7-year prison term for Lodi surgeon for insurance fraud - Insurance News | InsuranceNewsNet

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September 8, 2022 Regulation News
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7-year prison term for Lodi surgeon for insurance fraud

Record (Stockton, CA)
A Lodi orthopedic surgeon found guilty of repeatedly defrauding the Medi-Cal and Medicare programs has been sentenced to seven years of prison, state Attorney General Rob Bonta announced Tuesday.

Gary Wisner, a surgeon in Lodi, received his prison sentence in Sacramento County Superior Court Friday after being convicted of 10 felony counts of health insurance fraud in June. Wisner's fraud scheme took place from 2012-16 when he administered excessive and medically unjustifiable X-rays to patients, according to Bonta.

Wisner had 26,000 patients under his care, according to Bonta's announcement. "Gary Wisner used both his patients and state resources to line his own pockets. 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."

Representatives from the California Department of Justice and the state's Division of Medi-Cal Fraud and Elder Abuse were made aware in November 2016 of Wisner possibly overbilling the Medi-Cal and Medicare programs by multiple government offices.

During the state investigation, authorities selected five files of Medi-Cal patients and five of Medicare patients randomly, which revealed that Wisner would administer X-rays even in routine office visits. The 10 files became the basis of the 10 felony charges Wisner was convicted of this year.

The investigation also showed that Wisner would X-ray multiple parts of a patient's body regardless of whether it had any relation to a patient's medical condition. He also made 10 individual patients do hundreds of unnecessary X-rays at the clinic.

"This sentence reaffirms what we know to be true: Abuse of power by medical practitioners will never be tolerated within our state's health care system," Bonta said.

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