An ophthalmologist from Leesburg, Florida is likely headed to prison after a federal jury found him guilty of 20 counts of healthcare fraud. Prosecutors say the 57 year old physician engaged in a multi-million dollar Medicare fraud scheme that hurt both taxpayers and patients.
Each count of healthcare fraud carries a maximum 10 year sentence, although judges can increase those penalties if patients suffered physical harm.
Typically we see Medicare fraud cases in which clinics, hospitals or physicians “upcode” their bills in the hopes of squeezing a few more bucks from taxpayers. Some very unscrupulous fraudsters bill Medicare for services never even provided. And then there is David Pon. Whether or not there is a special place reserved in Hell for Dr. Pon is debatable but there is likely a waiting prison cell.
U.S. District Court Judge Brian Davis revoked his bail and ordered that Pon be held in custody pending his sentencing in March of 2016. It is likely he will receive a lengthy sentence.
Jurors heard testimony from several patients that Pon intentionally misdiagnosed them with wet macular degeneration, an incurable disease that leads to blindness.
Instead of treating the patients for whatever eye problems they actually suffered, Pon chose the macular degeneration diagnosis so he could perform expensive diagnostic testing and laser treatments. Part of the treatment regimen also involves making injections of medications directly into the eye.
Like all medical procedures, the drugs and laser therapy involves risks and often comes with side effects. Worse than the physical side effects, however, is the emotional devastation felt by patients when they told they are going blind and their disease is incurable.
In announcing the conviction, Orlando’s U.S. Attorney Lee Bentley III said,
“The fraud committed by Dr. Pon, a well-trained ophthalmologist, was particularly egregious. He abused his position of trust and falsely diagnosed hundreds of Medicare patients with wet macular degeneration, a progressive eye disease that can lead to blindness. He instilled fear in his victims, performed unnecessary and sometimes dangerous medical procedures on their eyes, and asked the taxpayers of this country to pick up the tab.”
Although only charged with 20 counts of healthcare fraud, prosecutors estimate Pon misdiagnosed approximately 500 patients. Our prayers go out to his victims.
Many people think Medicare fraud is a victimless crime. Stories like this and the recent prosecution of Farid Fatah** in Detroit show the human side of these crimes.
In 1863, Congress passed the federal False Claims Act. That law pays whistleblowers in healthcare fraud cases up to 30% of whatever the government collects from wrongdoers. This case was prosecuted criminally and any monies collected will probably go to Pon’s victims. Most Medicare and Medicaid fraud cases, however, are prosecuted civilly. Last year the Justice Department handed out $635 million in award money to whistleblowers.
How do you qualify for a whistleblower reward in a healthcare fraud?
To qualify for an award, you must first possess inside or “original source” information about the fraud.
Next the fraud must involve federal tax dollars or programs. (Medicare, TriCare, VA healthcare and Medicaid all rely on tax dollars so they qualify.) Many states have their own similar whistleblower reward programs and two states – California and Illinois – have robust reward programs even for healthcare fraud involving private insurance.
If you think you qualify, give us a call. Picking up a phone and calling a fraud hotline does not qualify you for the big awards. You must file a lawsuit under seal in federal court.
For more information, contact attorney Brian Mahany at or by telephone at (direct). All inquiries are kept strictly confidential. Last year we helped clients collect over $100 million in award monies and helped the federal government collect over $10 billion for taxpayers.
MahanyLaw – America’s Medicare Fraud Lawyers