As a follow-up to my August 9, 2011, post concerning a fake physician’s indictment for fraud and HIPAA crimes, on September 14, 2011, Matthew Paul Brown, age 30, formerly of Atlanta, Georgia, and Nashville, Tennessee, pled guilty today in the United States District Court for the Northern District of Georgia to charges of health care fraud and wrongful disclosure of individually identifiable health information. The court will sentence Brown on November 22, 2011. He faces 170 years in prison for the fraud counts and 10 years for the HIPAA count. With his guilty plea, presumably under a plea bargain and the federal sentencing guidelines, he will not get anywhere near 180 years, but the judge will almost certainly impose significant time in federal prison.

Brown had approached numerous practicing physicians in the Atlanta area 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 that they received from the health care benefit programs. Brown had never been licensed in Georgia as a physician or any other kind of health care
practitioner.

The HIPAA criminal violation consisted of a disclosure by Brown of a spreadsheet that he had created with health information concerning each person that he had treated. Brown sent the spreadsheet to an undercover FBI agent, whom Brown believed to be an investor considering a large investment in Brown’s business.

This case, as discussed in the August 9, 2011, blog entry, illustrates just how broad the HITECH Act’s expansion of HIPAA criminal liability to employees and other individuals is, especially when coupled with the case discussed in my September 13, 2011, blog entry concerning a Canadian resident that had had no connection with a covered entity and that had dumped into a dumpster PHI that he had hoped to use to reopen a clinic.