The office manager at a Kalamazoo-area medical office will serve time in prison for his involvement in a healthcare fraud scheme that has also implicated the practice’s owner.
Mark J. Sabor, who worked in the office of Urological Solutions of Michigan, will serve two years in prison and help pay off a $1.26 million civil settlement for his involvement in a Medicare fraud conspiracy at his place of work that resulted in nearly a million dollars’ worth of false insurance claims, U.S. Attorney Andrew Birge announced on Monday, June 29.
The prison sentence was intended, in part, to deter other healthcare providers from bilking government programs, according to a news release explaining the reasoning of U.S. District Judge Janet T. Neff, who sentenced Sabor.
The owner of the medical practice, Dr. Roger Beyer, and his wife, Susan Wright, a nurse practitioner, each previously pleaded guilty to fraudulently billing Medicare for certain services. They also admitted reusing single-use medical tools on multiple patients at their Kalamazoo-area clinic, and while operating a mobile urological service in the greater Traverse City, Grand Rapids and Kalamazoo areas.
The judgment found that Sabor was complicit in his workplace, defrauding Medicare of about $914,000 in false claims. These included coding a therapy service known as pelvic muscle rehabilitation (PMR) as something more lucrative, doing likewise with ultrasound services, billing for evaluation and management services that did not take place, and billing for use of an unlicensed nursing assistant.
Sabor’s sentence was increased because the medical practice had already been ordered by an administrative law judge in 2011 not to bill Medicare for the PMR therapy, according to the news release.
“Instead of following the rules, Mr. Sabor and USM found new ways to exploit the Medicare program of hundreds of thousands of dollars,” said Birge in a statement. “As the government emphasized in its sentencing memorandum, ‘If you bill the government, learn the rules; if you are audited and found to be doing something wrong, rectify your practices; if a judge tells you to stop billing improperly, stop it. And if you don’t, expect to pay back the ill-gotten gains and anticipate a prison sentence.’”
Sabor will also pay $150,000 towards a $1.26 million civil settlement, established under the federal False Claims Act, in order to reimburse the Medicare program of the defrauded money.
Sabor pleaded guilty to the felony conspiracy charges in December, according to public court records. He’d worked for the health facility since March 2007, according to a public LinkedIn profile.
U.S. attorneys, investigators from two federal agencies and the FBI investigated Urological Solutions of Michigan and Women’s Health Care Specialists, located at 7110 Stadium Drive in Oshtemo Township, after a nurse in the office said that a single-use rectal pressure sensor had been used more than 100 times before being replaced, a move that could have caused viral transmission.
On May 15, Beyer pleaded guilty to conspiracy to commit healthcare fraud and adulteration of a medical device, and Wright pleaded guilty to deliberately concealing her knowledge of the healthcare fraud – known as “misprision” – and to adulteration of a medical device.
Beyer and Wright are scheduled to be sentenced by Neff on Sept. 9.
Conspiracy to commit healthcare fraud can carry a fine of $250,000 and up to 10 years in prison.
The misuse of a medical device can carry a fine of $100,000 and up to one year in prison. Beyer may face up to three years for having directed his staff to misuse the devices.
Misprision of fraud can carry a fine of $250,000 and up to three years in prison, according to court documents.
No known infections resulted from the reuse of the tools, according to the Michigan Department of Health and Human Services, which received the nurse’s complaint in May of last year.