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.
Assistant Attorney General Brian A. Benczkowski of the
Justice Department’s Criminal Division, U.S. Attorney Brandon J. Fremin of the
Middle District of Louisiana, Special Agent in Charge C.J. Porter of the U.S.
Department of Health and Human Services Office of Inspector General’s (HHS-OIG)
Dallas Field Office and Special Agent in Charge Eric J. Rommal of the FBI’s New
Orleans Field Office made the announcement.
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 case was investigated by HHS-OIG and the FBI, and was
brought as part of the Medicare Fraud Strike Force, supervised by the Criminal
Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District
of Louisiana. Assistant Chief Dustin M.
Davis and Trial Attorney Justin M. Woodard of the Fraud Section and Assistant
U.S. Attorney Elizabeth E. White of the Middle District of Louisiana are
prosecuting the case.
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.
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