Doctors and care providers bear the responsibility of providing exceptional care and support for their patients. However, some care providers find themselves in legal trouble, not because of medical negligence or mistakes, but because of improper billing practices or other types of health care fraud. One Michigan surgeon is facing an extensive prison sentence after he was convicted of fraudulent billing practices and more.
Time behind bars
The vascular surgeon will spend 80 months in prison due to his role in a scheme that involved defrauding different health care programs. This process a profit of several million dollars in a complex operation of fraudulently billing both Medicare and Medicaid, as well as Blue Cross Blue Shield of Michigan. Prosecutors said that the surgeon began this operation back in 2009.
He was accused of billing for multiple stent placements in the same blood vessels, as well as creating the documentation to verify the medical need for this. In reality, however, he did not actually place those stents, and the defendant verified that he billed for services not rendered. It was estimated that the scheme resulted in the loss of more than $14,000,000.
Details of his plea agreement
The Michigan surgeon plead guilty to healthcare fraud, and part of his agreement included restitution. There are times when it may be most prudent for a defendant to accept a plea deal rather than go to trial. An assessment of the situation will reveal what defense options are available, and it will be helpful to work with an experienced attorney when facing such serious criminal charges.