Several doctors, employees at BR pain management clinic involved in Medicare fraud schemes

Several doctors, employees at BR pain management clinic involved in Medicare fraud schemes

WASHINGTON (WAFB) - A Baton Rouge doctor has been sentenced to prison for his role in a scheme to defraud Medicare and other health insurers.

The Department of Justice (DOJ) says on Monday, May 20, Dr. John Eastham Clark, 66, was sentenced to 37 months in prison, plus two years of supervised release by Chief U.S. District Judge Shelly Dick. Clark was also ordered to pay $254,962.80 in restitution.

Back in February, Clark pleaded guilty to one count of conspiracy to commit healthcare fraud.

The DOJ says Clark was a co-owner and medical director of Louisiana Spine & Sports, llc, a pain management clinic in Baton Rouge. Clark submitted fraudulent claims to Medicare and other health insurers, the DOJ says. In his plea, Clark admitted that between June of 2005 and March of 2015, he and his billing supervisor, Charlene Anita Severio, as well as others, conspired to submit those fraudulent claims, indicating that minor surgical procedures happened on days after office visits, when in fact, the office visits and procedures took place on the same day.

Clark admitted that this practice, commonly called “unbundling,” was done with the intent to defraud insurance providers for non-reimbursable office visits. Clark also admitted to falsifying records to substantiate those fraudulent claims, and also directed others to do so.

The DOJ says in February, Severio also pleaded guilty to one count of conspiracy to commit healthcare fraud and wire fraud, plus two counts of healthcare fraud. Her sentencing is scheduled for May 22.

Similarly, on Nov. 20, 2018, Dr. Gray Wesley Barrow, another co-owner of Louisiana Spine & Sports, also pleaded guilty for his role in a scheme to get around $336,000 in illegal healthcare kickback payments. Barrow will be sentenced June 7.

Additionally, Christopher William Armstrong, a former physician’s assistant at the clinic, pleaded guilty Nov. 27, 2018 for his part in a scheme to illegally distribute thousands of oxycodone pills. Armstrong is scheduled for sentencing on June 24.

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