Chicago doctor convicted in $3.5 million insurance fraud

The doctor billed insurance companies for operations he never actually performed

Chicago doctor convicted in $3.5 million insurance fraud

Insurance News

By Ryan Smith

A Chicago doctor has been convicted of healthcare fraud for billing insurance companies $3.5 million for operations he never performed.

Dr. Paul Madison, 65, was found guilty of six counts of healthcare fraud, three counts of lying about the delivery of medical treatment and two counts of aggravated identity theft, according to a report by NBC 5 Chicago. Madison was an anesthesiologist and pain-management specialist for Watertower SurgiCenter, a Chicago medical center he owned. According to prosecutors, between 2005 and 2009, he ordered his staff to bill insurers for surgical procedures that were never actually performed.

Madison issued fake bills for more than $3.5 million and ultimately scammed insurers out of more than $783,000. When state regulators caught wind of the scheme in 2007, Madison told his billing director to purge patient files and lie to investigators, according to NBC 5 Chicago. He was indicted on federal charges in 2012.

Prosecutors said that Madison also submitted insurance claims bearing phony identities. At least twice, he falsified patients’ names, addresses and birthdays without their knowledge, NBC 5 Chicago reported.

Madison will be sentenced in March. He faces up to 79 years in prison.


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