‘Preying’ on patients’ trust. Kentucky doctor faces prison in fraud case.

Lexington Herald-Leader (KY)

May 03-- May 3--A Kentucky doctor convicted of health fraud after allegedly performing hundreds of unnecessary heart operations has been sentenced to five years in prison

Richard E. Paulus, 71, also faces $1.1 million in restitution.

U.S. District Judge David L. Bunning sentenced Paulus on Thursday.

Paulus, a cardiologist who practiced at King's Daughters Medical Center in Ashland, billed more to Medicare for certain heart procedures than any cardiologist in the country from 2006 through 2011, according to a court record.

The hospital paid him a total of $10 million between 2009 and mid-2013, when Paulus retired, according to court records.

Ultimately, anonymous complaints about Paulus led to investigations, and a federal grand jury accused him of performing stent operations and other procedures that patients didn't really need so that he could make more money.

Paulus strongly denied doing anything wrong, but a jury convicted him in 2016 on one charge of health fraud and 10 charges of making false statements.

The jury ruled Paulus put false information in patients' records saying they had more severe blockages than tests showed, in order to justify putting stents in them.

Defense attorneys asked Bunning to place Paulus on probation, saying he had provided years of selfless service to patients and the community. Many of his operations were not included in fraud allegations.

Paulus worked fanatical hours to help patients, never inquired about someone's ability to pay and often treated people free of charge, his defense attorneys said.

One former co-worker said Paulus wore shoes held together with duct tape for a year because he was too busy to get a new pair, his attorneys said.

"Richard's sacrifices on behalf of his patients have been unparalleled, but his lifetime societal contributions extend well beyond the hospital doors," defense attorneys said in a memorandum.

Paulus' civic work included a $1 million donation to create a wellness and research foundation; $10,000 toward the college fund of a young man whose father had died; and his effort to help start a church he attends regularly.

Paulus reportedly drove around at Thanksgiving and picked up homeless people to take them to eat, and at Christmas took all the remaining tags from angel trees to buy gifts for people, his attorneys said.

There was no evidence Paulus lied about patients' symptoms, pressured them to have operations, billed for services he didn't provide or destroyed evidence, his attorneys argued.

But the prosecutor, Assistant U.S. Attorney Kate K. Smith, said Paulus lied about patients' conditions, performed invasive procedures that put them at risk, and caused millions in losses to insurance programs.

Paulus "did more than just steal money from a monolithic government program. He did so by preying on the trust his patients placed in him to help them, instead of hurt them," Smith wrote.

Court records indicate Paulus intends to appeal to try to get a new trial.

Bunning ordered him to report to prison on June 24, but defense attorneys plan to ask that he be allowed to remain free on bond pending an appeal.

In a separate civil case, King's Daughters agreed in May 2014 to pay the government $40.9 million to settle claims that it knew Paulus and other doctors were performing surgeries that were not medically justified.

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