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Doctor gets 20-year prison sentence for health care fraud

The Department of Justice (DOJ) recently accused a neurosurgeon of partaking in a health care fraud scheme that cost the government almost $3 million.

What was the alleged scheme?

According to the prosecution, the physician was associated with a medical device company that manufactured spinal implant devices. The government stated the physician received financial gain from using the spinal devices from this company. They state the physician failed to disclose his connection to this company and intentionally concealed his ownership interests.

The DOJ also states the physician encouraged patients to receive unnecessarily complex or unneeded spinal surgery. They argue the motivation for these recommendations was not patient need, but financial gain.

The investigation and resulting charges provide an opportunity for other physicians to learn how careful they must be when considering helping with medical devices within their practice. Before pursuing such opportunities, it is wise to seek legal counsel to review the potential relationship and better ensure it is legal.

What happened to the physician?

The doctor chose to accept a plea deal. The deal required the physician to admit he received the financial incentives outlined above and was responsible for “serious bodily injury to his patients.” The court sentenced the doctor to 235-month imprisonment and $1.9 million in restitution payments to the government, insurance companies and patients.

The physician appealed the long sentence. A federal appeals court recently upheld the long sentence.

Why did this doctor receive such a long prison sentence?

According to the federal appeals court, the long sentence was justified in this case as the surgeon not only received financial gain from his relationship with the medical device company but also injured his patients in the process.

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