Manager of Mobile West Michigan Urological Practice Sentenced to Prison for Role in Healthcare Fraud Scheme
Department of Justice
U.S. Attorney’s Office
Western District of Michigan
FOR IMMEDIATE RELEASE
Monday, June 29, 2020
Office Manager Mark J. Sabor Sentenced Today for Conspiracy to Commit Healthcare Fraud and Agrees to Pay Share of Civil Settlement Totaling $1.26 Million
GRAND RAPIDS, MICHIGAN — U.S. Attorney Andrew B. Birge announced today that U.S. District Judge Janet T. Neff sentenced Mark J. Sabor to two years of incarceration for his involvement in a conspiracy to commit healthcare fraud. Mr. Sabor was the manager of Urological Solutions of Michigan ("USM"), a mobile medical practice providing urological services to patients in their homes and assisted living facilities in the greater Traverse City, Grand Rapids, and Kalamazoo areas.
Judge Neff found that Mr. Sabor was complicit in several fraud schemes committed by USM, resulting in approximately $914,000 in false claims submitted by USM and paid by Medicare. These schemes included billing pelvic muscle rehabilitation ("PMR) therapy using improper—and more lucrative—diagnostic codes, billing for evaluation and management ("E&M") services that did not occur, upcoding ultrasound services, and billing for the services of an unlicensed nurse assistant. Judge Neff applied an enhancement to Mr. Sabor’s sentencing guidelines based on the fact that an administrative law judge in 2011 ruled that USM should not bill Medicare for the PMR therapy using the diagnostic codes. In imposing the prison sentence, Judge Neff emphasized the need to deter other healthcare practitioners and practice managers from cheating important government programs and to promote respect for the law.
Mr. Sabor’s conviction was part of a larger investigation of USM’s owner, Roger D. Beyer, M.D., and his wife, Susan E. Wright, N.P., J.D. Dr. Beyer was the owner of USM and Women’s Health Care Specialists, P.C. ("WHCS"), an obstetrics-gynecology practice in Kalamazoo. Ms. Wright was an employee of WHCS.
On May 15, 2020, Dr. Beyer pleaded guilty in the U.S. District Court for the Western District of Michigan to conspiracy to commit healthcare fraud and adulteration of a medical device. That same day, Ms. Wright pleaded guilty to misprision of healthcare fraud and the adulteration of a medical device. Specifically, Ms. Wright admitted that she knew that USM fraudulently billed Medicare for E&M services to patients on the same date of service as the PMR therapy, but she never informed authorities. Both Dr. Beyer and Ms. Wright are scheduled to be sentenced before Judge Neff on September 9, 2020.
In addition to their convictions, all defendants entered into civil settlements with the United States to resolve their civil liability under the False Claims Act. In total, the defendants, including the now-closed USM and WHCS practices, paid $1,260,000 for submitting or causing the submission of false claims for reimbursement to Medicare as part of numerous alleged healthcare fraud schemes. For his role in the alleged misconduct, Mr. Sabor agreed to pay a civil settlement of $150,000.
"Mr. Sabor’s misconduct in these healthcare fraud schemes was particularly egregious because USM continued to improperly bill Medicare even after it had been warned not to do so by an administrative law judge," stated U.S. Attorney Birge. "Instead of following the rules, Mr. Sabor and USM found new ways to exploit the Medicare Program of hundreds of thousands of dollars. As the Government emphasized in its sentencing memorandum, ‘If you bill the government, learn the rules; if you are audited and found to be doing something wrong, rectify your practices; if a judge tells you to stop billing improperly, stop it. And if you don’t, expect to pay back the ill-gotten gains and anticipate a prison sentence.’"
"The defendant’s conduct in this case was clearly motivated by greed," said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region ("HHS-OIG"). "Billing for services not rendered, up-coding the actual services provided, billing for unlicensed personnel; these actions demonstrate a complete disregard for the law and resulted in a criminal conviction. The OIG will continue to work with our prosecutorial and law enforcement partners to ensure that those who commit these criminal acts are held accountable."
"Today’s sentence is the result of the dedicated efforts of multiple investigative agencies and prosecutors who collaborated to protect the integrity of the Medicare program," said Steven M. D’Antuono, Special Agent in Charge of the Federal Bureau of Investigation ("FBI") in Michigan. "Health care fraud costs our country billions of dollars a year and drives up the cost of care for every single taxpayer, but especially for the disabled and elderly citizens who are entitled to the benefits this program provides."
This case was the result of a joint investigation by HHS-OIG, FBI, and the Food & Drug Administration’s Office of Criminal Investigations, in coordination with the U.S. Attorney’s Office for the Western District of Michigan. Assistant U.S. Attorney Raymond E. Beckering III prosecuted the criminal case, and Assistant U.S. Attorney Andrew J. Hull represented the United States in the civil case.
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Topic(s):
Health Care Fraud
Component(s):
USAO - Michigan, Western