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Undergoing chemotherapy when you have cancer can be a terrible experience. Undergoing chemotherapy unnecessarily when you don’t have cancer is worse.

That’s what happened to some patients of a Detroit-area oncologist, according to federal investigators, who say the physician netted millions of dollars from Medicare by needlessly treating people for various ailments, including cancer. Indicted Wednesday on a charge of Medicare fraud, Dr. Farid Fata is being held in a Detroit jail on $9 million bond.

“We have been trained to trust doctors with our lives,” says Barbara McQuade, the U.S. Attorney for the Eastern District of Michigan, who is helping prosecute Fata. “When you see a case like this, it’s startling.”

The Fata case, which is being investigated and prosecuted under the direction of a task force run jointly by the federal departments of Justice and Health and Human Services, is highly unusual. Typical Medicare fraud cases involve health care providers billing the government for services that were never delivered. Some fraudulent providers buy Medicare ID numbers on the street. Others pad billings to increase profits or procure medications to sell illegally. Many are found out when federal investigators spot anomalies in their billings. But Fata appears to have been charged after whistleblowers approached federal authorities with information that he was potentially injuring patients just to up profits. McQuade, whose office has prosecuted numerous Medicare fraud cases in Detroit, says she’s seen lots of schemes but “nothing as egregious as this.”

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According to a criminal complaint filed on August 6 and based on an investigation by the FBI, Fata routinely prescribed chemotherapy and other drastic medical interventions for patients who were either healthy, or ill but in need of alternate treatments. He did so purely to increase his own income, according to prosecutors, who say Fata billed Medicare for some $150 million in services between August 2010 and July 2013, some of it fraudluently. The complaint, based on interviews with several nurse practitioners, medical assistants and an oncologist who worked for Fata, reads like a horror novel.

The oncologist told the FBI of one patient who received chemotherapy under Fata’s care, even though the patient was in remission. The oncologist advised the patient to get a second opinion and he or she never returned to see Fata. The oncologist also told the FBI that Fata ordered chemotherapy for all of his end-of-life patients, even if the treatment would not improve or extend their lives. The oncologist told the FBI, “no other physician would do this and would let the patient die in peace.” The oncologist also said Fata sometimes issued patients life-long prescriptions of drug treatment for low platelet conditions, without informing patients that surgery was a treatment alternative to years of drug therapy. The oncologist also told the FBI that many of Fata’s patients received intravenous immunoglobulin therapy even though they did not need it. A nurse practitioner who worked for Fata examined charts for 40 patients undergoing this treatment and found that 38 did not need it at all.

The criminal complaint also outlines accusations that Fata arranged for foreign doctors, who might have been unlicensed to practice medicine in the U.S., to treat patients in his multiple clinic locations. “Dr. Fata sees the patient only for 2-3 minutes. The patients frequently complain about it,” states the complaint. In even more egregious cases, investigators say Fata falsified cancer diagnoses in order to justify—and receive payment for—positron emission tomography (PET) scans, which include radiation. These diagnoses, say investigators, are “written in the chart purely to justify the fraudulent billing to the insurance company.”

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Incredibly, the complaint gets worse. Investigators said one patient fell and hit his head at one of Fata’s clinics. But before sending the patient to the hospital for treatment, Fata allegedly directed an employee to give the patient chemotherapy. “The patient later died from his head injury,” according to the complaint.

Fata’s lawyer, Christopher Andreoff, says the doctor has no prior criminal record and “is devastated” by the accusations.

“His entire medical practice and his treatment of patients has come to a complete standstill,” says Andreoff. “His liquid assets are frozen and he’s not going to be able to pay payroll.” The FBI investigation and indictment “came out of the dark like a bad thunderstorm,” he added.

According to the Detroit Free Press, Fata could face 10 years in prison and a $250,000 fine if convicted. McQuade says the investigation is ongoing. No trial date has been set, but Andreoff says he expects prosecutors to provide more information to Fata’s defense team, including the names of current and former Fata employees who spoke to the FBI.

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