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Waterbury doctor Juan Fica dodged the bullet — or so he thought. A state inspector suspected Fica’s associate, Elie Nakouzi, was practicing medicine without a license. But the state Department of Public Health found an insufficient basis to proceed with the investigation and closed the case in 1999. Six years later, however, federal prosecutors are proceeding with a nine-count federal Medicare fraud action against Fica and Nakouzi, based on a whistleblower suit by one of Fica’s former employees. Jury selection is expected to start in early January. Fica contends DPH officials’ decision to drop the case was essentially an endorsement of his medical practice’s operations, which he relied on to his detriment. But that argument recently failed to convince U.S. District Judge Mark R. Kravitz to dismiss the federal case. Fica and Nakouzi each face significant prison terms and fines if convicted. Nakouzi, a 51-year-old native of Lebanon who now resides in Hamden, Conn., received a medical degree from a school in Grenada. He never served an internship, never passed his medical boards and is not licensed to practice medicine in any state. He began working for Fica’s internal medicine practice in 1996. Government prosecutors contend Fica, who fled Pinochet’s Chile in 1977 when he was 28, conspired with Nakouzi to defraud health care insurers by submitting claims in Fica’s name for medical services that Nakouzi allegedly provided. Fica argued in an unsuccessful bid to dismiss the indictment that the decision by DPH officials to close the investigation estopped the federal prosecution. Fica considered the agency’s decision to be an endorsement of his employment of Nakouzi, said Fica’s attorney, Gary H. Collins of Day, Berry & Howard’s Hartford office. “Dr. Fica maintains his position that he relied on the state investigators’ conclusion that his business model comported with all federal rules and regulations,” Collins said. That business model included utilizing Nakouzi as an assistant, Collins maintained. Kravitz, however, ruled last month that the defendants’ entrapment defense is a question of fact for the jury. Not only is it questionable whether a state action can estop a federal prosecution but the state DPH investigation was limited to Nakouzi’s unlicensed practice of medicine, while the federal case concerns theft, Kravitz noted. The federal prosecution, he determined, is also based on allegations of misconduct occurring after the state investigation concluded. Furthermore, the Department of Public Health letter to Nakouzi did not appear to be “the explicit official sanction” that Fica claims it was, Kravitz wrote. Dominick J. Thomas Jr., of Cohen & Thomas in Derby, represents Nakouzi. “I can only say that my client is innocent of the charges, and that will all come out at trial,” he said last week. Regardless of whether Fica justifiably relied on the DPH letter, he might have escaped federal prosecutors’ attention had the doctor’s former nurse practitioner not filed a whistleblower suit in 2004, detailing the alleged fraud. Under the qui tam provisions of the False Claims Act, private citizens are authorized to bring suits exposing health care and other fraud against the federal government, in exchange for a cut of the government’s recovery. Since the act was expanded in 1986 to combat rampant fraud against the government, settlements and judgments in qui tam suits have totaled over $12 billion, according to U.S. Treasury figures.

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