Corporate Compliance

CA physician sentenced to 18 months in prison for falsely billing cancer medications

Compliance Monitor, August 3, 2011

Glen R. Justice, MD, 66, of Corona del Mar, CA, was sentenced to 18 months in federal prison for fraudulently billing $1 million worth of injectable cancer medications, according to a Department of Justice (DOJ) press release.

Justice ran the Pacific Coast Hematology/Oncology Medical Group in Fountain Valley, CA. During that time he billed Medicare and other payers for injectable cancer medications that patients never received. In some instances where patients did receive medications, Justice upcoded claims to falsely indicate that he administered more expensive injectable medications than he actually gave patients.

In addition to the prison term, Justice was ordered to pay $1,004,689 in restitution to the public and private health insurance providers affected by his actions, which include Medicare, Tricare, carriers contracted with the federal government through the Federal Employee Health Benefit Program, and Blue Cross and Blue Shield of California.

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