Union doctor one of two sentenced to federal prison for role in healthcare fraud scheme - Insurance News | InsuranceNewsNet

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April 16, 2024 Newswires
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Union doctor one of two sentenced to federal prison for role in healthcare fraud scheme

NKyTribune.com (KY)

The owner and the medical director of the Northern Kentucky Center for Pain Relief in Florence have been sentenced to federal prison after being convicted for their roles in a scheme that defrauded Medicare, Medicaid and commercial insurance companies of over $4 million for medically unnecessary urine drug testing.

The Kentucky Attorney General's Medicaid Fraud and Abuse Control Unit, FBI, DEA and HHS-OIG investigated the case, which led to a federal jury convicting Dr. William Lawrence Siefert of health care fraud and NKY Dr. Timothy Ehn of health care fraud and conspiracy to commit health care fraud.

According to Attorney General Russell Coleman, Dr. William Lawrence Siefert, 70, of Dayton, Ohio, the clinic's medical director, was sentenced to one year and six months in prison and ordered to pay $1,968,763.10 in restitution. Dr. Timothy Ehn, 51, of Union, the clinic owner and a licensed chiropractor, was sentenced to two years and six months in prison and ordered to pay $3,773,569.30 in restitution.

"Through zealous collaboration with our law enforcement partners, we're holding these defendants accountable," Coleman said. "I'm especially proud of Detective Supervisor Mike McGuffey and the entire Attorney General's Medicaid Fraud and Abuse team for investigating these crimes and delivering justice."

According to court documents and evidence presented at trial, Ehn and Siefert orchestrated a scheme in which clinic staff billed for urine drug tests that were not medically necessary but were lucratively reimbursed by taxpayer-funded insurance providers like Medicare and Medicaid.

Ehn and Siefert continued in their scheme even as their expensive drug testing machine malfunctioned because it was not properly maintained, which caused the machine to produce results that falsely suggested patients were testing positive for street drugs like ecstasy or heroin. Insurance proceeds from urine drug testing ended up comprising three-quarters of the clinic's revenue.

"The defendants enriched themselves through a fraudulent urine drug testing scheme that cost Medicare, Medicaid, and commercial insurance companies over $4 million," said Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the U.S. Justice Department's Criminal Division. "The Criminal Division is committed to protecting American taxpayers from doctors who abuse their positions to steal public money by billing for unnecessary medical procedures."

Report a health care fraud violation via e-mail to [email protected].

The post Union doctor one of two sentenced to federal prison for role in healthcare fraud scheme appeared first on NKyTribune.

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