Investigators see through California doctor's X-ray scam

Investigators see through California doctor's X-ray scam | Insurance Business America

Investigators see through California doctor's X-ray scam

A California orthopedic surgeon has been convicted on 10 felony counts of healthcare insurance fraud after scamming Medicare and Medi-Cal by administering excessive and medically unjustifiable X-rays to his patients.

Surgeon Gary Wisner was convicted following a two-week trial in Sacramento County Superior Court, according to California Attorney General Rob Bonta.

“When medical practitioners abuse their power, it’s always at the expense of patients under their care,” Bonta said. “Gary Wisner abused the position he held as a healthcare provider by subjecting his patients to unnecessary procedures to secure additional profits. I want to express my gratitude to the San Joaquin County District Attorney’s Office, who aided us throughout the course of this investigation. The California Department of Justice and our law enforcement partners will continue to hold accountable those who attempt to use the Medi-Cal program for personal gain, and to safeguard those it serves.”

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In November of 2016, representatives of the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA) were notified by multiple government offices that Wisner was suspected of overbilling the Medi-Cal and Medicare programs. DMFEA’s investigation revealed that Wisner would administer X-rays to patients even during routine office visits, and would X-ray multiple parts of a patient’s body – regardless of whether it had any relation to the patient’s medical issue.

Evidence presented at trial showed that between 2012 and 2016, Wisner subjected 10 patients to hundreds of unnecessary X-rays at his clinic.

Wisner is also the subject of an independent criminal complaint filed by the San Joaquin County District Attorney’s Office for workers’ compensation fraud. That case is still pending.