A physician immigrated to the United States in 1991 and established a medical practice called Compassionate Doctors. By 2013 the practice and its related health care entities boasted some 44 employees and contractors, including six additional physicians and five pharmacists. On May 30 of this year, a U.S. government official cited four distinct medical business models—one marked by “brilliance”– and called the doctor “the first to successfully combine them all.”

But it’s unlikely that Dr. Ashrafkhan will list the quotation on his resume. Why? Because the government official was an Acting U.S. Attorney, and the quotation appeared in a Sentencing Memorandum following the doctor’s conviction for participating in a conspiracy to distribute prescription pills and commit health care fraud, as well as money laundering.

The four distinct medical business models? (1) Paying marketers to find people to pose as patients; (2) using unlicensed employees to seek fake patients and create fraudulent charts; (3) paying physicians simply to sign charts and prescriptions; and (4) billing Medicare and Medicaid under a code for a substitute physician to mask the identity of the physician supposedly providing the service.

According to the Sentencing Memorandum, the scheme ran from 2006 to 2013 and generated millions of doses of controlled substances, mostly opiates, with a street value over $10 million. And according to the Memo, the street is where the drugs generally went after the “patients” received them.

The Sentencing Memorandum was persuasive. On June 15 Dr. Ashrafkhan was sentenced to 23 years in prison. By the end of the term, he’ll be 82 and facing a new hurdle: deportation. He’s in the U.S. illegally.

The case is United States v. Ashrafkhan, No. 11-CR-20551 (E.D., sentencing June 15, 2017).