Chicago ASC physician convicted in $3.5M billing fraud scheme: 5 things to know

Paul Madison, MD, was convicted of healthcare fraud, aggravated identity theft and lying about medical treatment delivery after directing staff to fraudulently bill for procedures at the surgery center where he practiced, according to a Chicago Sun Times report.

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Here are five things to know:

1. Dr. Madison, an anesthesiologist and pain management specialist at Watertower SurgiCenter in Chicago, was convicted of ordering staff to fraudulently bill for surgeries that weren’t performed from 2005 to 2009.

2. Under his direction, Dr. Madison’s staff fraudulently billed for more than $3.5 million and wrongly received $783,000, according to an FBI report. 

3. In 2007, Illinois state regulators discovered the fraud and at that time Dr. Madison directed staff members to destroy records and lie to investigators, according to the report.

4. Initially indicted in 2012, a federal jury convicted Dr. Madison last week of six counts of healthcare fraud, three counts of lying about medical treatment and two counts of aggravated identity theft, according to the report. He will be sentenced in March 2019.

5. Dr. Madison’s maximum sentence is 79 years in prison.

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At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

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Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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