March 13--Chicago podiatrist Dr. Shanin Moshiri was meeting with an administrator at Sacred Heart Hospital two years ago to collect what prosecutors allege was his monthly $2,000 kickback for referring Medicare patients to the West Side facility.
Moshiri was caught on an undercover FBI recording complaining that the hospital's CEO, Edward Novak, never seemed to be satisfied with the number of patients the hospital was taking on through the illegal referrals.
"He wants the Taj Mahal, all or nothing," Moshiri told Anthony Puorro, who at the time was Novak's second-in-command, on the recording. "He should be very happy I bring my patients here. ... I'm the most active podiatrist at the hospital."
That recording from March 2013 was highlighted Thursday as federal prosecutors began closing arguments in the trial of Novak and two of his top administrators on charges of running a massive Medicare fraud scheme that doled out hundreds of thousands of dollars in kickbacks to doctors.
Prosecutors allege that the now-closed hospital, which had no religious affiliation, was so desperate for revenue that it enticed physicians to refer patients by kicking back money to them -- much of it disguised as teaching contracts, lease agreements and staffing perks.
Attorneys for Novak and co-defendants Clarence Naglevoort and Roy Payawal have said that underlings were to blame for the misconduct, pointing the finger at Puorro and Noemi Velgara, the hospital's former vice president who also agreed to wear a wire after authorities approached her about her misconduct. They also said there was nothing unorthodox about a hospital trying to drum up business.
In six weeks of testimony, jurors heard numerous undercover recordings and testimony from dozens of witnesses. Among them was William Noorlag, who ran the hospital's podiatric residency program for more than a decade. He testified that Novak had set up teaching contracts to disguise kickbacks to physicians after he had grown concerned at a decrease in the number of podiatric patients in the early 2000s.
Noorlag said Novak stressed to him the need to make the contracts appear legitimate, quoting him as saying in 2001, "Bill, you better make sure the evaluations and paperwork are done because if I go down for this, you're going down with me."
Among the evidence at trial was a ledger created by one doctor documenting all the kickbacks he was paid that were disguised as teaching fees, an exhibit that Assistant U.S. Attorney Ryan Hedges called in his closing argument a "contemporaneous journal of crime."
"Teaching wasn't the point, teaching was the cover," Hedges said.
Dr. Subir Maitra, one of the hospital's few surgeons, took more than $68,000 in kickbacks from 2010 to 2013, performing 592 surgeries that brought in nearly $750,000 to the hospital in Medicare reimbursements, Hedges said.
"That's a lot of surgeries. That's a lot of revenue for the hospital," he said.
In his closing argument Thursday, Novak's attorney, Sergio Acosta, said there was no evidence Novak was directly involved in any kickback scheme. He told jurors they could not convict based on innuendo or the mere suggestion of improper deals.
"(Prosecutors) can't just stand up in front of you and say, 'C'mon, you know what's going on,'" Acosta said. "That's not evidence."
With the trial off on Fridays, the closing arguments are scheduled to resume on Monday. Deliberations could begin Tuesday.
Federal authorities raided the hospital in 2013 amid bombshell allegations that doctors were performing medically unnecessary tracheotomies and giving heavy sedation to patients in a process called "snowing."
At least five deaths at the hospital had been under scrutiny at one time, authorities said.
But when the indictment came six months later, none of the allegations involving patient deaths or oversedation was leveled against any of the defendants.
jmeisner@tribpub.com
