A Baton Rouge, Louisiana-based doctor was sentenced to 37 months in prison followed by two years of supervised release today for his role in a scheme to defraud Medicare and other health care insurers.
John Eastham Clark, M.D., 66, of Baton Rouge, was sentenced by Chief U.S. District Judge Shelly D. Dick of the Middle District of Louisiana, who also ordered Clark to pay $254,962.80 in restitution. In February 2019, Clark pleaded guilty to one count of conspiracy to commit health care fraud.
Clark was a co-owner and the medical director of Louisiana Spine & Sports LLC, a pain management clinic located in Baton Rouge. The charge stems from Clark’s role in a scheme to submit fraudulent claims to Medicare and other health care insurers.
As part of his guilty plea, Clark admitted that from approximately June 2005 through March 2015, he, along with his billing supervisor Charlene Anita Severio and others, conspired to submit fraudulent claims indicating that minor surgical procedures occurred on days subsequent to office visits, when in fact the office visits and procedures took place on the same day. Clark admitted that this practice, commonly referred to as “unbundling,” was done to defraud health care insurers for non-reimbursable office visits. Clark further admitted to falsifying, and directing Severio and others to falsify, records substantiating the fraudulent claims.
In February 2019, Severio pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and two counts of health care fraud. She is scheduled to be sentenced on May 22 by Chief Judge Dick.
In another case involving Louisiana Spine & Sports, on Nov. 20, 2018, Gray Wesley Barrow, M.D., a co-owner of the company, pleaded guilty for his role in a scheme to receive approximately $336,000 in illegal health care kickback payments.
Barrow is scheduled to be sentenced on June 7, 2019, by U.S. District Judge Brian A. Jackson of the Middle District of Louisiana. In addition, Christopher William Armstrong, a former physician’s assistant at Louisiana Spine & Sports, pleaded guilty on Nov. 27, 2018 for his role in a scheme to unlawfully distribute thousands of oxycodone pills. Armstrong is scheduled to be sentenced on June 24, 2019, by U.S. District Judge John W. deGravelles of the Middle District of Louisiana.
The Medicare Fraud Strike Force is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.
In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.