Louisiana Doctor Sentenced to Prison in $500K Workers’ Comp Fraud Case

A Baton Rouge, Louisiana, doctor has been sentenced to 18 months in federal prison after being convicted of participating in a workers’ compensation fraud scheme in which he submitted more than $500,000 in false claims, according to the U.S. Attorney’s Office for the Middle District of Louisiana.

Marvin Clifton, M.D., age 71, whose medical practice included physical therapy, also was sentenced to two years of supervised release following his imprisonment, and to pay a $50,000 fine and a $100 special assessment.

In his guilty plea, Clifton acknowledged that some of his patients received medical benefits under the Office of Workers’ Compensation Program (Workers’ Comp Program), a federal health care benefit program that provides wage replacement benefits, medical treatment, vocational rehabilitation, and other benefits to certain workers or their dependents who experienced work-related injuries or occupational disease.

Between January 2015 and January 2019, Clifton engaged in a scheme defraud by knowingly and willfully falsifying and concealing material facts, the U.S. Attorney’s Office said. He directed his office managers to falsify medical bills claiming Clifton had provided medical treatment such as physical therapy to workers’ comp patients, when he had not provided the services.

In some instances, according to officials, Clifton would direct his office managers to bill for treatment on days his office was closed, and on other occasions, he directed his office managers to bill for longer treatment sessions than what had actually been provided.

Throughout the course of this scheme, and through numerous transactions, Clifton submitted over $500,000 of falsified bills, through which he obtained approximately $340,342.58 in federal funds from the United States Department of Labor to which he was not entitled.

This matter was investigated by the Federal Bureau of Investigation, the U.S. Postal Service Office of Inspector General, and the U.S. Department of Labor Office of Inspector General, and was prosecuted by Assistant U.S. Attorney Peter J. Smyczek.

Source: U.S. Attorney’s Office for the Middle District of Louisiana

Topics USA Fraud Workers' Compensation Louisiana