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PHYSICIAN PLEADS GUILTY TO HEALTH CARE FRAUD OFFENSE
The Office of Inspector General (OIG) has investigated many fraudulent workers’ compensation claim cases. Most of these investigations involve postal employees scamming the system. But, employees aren’t the only ones who abuse the system. Sometimes, medical providers used by postal employees injured on the job, defraud and abuse the system. A few seek to take advantage of this program by submitting false bills, colluding with claimants to extend benefits, or falsifying claim documents. But OIG Special Agents, along with the Department of Labor OIG, found an orthopedic surgeon in New Orleans with a scam of his own.
The surgeon, who operated a medical practice in New Orleans, claimed to have performed health care services after Hurricane Katrina when his office was not even open! Forty-seven of the claims involved names of postal employees. The surgeon pled guilty in federal court to fraud and has agreed to pay $750,000.00 in restitution. He also faces a possible maximum sentence of 10 years in prison and a fine of $250,000 at his sentencing in May.
DR. WINDSOR DENNIS, age 78, and a resident of New Orleans, Louisiana, pled guilty in federal court today before U. S. District Judge Ivan L. R. Lemelle to one count of health care fraud, announced U. S. Attorney Jim Letten.
According to court documents, DR. DENNIS, an orthopaedic surgeon who operated a medical practice in New Orleans, billed the U. S. Department of Labor, Office of Worker’s Compensation, for health care services he claimed to have performed after Hurricane Katrina when his office was not open. He has agreed to pay $750,000.00 in restitution to the U. S. Department of Labor.
DR. DENNIS faces a possible maximum sentence of ten (10) years, a fine of $250,000 and three (3) years of supervised release following any term of imprisonment. Sentencing has been scheduled for May 26, 2010.
Daniel R. Petrole, Acting Inspector General, United States Department of Labor, stated:
“This plea is the result of collaboration by several Federal agencies working together to root out workers’ compensation fraud and bring those responsible to justice. We will continue to detect and quickly respond to fraud schemes perpetrated against the Department of Labor programs.”
David C. Williams, Inspector General for the U.S. Postal Service, added”
“Today’s plea and restitution agreement by Dr. Windsor Dennis is a significant victory in the ongoing battle against fraudulent workers’ compensation claims. The workers’ compensation program benefits thousands of postal employees who have received legitimate on-the-job injuries. But false claims, particularly by health care providers, undermine the system.”
The case was investigated by the Offices of Inspector General for the United States Postal Service and the United States Department of Labor. The case is being prosecuted by Assistant U. S. Attorney Patrice Harris Sullivan.
This is by far NOT unique to N.O. Happens all over the country. The article mentions fraud by claimants and drs, which does happen. What they do NOT mention is the fraud perpetrated by the workers comp agency themselves and the agency where the claimant works. This happens at least as much. Those in charge at installations lie all the time saying they know for fact that an individual was not injured. Sometimes other employees go to management and make up stories about the claimant and the management take it as gospel truth without ever investigating the accusations, thereby making the claimants life hell. I KNOW this happens because it happened to my wife. After about 5 years the truth came out, but no punishment was ever handed out to the guilty parties. These people are hypocrites. Before calling others liars and cheats they should go look in a mirror.