A man admitted Wednesday to posing as a doctor to defraud health care benefit providers of more than $1 million as he tended to hundreds of patients in metro Atlanta and Nashville, federal prosecutors said.
Matthew Paul Brown, 30, pleaded guilty to 17 counts of health care fraud and to wrongfully disclosing patients’ confidential information, according to a news release from the U.S. Attorney’s Office in Atlanta.
“This defendant’s crime defrauded over a thousand people of the care they deserved and defrauded Medicare, Medicaid and private health insurance companies of funds intended and needed for legitimate health care,” United States Attorney Sally Quillian Yates said.
According to the charges, Brown carried out his scheme from November 2009 through April 5.
He approached practicing physicians, offered allergy-related care to their patients and persuaded them to bill Medicare, Medicaid and private health insurers using the doctors’ own provider numbers. The physicians agreed to pay Brown between 50 and 58 percent of roughly $1.2 million in total reimbursements.
Brown has never been licensed in Georgia as a physician, physician assistant, nurse or clinical nurse specialist, prosecutors said.
Though Brown administered allergy shots to patients, he used medicines and needles purchased from a commercial pharmacy.
Prosecutors said they were unaware of anyone seriously injured by his care. The U.S. Attorney’s Office said it has notified all those treated by Brown it has been able to locate.
The defendant also admitted disclosing patients’ information in violation of the federal Health Insurance Portability and Accountability Act (HIPAA). He had sent a spreadsheet containing patient data to an undercover FBI agent Brown believed to be a potential investor in his business, prosecutors said.
Brown’s sentencing is scheduled for Nov. 22 before U.S. District Judge Amy Totenberg. He faces a maximum prison term of 10 years and a fine of up to $250,000 on each count against him, prosecutors said.
The case was investigated by the FBI assisted by the Duluth Police Department. Assistant U.S. Attorney Alana R. Black is prosecuting the case.
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