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Doctor convicted of using insurance claims to defraud government

A Florida jury has convicted a West Palm Beach physician of 67 counts of Medicare fraud in a case that has significant ties to the corruption and bribery charges against Senator Bob Menendez.

The physician was convicted of performing eye treatments on patients that weren't medically necessary and, in some cases, simply billing Medicare for expensive procedures that were never even performed. In total, the doctor scammed the federal government out of more than $100 million in insurance money.

While he's already repaid millions to the federal government, the physician now faces the possibility of 15 to 20 years in prison thanks to the convictions. At 62 years of age, that could amount to a life sentence. Prosecutors are expected to use the conviction and the looming threat of jail time as leverage to encourage the doctor to testify against his longtime friend, Senator Menendez, in the senator's upcoming trial.

While the senator denies any guilt, he's accused to trying to intervene with federal officials on the doctor's behalf when the billing issues first came to light. It's important to note that the doctor wasn't just a personal friend -- he was also a significant contributor to the senator's campaign funds.

Ultimately, the senator's attempts at intervention were unable to prevent the doctor from facing charges.

This case serves as a reminder that the federal government is taking a hard look at Medicare and Medicaid fraud cases these days. Even innocent billing mistakes can open a physician's office up to an investigation. In the past, a lot of physicians could escape the harsher consequences of improper billing by simply repaying the government what it was owed and paying a fine, but those days are long gone.

It's also an example of how prosecutors can strategically tackle a corruption case by bringing the case that they feel more confident of winning to trial first. If they secure a conviction, they can use that conviction to barter with the defendant for his or her testimony against someone else that's involved -- strengthening their case against that individual considerably.

White collar crimes, particularly those involving insurance fraud, are taken very seriously these days. If you believe that you are under investigation for any reason, the guidance of an attorney can be very helpful.

Source: Politico, "Key figure in Menendez corruption case convicted of fraud," John Bresnahan and Josh Gerstein, April 30, 2017

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