Thursday, December 15, 2011

Fake Doc Sentenced in Healthcare Fraud Case

A recent report by the National Newswire Services indicated that Matthew Paul Brown was recently sentenced by a federal judge in Georgia to five years in prison for health care fraud and wrongful disclosure of patient information. The prosecuting United States Attorney, Sally Quillian Yates, claimed that Brown pretended to be a doctor and that he treated over 1,000 patients without actually being licensed to practice medicine.  Yates said, “His crime defrauded those individual victims of the care they deserved, and defrauded Medicare, Medicaid and private health insurance companies of funds intended and needed for legitimate health care.” Mr. Brown was sentenced to just over five years in prison, three of those years being served on supervised release. He was also ordered to pay more than $1,000,000.00 in restitution to his victims.

Brown ran his operation out of both Atlanta, Georgia and Nashville, Tennessee. While in Atlanta, he convinced practicing physicians to bill Medicare, Medicaid, and private health insurance companies for allergy services that were reportedly performed by him, even though he was not licensed to practice medicine in the state of Georgia. The physicians would then pay Brown a percentage of the funds that they received from the federal government and those private insurance companies. Thankfully, none of Brown’s victims have been found to be seriously hurt or injured due to his fraud and dishonesty, however, the federal government says the case remains open.

The FBI helped conduct the investigation and a spokesperson for the Bureau had this to say about the case: “The FBI remains committed to investigating these types of health care fraud matters, to include fraud against private health care companies and [M]edicare fraud. Individuals such as Mr. Brown, who attempt to profit through such fraudulent schemes at the expense of others who truly rely on these programs for their health care will remain as the priority focus of the FBI’s health care fraud efforts.”

In addition to the health care fraud charges, Brown pled guilty to wrongful disclosure of patient information, which, under the Health Insurance Portability Accountability Act (HIPAA), carries potential criminal penalties, including a possible fine of between $50,000 and $250,000 along with a prison sentence ranging from one to ten years.

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