A Baton Rouge doctor will spend over three years in Federal custody after being convicted for allegedly participating in a conspiracy to defraud Medicare.
Federal officials say the 66-year-old doctor, who was once part owner of a pain management clinic, submitted a series of false claims to Medicare and other insurers starting in early 2005 and continuing for over a decade.
Per investigators, the doctor sent claims to Medicare indicating that he carried out minor surgical procedures on a day following the patients’ initial visit, despite the procedure and the visit occurring on the same day. Investigators say he billed thusly, which is a fraudulent practice known as “unbundling,” in order to permit him to claim otherwise unreimbursable office visits on bills to Medicare.
In addition to submitting false claims to Medicare, investigators say he created false records that were meant to substantiate the false claims as well as directing others to generate similarly fraudulent paperwork for the same reason.
The billing supervisor at the clinic was also indicted for her alleged involvement in the scheme. She pled guilty to one count of conspiracy to commit health care fraud and wire fraud and two counts of health care fraud and is scheduled to be sentenced this week.
Meanwhile, the doctor pled guilty to one count of conspiracy to commit health care fraud in February in the chambers of Chief U.S. District Judge Shelly D. Dick of the Middle District of Louisiana. He was sentenced last week to 37 months in Federal prison, 2 years of supervised release, and ordered to pay $254,962.80 in restitution to the Federal government.