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On Monday, I told you about Farid Fata, a former cancer specialist from the Detroit area who is the admitted mastermind of one of the most monstrous frauds ever uncovered in American history. Fata falsely told perfectly healthy people they had cancer and subjected them to invasive chemotherapy. He then stuck Medicare and private insurance with $34.7 million worth of fraudulent claims. He was finally arrested last year, and pleaded guilty to turning his practice into a health care fraud racket. Earlier today, Fata was sentenced to 45 years in federal prison, which at his age all but assures that he will die behind bars.

The 50-year-old Fata begged federal judge Paul Borman for mercy, speaking out for the first time since pleading guilty last summer to health care fraud, money laundering and soliciting kickbacks from two hospices. He said he was “horribly ashamed” of his behavior at his Michigan Hematology and Oncology clinic, saying he gave in to a “self-destructive” quest for power and wealth. He also apologized to his patients, saying, “They came to me for compassion and care. I failed them.”

Fata asked for a 25-year sentence, claiming that his health has become so precarious that he may not live even that long. Fata also wanted a chance to be able to die at home. Frankly, that suggestion is downright insulting. This wasn’t just a case of overbilling. This quack knowingly subjected people to chemo regimens they didn’t even need, and was almost certainly aware that they could suffer debilitating problems or even die as a result.

Many of them have to endure a lifetime’s worth of health issues. One victim, Robert Sobieray, lost all but one tooth. Another, known only as “C. C.,” has bladder and bowel issues and kidney disease. The term “monster” may be overused, but there’s no other printable way to describe a doctor who could do this to his patients knowing that he was putting them at so much risk.

Incredibly, Fata would likely still be at it if not for one of his patients, Rhonda Flagg, breaking her leg in July 2013–just hours after starting what she thought would be a lifetime of chemo treatments for a supposed case of multiple myeloma, an invasive bone marrow cancer. According to NBC News, Fata was on vacation in Lebanon that day, so one of the staff physicians, Soe Maunglay, took charge of her care. Maunglay was dumbfounded to see that Flagg’s numbers were completely normal–meaning that in all likelihood, she didn’t have cancer at all.

Maunglay and MHO’s practice manager, George Karadsheh, spent a month digging through Fata’s files. What they saw was enough to make Karadsheh call the FBI a month after Maunglay’s visit with Flagg. Fata was arrested a few days later, and pleaded guilty last fall. However, it’s clear that even now, he doesn’t understand the seriousness of his crimes. Fortunately, Borman did. The judge said that a lengthy prison term was necessary because of Fata’s “huge, horrific series of criminal acts.” He added that Fata “shut down whatever compassion he had” and used his own patients as cash cows.

U. S. Attorney Barbara McQuade wanted Fata sentenced to 175 years, the maximum possible under sentencing guidelines. Although the sentence Borman ultimately imposed is barely a fourth of that, it still makes it a near-certainty that Fata will die in prison. I wrote on Monday that nothing less than 40 years would have been acceptable, as it would eliminate any realistic chance of him ever being free. Anyone who displays the total disregard for human life that Fata displayed simply cannot be allowed to live among us again, ever.

McQuade didn’t see this as just another health care fraud. To her mind, it was “the most serious fraud case” of any sort in American history due to its sheer egregiousness. At the very least, it should make the top five, if only because of the horrific damage Fata inflicted on his patients and their families. In light of that damage, it’s simply outrageous that Fata asked for a chance he denied so many of his patients–the chance to die with some measure of dignity. No, Farid. You deserve to serve every second of those 45 years, and then go before the Supreme Judge for whatever sentence he feels you deserve.