On October 24th, Dr. Robert E. Windsor of Forsyth County, Georgia was sentenced to three years and two months in federal prison after pleading guilty to health care fraud in March. The 55 year-old was also ordered to serve 200 hours of community service and to pay $1.17 million in restitution to health insurers. Windsor is the subject of just one of the latest in a long line of stories about doctors committing health care fraud in our country.
As reported by Isabel Hughes of Forsyth County News, Windsor will also endure three years of supervised release once his prison sentence is over. Between January 2010 and July 2013, Windsor’s duties included monitoring the neurological health of patients undergoing surgery. However, his duties were neglected. Instead of tending to his patients, he pretended to do so by having unqualified medical assistants do some dirty work.
According to a Department of Justice news release, the unqualified assistants used Windsor’s log-in credentials to make it seem as if the doctor was monitoring the patients himself. Following the monitoring of each surgery, Windsor was to create a report for American Neuromonitoring Associates P.C. and its sister company, who would use the reports to bill patients and their health insurance companies.
And, as you may have guessed, as per the agreement, Windsor would be paid a fee for each of the surgeries he monitored. Of course, Windsor wasn’t doing any monitoring. And, neither were his assistants as they, not being doctors, were not permitted to perform any monitoring services. In fact, during many of the surgeries that Windsor claimed to have monitored, he was actually on a plane travelling internationally.
Needless to say, Windsor’s actions have been met with utter disgust. George Crouch, who is the assistant special agent in charge at the FBI Atlanta field office, had this to say: “It is incomprehensible the lengths that some people will go to defraud our health care system. But even more reprehensible is the willingness of health care providers like Dr. Windsor to thoughtlessly put patients’ health at risk to profit from the system.”
InsuranceNewsNet.com also recently covered Dr. Windsor’s story. They quoted Derrick L. Jackson, who is a Special Agent in Charge for the HHS Office of Inspector General, as saying the following: “In my many years of investigating health care fraud, Dr. Windsor’s utter disregard for patient safety and his extreme greed stand out. His arrogance in billing for fraudulent services performed by an unqualified employee on patients undergoing surgery is truly shocking.”
As we’ve pointed out in a number of our recent blogs, there seems to be an increase in the amount of health insurance fraud cases taking place in the United States. And while we’re happy to report on the stories where fraudsters are paying the price for their actions, there is clearly a lot more work that can be done to diminish health care fraud in our country. The team, here at Allegiant Experts, is committed to doing its part.
Our clinical experts are dedicated to assisting attorneys with their litigations against those who commit health insurance fraud. For more information about our experience, expertise and how we may be able help your case, please don’t hesitate to contact us at 407-217-5831.