Judge Robert N. Chatigny sentenced David Lester Johnston, 46, of Ridgefield,
Monday to three months in prison for health care fraud.
Johnston is an
osteopathic physician who operates Osteopathic Wellness Center, LLC,
On Jan. 16, he
pleaded guilty to one count of health care fraud and admitted that he engaged
in a scheme to defraud several private health insurance companies by submitting
claims for evaluation and management services (physician office visits) that he
did not perform, and by misrepresenting the nature of the services that were
performed, according to court documents.
court documents and statements made in court, Johnston submitted claims for
physician office visits that were not performed at all. Instead, the patients
only received massages and related services from a massage therapist. In
addition, he falsely described the services rendered and falsely stated that he
himself had rendered the services.
investigation revealed that on several occasions Johnston was out of the
country when the massage therapist was seeing Johnston’s patients.
ordered to pay restitution in the amount of $172,950.
In addition, as
part of the resolution of this case, Johnston entered into a civil settlement
with the government and has agreed to pay $270,528 to settle federal civil
claims that Johnston submitted false claims to the Medicare program for office visits, osteopathic manipulative
treatment and physical therapy services that were not performed. Instead, the
Medicare patients treated by the massage therapist in Johnston’s practice only
received massages and related services. Medicare does not recognize massage
therapists as providers and they are not eligible to participate in the
Medicare program. Johnston nevertheless billed the Medicare program as if he
had provided the services in question.
Pursuant to the civil settlement, Johnston has been
excluded from participation in all federal health care programs for a period of