PA Doc Sentenced in $1.8 Million Fraud

Insurance Fraud — By on March 30, 2012 at 3:26 PM

Temple University’s School of Medicine no doubt has a faculty that makes them very proud and has turned out a huge number of highly educated students over the years. One faculty member they probably aren’t too proud of however is a past assistant dean of medical affairs and the chairman of the ophthalmology department.

According to prosecutors and the Philadelphia Daily News, Dr. Joseph J. Kubacki, 62, claimed to have seen several patients while he was out of town, and several others that were actually treated by resident doctors. He did however bill Medicare and private health insurers as if he had seen or treated the patients himself.

Kubacki also falsified patient charts by making notations that he had consulted with the patients who were seen only by resident doctors –who are paid salaries and not permitted to bill insurers.

The indictment states that the fraudulent billing scheme began in 2002 and went on until 2007.

Kubacki was convicted by a jury back in August on 150 counts of health care fraud and related offenses and was taken into custody after the verdict.

Prior to his sentencing, Kubacki told U.S. District Judge Eduardo Robreno that he would take responsibility for his fraud but that he did not do it because he was motivated by greed.

Kubacki implied that he had the best interests of the school in mind. The pediatric eye specialist said that when he became chairman he inherited a department that was “dysfunctional,” $700,000 in the red, understaffed and lacked adequate space and proper equipment.

Kubacki said he was under “tremendous pressure to turn it around.”

“So, I signed the charts to keep the department afloat. I could have made more money in private practice,” he said.

So, he did it for the sake of the University?  Not so fast.  Ronald H. Levine, a lawyer for Temple, stated, “Asking Kubacki to manage his department effectively provided him no license to defraud either insurance payers or Temple.” He also noted that said Kubacki “acted on his own and in defiance” of Temple’s “repeated compliance training” about proper billing.

Assistant U.S. Attorney Anthony Kyriakakis stated that Kubacki’s criminal misdeeds were motivated “for his own personal benefit,” noting that the billing scheme helped Kubacki collect tens of thousands of dollars in annual bonuses.

As for the bogus bills on the days that Kubacki was absent, prosecutors say they identified 31 private insurers and 215 individuals who made co-pays of $25.

Judge Robreno sentenced Kubacki to over 7 years in federal prison and ordered him to pay a restitution fee to the patient victims of $5,445, over $1 million to Temple, and a $15,000 fine.

There was no evidence that Kubacki’s scheme harmed any patients.

Kubacki left Temple in November of 2007 after an internal investigation and had been living in Destin, Florida prior to the trial.


This post is authored by Trace America.

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