Imaging fraud lands surgeon in jail
An orthopedic surgeon in California will spend seven years in prison for needlessly X-raying 10 patients hundreds of times over a four-year stretch.
It’s likely the physician’s scam was broader, as investigators chose the 10 sets of records found fraudulent at random from a caseload of 26,000 patients.
The surgeon, Gary Wisner, MD, practiced in Lodi and had admitting privileges at 214-bed Lodi Memorial Hospital.
California Attorney General Rob Bonta announced the sentencing Sept. 6, three months after securing convictions of Wisner on 10 felony counts of health insurance fraud.
Along with the 10 patients, any or all of whom may have been harmed by cumulative radiation doses, Wisner’s victims included Medicare and California’s Medicaid program, Bonta notes.
“Gary Wisner used both his patients and state resources to line his own pockets,” Bonta says in the announcement. “Due to his dishonest behavior, patients at his clinic had to undergo unnecessary medical tests so he could steal from the state’s Medi-Cal funds.”
The announcement says the California DOJ launched the Wisner investigation upon learning of the physician’s suspicious billing behavior from numerous government offices.
Five of the patients whose files they selected for scrutiny were covered by Medi-Cal and five by Medicare.
The investigation, which was carried out by the state DOJ’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA), “revealed Wisner would administer X-rays even in routine office visits and would X-ray multiple parts of a patient’s body regardless of whether it had any relation to a patient’s medical condition,” Bonta’s office reports.
Bonta’s office adds that Wisner is presently under investigation for a separate crime, workers’ compensation fraud.
Full announcement here.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.