. District Judge Victor Marrero)

Dr Peter J Ajemian

Dr Peter J Ajemian

_____________________

State: New York – Felony conviction relating to health care fraud  (1/20/2014)

  • Action Taken: Exclusion from Medicare Program
  • Summary: Federal sanction
  • State: New York
  • Felony conviction  (6/28/2013)
  • Action Taken: Surrender
  • Summary: Please reference the following Document
  • Documentation: Download here (PDF)

The U.S. Attorney’s Office, Southern District of New York, has announced that Doctor Peter J. Ajemian was sentenced today in Manhattan Federal Court to an 8-year prison term. This, as the result of his role in a massive Long Island Railroad – LIRR – fraud scheme that enabled employees to falsely claim early retirement and disability based upon non-existent disability assessments.

Investigators discovered that over a 10-year span beginning in 1998, Ajemian falsely documented on 735 medical charts of retiring LIRR employees, that they were eligible for physical disability benefits. In his position at the time, Ajemian was responsible for treating 50% of the LIRR employees who retired and received disability benefits. AJEMIAN changed his ‘not guilty’ plea to ‘guilty’ January 2013 to Health Care Fraud, Mail Fraud and Wire Fraud, before U.S. District Judge Victor Marrero. It was Marrero who imposed Ajemian’s federal prison sentence.

“Today Dr. Ajemian begins to pay the price for being a key facilitator of a massive disability fraud on the LIRR, that he admitted resulted in losses of millions of dollars.(Manhattan U.S. Attorney Preet Bharara)

The Railroad Retirement Board functions as an independent government agency to administer benefit programs, including disability benefits, to the nation’s railroad workers and their families. A unique LIRR contract allowed employees to retire at the relatively young age of 50.

Ajemian. as a certified orthopedist, was instrumental in ensuring LIRR retirees receive disability benefits to which they were not entitled. Between the late 1990s and 2008, this criminal physician declared 95% of the LIRR employees he evaluated as “disabled.” He routinely created false documentation to show the train employees’ steady decline in health coincided with their pre-planned retirement dates. He then provided to those LIRR employees medical reports to submit to the Retirement Board, that claimed they should receive disability annuities. These medical narratives were at times fabricated, at other times grossly exaggerated, so the doctor could recommend work restrictions that – if legitimate – would render it impossible for the railroad employees to continue performing their jobs.

Ajemian, in return, received an average of $1000 in cash for his fake reports from each employee. He also amassed $2,500,000 in health insurance payments for bogus medical treatments. The “patients” received $90,000,000 in disability benefit payments.

Ajemian, age 63, lived in luxury in Oyster Bay Cove until he was moved behind bars. He was also ordered to forfeit $116,000,000 and pay another $116,000,000 in restitution.

Here’s another view of this seriously ugly American health fraud case:

http://www.rrb.gov/pdf/oig/pr081913.pdf

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