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DA decides not to prosecute doctor for supposed insurance fraud

Charges against a California doctor were dismissed who had been accused of perjury, making a false claim and preparing a false claim.  The doctor's attorney stated that there was no evidence to support his client being criminally prosecuted.

The doctor was accused of conducting unnecessary surgical procedures as a supposed insurance fraud scheme.  The doctor apparently had agreed to pay restitution to patients and the charges were then dropped.  The doctor further agreed to change certain of his practices and to make certain the patients consented to all procedures and understood what they were being billed for.

The doctor's patients were said to have supported having the charges dropped. Another lawyer representing the doctor stated that his client paid a "token" amount to resolve the matter after five experts had found the doctor's actions to be proper.

The deputy district attorney in any event maintained that additional surgical procedures were performed so that the doctor could bill both patients and the insurance companies.  While they claimed that there were concerns regarding multiple patients, the charges ultimately only concerned one patient.  The deputy attorney also stated that the charges involved a "gray area" in that the doctor had cooperated with the investigation and had not harmed any patients.

We cannot assume that because someone was charged with a criminal offense that there is solid evidence of that person's guilt.  In the above matter the doctor's reputation was probably injured due to the investigation and his medical license was also likely at risk.  Experienced criminal defense attorneys are needed in such circumstances to make certain charges against the client are put into context.

Source: Orange County Register, "Felony charges dropped against Newport Beach doctor," Eric Hartley, April 14, 2014

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