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Surgeon pleads guilty to defrauding government in insurance case

South Carolina residents concerned about medical malpractice may have heard of the recent sentencing of a New York surgeon who admitted to performing thousands of surgeries improperly from 2007 to 2011 and defrauding the federal government. The surgeon pled guilty to one count of health care fraud and was sentenced to four and a half years in federal prison. He was also ordered to pay $5 million in restitution to the government for fraudulent Medicare claims and had his medical license suspended.

The government presented evidence that the surgeon had performed thousands of surgeries, sometimes as many as 20 a day, for which he had billed health insurance companies more than $35 million in total. The medical group that employed him during the scheme allegedly rewarded him with more than $7.5 million in compensation for his work. The surgeon said in court during his sentencing that the pay and the admiration of his fellow shareholders were his primary motivation.

While this is the end of the criminal insurance fraud case, more than 260 civil plaintiffs are still waiting for their claims of medical malpractice against the surgeon to go forward. An order of stay had been issued, preventing the defendant and his former employers from responding to the civil suits so that he would not incriminate himself in the federal case.

The stay has been lifted, so the civil cases may now be able to proceed. The medical malpractice attorneys who are representing their plaintiffs may help their clients recover damages from the surgeon for the botched surgeries that were performed, and the plaintiffs are hoping to finally get some closure.

Source: ABC News, "Judgment Day for Surgeon Who Admitted to Fake Surgeries", Liz Neporent, March 07, 2014

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