A federal jury found a prominent Northern Virginia dermatologist not guilty Monday of defrauding insurance companies by making false claims and performing unnecessary skin-removal procedures.
Amir Bajoghli, 45, who runs a thriving practice in the Washington area, has earned a pile of awards and commendations and lives in a $3.5 million home in McLean with his wife and three sons.
But during five weeks of testimony in the U.S. District Court in Alexandria, prosecutors painted a much darker portrait of Bajoghli, casting him as a rogue doctor who regularly told healthy patients they had skin cancer and who performed unnecessary and costly procedures in order to bilk insurance companies. They also said that Bajoghli routinely farmed out slides of skin cells to be analyzed on the cheap, but then submitted claims saying he had done the work, which allowed him to be compensated at a much higher rate.
“This is a case about lies and greed,” Assistant U.S. Attorney Paul Nathanson told jurors during the opening arguments of the trial, which began in late October. In the wood-paneled, sixth-floor courtroom, Nathanson argued that Bajoghli had lied to Medicare and insurance companies and repeatedly committed fraud. He cited 80 instances between 2009 and 2012 in which Bajoghli said cancer was present when in fact “there was no cancer there.”
The fraud, the government alleged, also involved having unlicensed and unqualified staff members perform procedures for which they had not been trained, including complex suturing and skin grafts.
Defense attorneys rejected all of the government’s claims and asserted that Bajoghli, the owner of Skin & Laser Surgery Center, with offices in Northern Virginia, never performed a procedure on a lesion that he did not believe was cancer. And they pointed out that experts looking at slides of skin cells often disagree when trying to determine whether the cells are cancerous.
“This prosecution was vexatious, frivolous, and in bad faith from the very beginning,” Kirk Ogrosky, one of Bajoghli’s attorneys, said in a statement Monday.
Defense lawyer Peter White of Schulte Roth & Zabel told the jury in his closing argument that “their case stinks. There is a complete failure by the government to prove fraudulent intent.”
Bajoghli’s attorneys argued that Bajoghli, a graduate of William & Mary and of Virginia Commonwealth University, was aggressively identifying and treating cancerous skin cells and that nothing about his practice or his billing was unacceptable.
“Everything that the insurers paid for, they got. And they got it with good quality,” White said in his closing argument. He urged the jury to find Bajoghli innocent of all charges.
“Let him go back to saving patients’ lives,” he said.
The jury agreed with the defense and found Bajoghli not guilty on all 41 charges against him. In a statement following his acquittal, the doctor offered thanks to the jury but was also sharply critical of the government’s case against him.
“Throughout this case, I cooperated with the government in every way possible and they pursued me without regard for the truth,” he said. “Thankfully the jurors were able to hear the facts.”
The case against Bajoghli was complex, and jury members were asked to consider evidence from a wide range of experts on what constituted fraud, the intricacies of insurance claim forms and discrepancies related to skin-cancer diagnoses.
Much of the case looked at a skin-cancer removal method called Mohs, which involves removing the cancer layer by layer in order to limit the amount of healthy skin that has to be removed. The practice is costlier than standard skin-cancer removal but is also believed to be more effective in most cases.
Bajoghli told insurance companies the test results showed cancer and that the Mohs procedures were medically necessary, Nathanson argued, because, “frankly, that was the only way he would get paid.”
The government’s first witness, Zineb Moussafir, a medical assistant in Bajoghli’s practice from 2009 to 2012, testified that she regularly performed wound repairs, skin grafts, and internal and external sutures, despite not being licensed by the state of Virginia and having had no training to do the procedures. She said that other medical assistants in the practice did the same, most of the time without any supervision.
But Ogrosky, of Arnold & Porter, successfully cast doubt on some of the government’s expert witnesses and on others who testified against the doctor. And the defense convinced the jury that Bajoghli never acted with the intent to defraud or mislead insurance companies.
“I’m pleased with the verdict and happy that the jury reached the right result,” White said Monday. “I thought that the judge did an excellent job giving him a fair trial, and I’m happy that he can go back to practicing medicine.”