Fake Doctor Guilty Of Health Care Fraud And Criminal HIPAA Violations

Matthew Paul Brown impersonated a doctor, treated over 1,000 patients, and, to boot, wrongfully disclosed their health information. Now, he has pleaded guilty in federal district court to charges of health care fraud and wrongful disclosure of individually identifiable health information. 

U.S. Attorney Sally Quillian Yates said, “Medicare and Medicaid provide treatment for some of our community’s most vulnerable citizens: the elderly, young children, and the financially needy. These vulnerable citizens deserve to be treated by medical personnel who have been duly trained and licensed and not by someone impersonating a doctor. This defendant’s crime defrauded over a thousand people of the care they deserved and defrauded Medicare, Medicaid, and private health insurance companies of funds intended and needed for legitimate health care.”
 
According to U.S. Attorney Yates and the charges:
 
From November 2009 through April 5, 2011, Brown carried out a health care fraud scheme in the metro Atlanta and Nashville, Tennessee areas. While operating in the Atlanta area, from November 2009 through August 2010, Brown approached numerous practicing physicians and persuaded them to bill Medicare, Medicaid, and private health insurers under their own provider numbers for allergy-related care provided by Brown. The care was provided both at the physicians’ own offices and at health fairs, with the physicians agreeing to pay Brown between 50 and 85 percent of a total of approximately $1.2 million they received from the health care benefit programs. Brown has never been licensed in Georgia as a physician, physician assistant, nurse practitioner, or clinical nurse specialist.
 
The federal government is not aware of any patients who were seriously injured by care received from Brown. Brown purchased the needles and allergy shots he used from a commercial pharmacy. The U.S. says that it is not aware of any evidence that Brown ever used unsterile needles for the shots. The U.S. Attorney’s office has notified the individuals treated by Brown, to the extent it was possible to identify and locate them.
 
Brown also pleaded guilty to wrongful disclosure of individually identifiable health information, in violation of the Health Insurance Portability and Accountability Act (“HIPAA”). The individually identifiable health information wrongfully disclosed by Brown was a spreadsheet he created with information concerning each person he treated. Brown sent the spreadsheet to an undercover FBI agent, who Brown believed to be an investor considering a large investment in Brown’s business.
 
Brown was indicted in April 2011. The indictment charges 17 counts of health care fraud, each of which carries a maximum sentence of 10 years in prison and a fine of up to $250,000. The HIPAA charge also carries a maximum sentence of 10 years in prison and a fine of up to $250,000.