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NY Surgeon Pleads Guilty to Fraud for Faking Surgeries

Handout(WHITE PLAINS, N.Y.) -- An orthopedic surgeon who botched and faked thousands of surgeries over a five-year period has pleaded guilty to one count of healthcare fraud.

Dr. Spyros Panos, who practiced medicine in Poughkeepsie, N.Y., changed his plea from not guilty to guilty when he appeared in federal court in White Plains, N.Y. last week.

Under a plea arrangement, he faces up to 10 years in federal prison and must pay a $250,000 fine.  He has also agreed to pay the government $5 million as restitution for false and overstated Medicare and Medicaid charges.

Panos was freed on bail and will be sentenced in March next year.

"I willingly and knowingly executed a scheme to defraud the health care benefit programs by causing my medical practice, Mid-Hudson Medical Group in Dutchess County, New York, to submit bills to insurance providers that included inaccurate billing codes in order to obtain higher insurance payments than that would have been paid for the procedures I actually performed," Panos read aloud from a written statement in court after entering his plea.

According to court transcripts, by pleading guilty, Panos admitted to making false representations of the medical services he performed.  For example, Panos claimed he performed various techniques and procedures during surgeries when in fact he did not, either because they weren't medically necessary or because they would have resulted in reduced payments from insurance providers.

The charges stated that from 2007 through 2011 Panos reported performing "thousands of surgical procedures, often as many as 20 or more in a single day," including many which were never carried out.  Panos and his former medical group submitted claims in excess of $35 million to health care providers.

The federal government claimed that as part of his scheme to defraud insurance providers, he routinely saw up to 90 patients in a single office day, charging insurance carriers an additional $3.5 million in claims during that time period, court records show.

Panos was joined in court by his wife, mother and two brothers.  He showed no emotion as he read his plea and statement. But after his guilty admission, he turned to his family and began sobbing.

"Mr. Panos, the only thing I'm going to say to you is that you appear to have a lot of support. That's a very positive sign. I pray for you and your family that all goes well from here on in and I wish you best of luck," District Judge Nelson Roman said to him.

Plaintiffs who have civil lawsuits still pending against Panos were far less sympathetic.

"I don't feel sorry for him at all. My family has been crying for four years," said Debra Nenni McNamee, whose mother Constance Nenni died shortly after having an allegedly faked knee surgery by Panos.

In March 2010, her mother underwent surgery to repair a left knee that had grown arthritic from 76 years of wear and tear, McNamee said.  She died less than 24 hours later.

McNamee said she was glad that Panos was finally forced to admit his guilt publically, though she said she is frustrated that the only thing he has confessed to is fraud.

There are 261 civil cases against Panos for performing fake, mismanaged or unneeded surgeries.

"The biggest disappointment is that his fraud case has consumed three years but the malpractice cases and the human beings he hurt have been put on hold," she said. "I can only hope that our cases move forward now.  We've been put on the back burner so the state can get their money back and we've been left with nothing but grief."

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