CASE ANALYSIS SUMMARY
Bottom Line: This case involved a physician who was convicted in federal court of healthcare fraud conspiracy and subsequently had their New York medical license revoked. The physician was found guilty after a jury trial of multiple federal crimes including conspiracy to defraud the United States and healthcare fraud, resulting in a 30-year prison sentence and over $8 million in restitution. The New York State Board for Professional Medical Conduct determined that these federal convictions constituted professional misconduct and revoked the physician’s license.
DETAILED CASE ANALYSIS
Effective Date: October 13, 2011
Type of Doctor: The physician was a medical doctor (M.D.) licensed to practice medicine in New York State (License #181530, issued February 23, 1990)
Disposition Type: Hearing determination and order resulting in license revocation
How many total charges? 1 charge of professional misconduct under New York State Education Law
What specifications of charges were alleged? The physician was charged with professional misconduct pursuant to Education Law §6530(9)(a)(ii) for having been convicted of committing an act constituting a crime under federal law. The underlying federal convictions included:
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- Conspiracy to Defraud the United States (18 U.S.C. §1371)
- Conspiracy to Commit Healthcare Fraud (18 U.S.C. §1349)
- Three counts of Submission of False Claims (18 U.S.C. §287)
How many patients were involved in each charge? The document does not specify the number of individual patients involved, but describes this as part of “a massive conspiracy to commit health care fraud”
Which charges was the licensee guilty of (either via hearing or negotiated consent)? The physician was found guilty of the single charge of professional misconduct. The Hearing Committee unanimously determined that the specification of professional misconduct should be sustained based on the underlying federal convictions.
Which charges was the licensee not guilty of? All charges resulted in guilty findings – there were no charges for which the physician was found not guilty.
Outcome/Penalties (specific to this case):
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- Primary Penalty: Complete revocation of license to practice medicine in New York State
- Rationale: The Hearing Committee determined that “no sanction short of revocation will suffice to punish such misconduct” due to the “widespread misconduct” that “represents an unforgivable breach of the public trust bestowed upon members of the medical profession”
- Underlying Federal Sentence: 30 years incarceration, restitution of $8,289,286, forfeiture of $100,000 bank account, three years supervised release, and $500 assessment
The physician failed to appear at the hearing in person or by counsel, and the determination was made after reviewing the entire record and hearing evidence and witness testimony.