A former orthopedic surgeon, is facing up to 32 years of prison and $500,000 in fines. The criminal complaint states the physician stole the identity of an orthopedic surgeon and used this identity to receive payment for the review of over $860,000 in Workers' Compensation cases.
He faces criminal charges for identity theft, wire fraud and health-care fraud.
A history of accusations
This is not the physician's first brush with the law. The surgeon pled guilty to allegations of health insurance fraud and was forced to surrender his medical license in 2013.
The allegations included completion of 20 surgeries and 90 patient exams per day. In addition to these criminal allegations the physician also faced 256 civil suits. These cases included allegations of either faking the surgical procedure or poor completion which resulted in injury.
The physician is accused of starting a company using another physician's name and credentialing information. He would review workers' comp cases that involved a treating physician who requested a variance from the accepted treatment plan for the injured worker. Based on his review of the variance, the surgeon would then report on whether or not the variance was an accepted practice for the injury.
The charges against the doctor will likely stand if the accusations are accurate. A physician cannot practice medicine without a medical license. The doctor surrendered his medical license five years ago. In addition to violating this basic tenant he also allegedly stole the identity of another physician in an attempt to circumvent this requirement -- also illegal.
There are two key lessons from this case: defend against criminal allegations and the ability to reinstate a medical license. Physicians that are under investigation can build a defense to protect their license and reputation. If a physician must surrender their medical license, he or she can seek reinstatement in the future. A physician can navigate these issues. An attorney can help.