A physician couple from Hollidaysburg, Pa., have pleaded guilty to healthcare fraud.
Anesthesiologist John Johnson, MD, 62, entered into an agreement to defraud health insurers for fraudulently billing for urine drug tests, according to a March 25 news release from the Justice Department.
He conspired with others in a scheme involving pain management practices in Central Pennsylvania, known as Lighthouse Medical and Pain Medicine of York. His co-conspirator and business partner, Rodney Yentzer, acquired the group at the suggestion of Dr. Johnson.
In 2016, Dr. Johnson, and Mr. Yentzer made a deal with a hospital to sell Lighthouse Medical's laboratory services in exchange for the right to bill. The hospital paid Lighthouse $900 per test in kickbacks, the release said. In total, the owners of the hospital billed payers approximately $1.4 billion for laboratory testing services that were not medically necessary, and Lighthouse Medical received $2.3 million in kickbacks over a four-month period; 85% of this amount went to Dr. Johnson.
Dr. Johnson's wife, Paula Johnson, MD, 62, both pleaded guilty to healthcare fraud and conspiracy to defraud the U.S. The couple conspired to evade payments that Dr. John Johnson was required to make for a prior criminal conviction.
In 2016, Dr. John Johnson was charged with conspiracy to commit mail fraud and wire fraud. In 2017, Dr. John Johnson got Mr. Yentzer to put Dr. Paula Johnson on the payroll before he was sentenced to 84 months in prison for fraudulent billing, the release said.
Dr. John Johnson instructed Mr. Yentzer to continue to bill every patient for two urine drug tests at each visit, the Justice Department said.
From mid-2017 to late 2019, Pain Medicine of York billed Medicare for around $10 million for urine testing, with more than $4 million paid out. Pain Medicine of York shut down in November 2019 after search warrants were executed.
Mr. Yentzer pleaded guilty in 2022 to charges related to the fraud, the release said.