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Dr. Marc J. Blatstein is in the early stages of the criminal case against him--including a motions hearing yesterday--yet the federal charges have already affected his practice. The Fredericksburg podiatrist was indicted in May for fraudulent billing. Within a month, the Office of Personnel Management suspended him from the Federal Employees Health Benefits Program.
The program provides health insurance coverage to federal workers and their families. The suspension means that Blatstein is not paid if he treats patients enrolled in the program.
In a letter to Blatstein, the federal agency said it was suspending him because of the seriousness of the charges against him and because of "deficiencies and unsafe conditions associated with your practice that pose a potential risk to the safety of patients."
The letter didn't specify the deficiencies. Edmund Byrnes, a public affairs specialist for the Office of Personnel Management, said yesterday that he could not talk about the details of Blatstein's suspension, though he did describe the action as rare.
The suspension has had "an extremely negative impact" on Blatstein's business, according to a court filing by David G. Barger, his attorney.
The suspension will remain in effect until the charges against him are resolved.
Blatstein continues to practice medicine at his Central Park office while he awaits an Oct. 3 jury trial in U.S. District Court in Richmond. He's been charged with one count of health-care fraud and seven counts of mail fraud.
The 52-year-old podiatrist was in federal court yesterday, while Barger, his attorney, argued that the evidence seized during a search of Blatstein's home and medical office should not be used.
Barger claimed that the 2004 search was based on a faulty affidavit, but U.S. District Judge Richard L. Williams rejected the motion.
Blatstein is charged with devising a scheme to make it look like he owned a free-standing surgery center. Prosecutors allege that with a phantom surgery center, Blatstein was able to bill insurance companies for two fees: a professional fee for the treatment he provided patients and a facility fee for the use of the center.
Investigators say in reality he did surgeries in a room within his office, and he was not eligible for the extra payment.
Blatstein denies the charge.
He incorporated his Central Park Ambulatory Surgery Center in June 1999, according to the indictment. Later he obtained a separate tax identification number, used a separate address next door to his office, and had a separate phone line and stationery.
Because it appeared he owned a separate surgery center, Blatstein received overpayments of $272,704 from health insurance companies, according to the indictment.
The seven mail fraud counts are individual instances when Blatstein is alleged to have used the U.S. Postal Service to send fraudulent reimbursement claims to insurance companies. He is alleged to have received the money from 2000 to 2003 from three insurance companies, Aetna, Government Employees Hospital Association and Mail Handlers Benefit Plan.
Last summer police searched Blatstein's office and his Lee's Hill home, removing patient files, billing records, tax returns, claims reports, preprinted office forms and a computer.
Soon after the indictment, Blatstein was restrained by the federal court from disposing of any of his assets. The prosecution has said that if Blatstein is convicted, it intends to go after those assets that he purchased with illegally obtained money.
i am not for one minute condoning what this doctor did.however,if they had gone after columbia medical (one billion in medicare fraud) with the same fervor i would understand.yet the reality is they didn't.corporations commit major healthcare fraud all the time and are simply slapped on the hand.
this guy should have been audited followed by a fine(a very heavy one) and some sort of probationary period.i don't know whose toes this poor sap stepped on.but they are out to ruin him.
Blatstein pleads guilty in federal court, faces 24 months in jail.
Quote:
Date published: 10/5/2005
RICHMOND–A Fredericksburg doctor faces 24 months in jail after pleading guilty today in federal court to one count of mail fraud.
Dr. Marc J. Blatstein, a podiatrist, admitted his role in a 4-year billing scam that involved a fake surgery center in Central Park. He collected $272,702 in insurance fees that he was not entitled to.
U.S. District Court Judge Richard L. Williams said he will sentence Blatstein Feb. 8, after completion of a presentence report. Blatstein’s plea agreement calls for a jail term of 24 months and full restitution.
Doctor dropped from federal insurance plan
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