My Doctor Reports

Doctor related news - Powered By EZDoctor

Osteopathic Physician Sentenced to Three Months for Health Fraud

U.S. District 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, in Ridgefield.

 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.

According to 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.

The investigation revealed that on several occasions Johnston was out of the country when the massage therapist was seeing Johnston’s patients.

Johnston was 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 five years.


blog comments powered by Disqus