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Pain Doctor Billed for Fake Surgeries
A pain management physician has agreed to a $20 million consent judgment in a case alleging he submitted false claims for surgeries and medical tests to federal health care programs, the Grimy Times has learned.
Dr. Robert Windsor, who owned pain management clinics in Georgia and Kentucky under the umbrella of National Pain Care, Inc., allegedly billed for surgical monitoring services he did not perform and for medically unnecessary diagnostic tests, according to the U.S. Attorney’s office in Atlanta.
“Windsor placed patients at risk by claiming that he was monitoring the neurological health of patients during surgery when he actually had an unqualified medical assistant do the work,” said U.S. Attorney John Horn. “Windsor unfortunately put his own interests above the health and safety of his patients.”
“Dr. Windsor placed personal gain above all else in his medical practice,” said Carlton B. Shier, Acting U.S. Attorney for the Eastern District of Kentucky. “In doing so, he put his patients at risk, and defrauded the United States. We will use every tool at our disposal to protect vital healthcare programs from those who seek unearned profit at the taxpayers’ expense.”
The government alleges that Dr. Windsor engaged in two schemes, including submitting false claims to Medicare, TRICARE, and FEHBP for the online, real time intraoperative monitoring of surgeries that Dr. Windsor did not personally monitor, that were not monitored by a physician, and that Dr. Windsor falsely represented had been monitored by him during the period from January 1, 2008 through July 22, 2013. On October 24, 2016, Dr. Windsor was sentenced to three years, two months in federal prison and three years of supervised release in connection with this conduct.
The government also alleges that Dr. Windsor submitted or caused the submission of false claims to Medicare, the Georgia and Kentucky Medicaid programs, TRICARE, and FEHBP for medically unnecessary balance tests, nerve conduction and electromyography procedures, and qualitative drug screens performed in Georgia and Kentucky during the period from January 1, 2010 through June 30, 2013.
The settlement highlights the commitment of federal and state agencies to protect the integrity of health care programs and the patients receiving medical services. ‘Providing medically unnecessary services to a vulnerable population, such as Medicare beneficiaries, places patients at risk and jeopardizes millions of taxpayer dollars,’ said Derrick Jackson, Special Agent in Charge of the U.S. Department of Health & Human Services, Office of Inspector General.
The investigation was conducted by the U.S. Department of Health & Human Services, Office of Inspector General, the FBI, the Defense Criminal Investigative Service, and the Georgia Department of Law. The case was prosecuted by the U.S. Attorney’s office in Atlanta.”
Key Facts
- State: Georgia
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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