July 25, 11

NEWS / Orange County Doctor Sentenced to 18 Months in Prison for Billing for Cancer Meds That Were Never Pr

SANTA ANA, CA—An Orange County cancer doctor was sentenced this morning to 18 months in federal prison for fraudulently submitting bills for approximately $1 million worth of injectable cancer medications that never were provided.

Dr. Glen R. Justice, 66, of Corona del Mar, was sentenced by United States District Judge Cormac J. Carney. Justice pleaded guilty in May 2010 to five counts of health care fraud.

Justice, who ran the Pacific Coast Hematology/Oncology Medical Group in Fountain Valley, defrauded health insurance providers, including the Medicare program, by billing for injectable cancer medications when patients never received those medications. In some instances where patients did receive medications, Justice “upcoded” claims made to health insurance providers by falsely claiming that he administered more expensive injectable medications than were actually given to patients.

The medications involved in the scheme included Neulasta, Neupogen, Procrit/Epogen/Aranesp, and Neumega. Justice’s scheme ran from at least 2004 through October 2009, despite being advised by staff about the improper billing and the execution of a search warrant at his medical group in November 2006. In a plea agreement filed in court, Justice acknowledged that the public and private health insurance providers—including Medicare, Tricare, carriers contracted with the federal government through the Federal Employee Health Benefit Program, and Blue Cross and Blue Shield of California—suffered losses of between $400,000 and $1 million.

During today’s sentencing hearing, Justice did not contest government allegations that he had violated his plea agreement by continuing to submit fraudulent bills after he signed the agreement in March 2010.

In addition to the prison term, Judge Carney ordered Justice to pay $1,004,689 in restitution.

This case is the product of a joint investigation by the Federal Bureau of Investigation, the U.S. Department of Health & Human Services - Office of Inspector General, IRS-Criminal Investigation, and the Department of Defense - Office of Inspector General.

http://www.fbi.gov/losangeles/press-releases/2011/orange-county-doctor-sentenced-to-18-months-in-prison-for-billing-for-cancer-meds-that-were-never-provided

Tags: criminal investigation,