Lodi, California-based orthopedic surgeon Gary R. Wisner, M.D. has been sentenced to seven years in prison for healthcare insurance fraud.
Earlier this year, after a two-week trial in the Sacramento County Superior Court, a jury found Dr. Wisner guilty of ten felony counts of healthcare insurance fraud. For OTW’s coverage of the case, see “Orthopedic Surgeon Found Guilty of Healthcare Insurance Fraud.”
The investigation into Dr. Wisner’s actions began in 2016 when the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse (DMFEA) was notified of the suspected fraud. The fraud involved both Medi-Cal (California’s Medicaid program) and Medicare.
From 2012 to 2016, Dr. Wisner overbilled both programs by administering, according to a California Department of Justice press release, “excessive and medically unjustifiable X-rays to his patients.” Ten patients were found to have undergone “hundreds of unnecessary X-rays at his clinic.”
At the time of the investigation, according to a California Department of Justice press release, Dr. Wisner operated a medical clinic with 26,000 patients under his care. During the investigation, DMFEA randomly looked into the files of five of his Medi-Cal patients and five of his Medicare patients. These 10 patients became the basis for the 10 felony charges.
In a California Department of Justice press release, California Attorney General Rob Bonta commented, “Gary Wisner used both his patients and state resources to line his own pockets. Due to his dishonest behavior, patients at his clinic had to undergo unnecessary medical tests so he could steal from the state’s Medi-Cal funds.”
Bonta continued, “This sentence reaffirms what we know to be true: Abuse of power by medical practitioners will never be tolerated within our state’s healthcare system. Thank you to our partners at the San Joaquin County District Attorney’s Office for their help throughout the course of this investigation. The California Department of Justice will continue to protect our state’s critical health resources from bad actors.”
