Convicted Indiana Physician to Pay $1.7M in Fraud Settlement
HAMMOND – A Burlington man who once operated pain management clinics in North-Central Indiana has agreed to a nearly $1.7 million settlement to resolve accusations of fraud against the Indiana Medicaid program.
The settlement, announced Wednesday by U.S. Attorney Adam L. Mildred, ends a civil battle that has spanned nearly a decade. Don J. Wagoner, 89, and his entity, Wagoner Medical Center, L.L.C., were accused of systematically overbilling the state for simple drug tests.
According to federal court documents, between 2011 and 2013, the Wagoner Medical Center required patients seeking opioid prescriptions to provide urine samples. Investigators found that the clinic used a simple, all-in-one “multiplex” screening kit that cost the business only $10 to process.
However, the clinic allegedly billed Indiana Medicaid as if they had collected and analyzed nine separate samples for each patient.
The Cost: The clinic was legally allowed to bill $20.83 per patient.
The Fraud: They instead received $171.27 or more per patient.
Over the course of 5,000 fraudulent claims, the clinic pocketed nearly $1 million in overpayments that they initially refused to pay back.
A Pattern of Malpractice
This settlement is the final chapter in a long history of legal trouble for Wagoner.
2013: Wagoner permanently surrendered his medical license following a criminal investigation into his “pill mill” prescribing practices.
Criminal Conviction: The investigation led to felony drug dealing convictions for Wagoner after authorities linked his prescribing habits to multiple patient deaths and widespread drug diversion.
2017: The U.S. and the State of Indiana filed the False Claims Act lawsuit that resulted in today’s settlement.
“Don Wagoner cannot be allowed to retain the fruits of his fraudulent Medicaid claims,” said U.S. Attorney Mildred. “Our office will continue to make it a priority to recover funds that were fraudulently received from the Medicare and Medicaid programs.”
Convicted Indiana Physician to Pay $1.7M in Fraud Settlement was originally published on wibc.com
