Doctor Ordered to Federal Prison for Workers Compensation Fraud

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More application documents;

Some people perceive taking money from government programs as allowable, because after all, they think they deserve it. But federal officials who build cases against these offenders are quick to point out otherwise. (Fraudsters don’t deserve free money, but they do deserve punishment for stealing benefits they don’t qualify for.) Every dollar stolen from a sick or injured person who struggles to get by on partial pay means there’s less money for providing medical assistance or funds to people who truly deserve the help.

A Louisiana doctor apparently did not think that way and now he is paying the price. (He wanted to pocket workers compensation funds for himself.) A federal judge last month sentenced Marvin Clifton to 18 months in prison for committing fraud against the federal Office of Workers’ Compensation Program, part of the U.S. Department of Labor.

Clifton, 71, was a licensed physician practicing in Baton Rouge when prosecutors say he repeatedly filed false claims with the workers compensation program regarding his patients who are federal employees. Clifton’s treatment included physical therapy, for which he directed his staff to falsify bills that were sent to the program, according to investigators. In some instances, the program was billed for treatment on days that the office was closed or for treatment sessions that went longer than he provided.

Clifton submitted over $500,000 of falsified bills between 2015-2019, through which he obtained $340,342 in federal funds that he was not entitled to, they said. (I wonder what he spent it all on.)

Clifton pleaded guilty to making false statements to illegally obtain funds from the Labor Department. In addition to the 18 months in federal prison (where there is no chance of parole), he will also serve two years of supervised release and pay a $50,000 fine.

Today’s Fraud of the Day comes from a Department of Justice press release, “Baton Rouge Doctor Sentenced to Federal Prison for Making False Statements Relating to Health Care Matters,” dated March 12, 2020.

United States Attorney Brandon J. Fremin announced that U.S. District Judge Brian A. Jackson sentenced Marvin Clifton, M.D., age 71, of Baton Rouge, Louisiana, to 18 months in federal prison following his conviction for making false statements relating to health care matters.  The Court further sentenced Dr. Clifton to two years of supervised release following his term of imprisonment and ordered him to pay a $50,000 fine and a $100 special assessment.

 

According to admissions made as part of Dr. Clifton’s guilty plea, Dr. Clifton was a licensed physician whose medical practice included physical therapy.  His patients included individuals that received medical benefits under the Office of Workers’ Compensation Program (“Workers’ Comp Program”).  The Workers’ Comp Program was a federal health care benefit program, providing wage replacement benefits, medical treatment, vocational rehabilitation, and other benefits to certain workers or their dependents who experienced work-related injuries or occupational disease. Qualified medical treatment provided under the Workers’ Comp Program was paid for by the U.S. Treasury.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.