A little white lie leads to an orange jumpsuit for one physician

by: Julia Kyles, CPC Sep 25, 2018

You know that doctors shouldn’t lie to auditors about their health care claims. A prosecutor can use a fib to show that improper claims constitute fraud.

But alternative facts that aren’t even related to claims can constitute obstruction, and result in jail time.

John Janick, M.D., of Port Charlotte, Fla., was sentenced to 5 months in prison, 3 years of supervised release for obstructing a Medicare audit. In addition, the doctor will have to pay Medicare $118,831 in restitution, the Department of Justice (DOJ) announced in a Sept. 14 press release:

According to the plea agreement, Janick lied to a Medicare program integrity contractor who was auditing Janick Medical Group. Specifically, Janick falsely claimed that a third-party employer was paying rent for office space utilized by his wife, Lisa McLaren Janick. The office space, located within the Janick Medical Group practice, was used by Lisa McLaren Janick to improperly access sensitive patient data that was then used to generate referrals from Dr. Janick to her third-party employer without regard for medical necessity.

It isn’t clear whether the audit was related to McLaren Janick’s activities, the practice’s claims or a combination of the two. But Janick may be the lucky one in this case. Lisa McLaren Janick pleaded guilty to two counts of health care fraud, according to a DOJ press release published July 20. She could receive up to 20 years in federal prison for each count.

Blog Tags: anti-fraud, OIG

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