Dr. David Lester Johnston, 47, of Ridgefield, who recently served three months in prison for committing health care fraud, was reprimanded Tuesday by the state Medical Examining Board in connection with the case.
The board placed Johnston’s medical license on probation for three years, ordered audits of his practice for two years after he resumes billing Medicare and insurance companies, and ordered him to pay a $3,000 fine, according to published reports.
A spokesman for the state Medical Examining Board could not immediately verify the information in the published reports.
Johnston gave a statement Wednesday to the Press.
“I am looking forward to moving on and continuing to practice in this beautiful town of Ridgefield and provide excellent osteopathic manual care and healing for my patients,” Johnston said in the statement.
“The good news is I’ll still be in Ridgefield,” he said.
Johnston, who operates the Osteopathic Wellness Center LLC in Ridgefield, is currently on three years of supervised release and in-home confinement in connection with the health insurance fraud case, according to the terms of his sentence as explained last year by Deirdre M. Daly, United States attorney for the District of Connecticut.
He must also perform 150 hours of community service.
On Jan. 16, 2015, Johnston pleaded guilty to one count of health care fraud and admitted that he engaged in a scheme to defraud several private health insurance companies by submitting claims for evaluation and management services (physician office visits) that he did not perform, and by misrepresenting the nature of the services that were performed.
According to court documents and statements made in court, Johnston submitted claims for physician office visits that were not performed at all. Instead, the patients received only massages and related services from a massage therapist. In addition, Johnston falsely described the services rendered and falsely stated that he himself had rendered the services. The investigation revealed that on several occasions, Johnston was out of the country when the massage therapist was seeing Johnston’s patients.
Johnston was ordered to pay restitution in the amount of $172,950.
In addition, as part of the resolution of the case, Johnston entered into a civil settlement with the government and has agreed to pay $270,528 to settle federal civil claims that Johnston submitted false claims to the Medicare program for office visits, osteopathic manipulative treatment and physical therapy services that were not performed. Instead, the Medicare patients treated by the massage therapist in Johnston’s practice received only massages and related services. Medicare does not recognize massage therapists as providers and they are not eligible to participate in the Medicare program. Johnston nevertheless billed the Medicare program as if he had provided the services in question.
Pursuant to the civil settlement, Johnston has been excluded from participation in all federal health care programs for a period of five years.
The matter was investigated by the office of the inspector general of the U.S. Department of Health and Human Services and the Federal Bureau of Investigation. The case was prosecuted by Assistant U.S. Attorneys Christopher Mattei, Heather Cherry and Richard Molot.
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