Roy G. Heilbron, a cardiologist in New Mexico, pleaded guilty to a charge of healthcare fraud on Feb. 17 and admitted he overcharged private insurers and Medicare.
Heilbron will be sentenced to two years in federal prison and will then be subject to supervised release as determined by the court, according to a Department of Justice (DOJ) news release.
In June 2015, Heilbron was charged with 24 counts of healthcare and wire fraud charges for allegedly defrauding Medicare and private insurers between January 2010 and May 2011.
As part of Heilbron’s plea agreement, he only admitted to one of the 24 counts. He admitted that from December 2009 through December 2011, he provided medical services at a medical clinic in Santa Fe, New Mexico, and contracted with Blue Cross and Blue Shield of New Mexico and Medicare. During that time period, Heilbron admitted he misrepresented patients’ diagnoses to obtain money from healthcare programs.
“I believe I was fraudulent in my billing and this is a resolution to what I did,” Heilbron told the judge presiding over the case, according to the Albuquerque Journal.
Although Heilbron only pleaded guilty to one charge, the DOJ said that Heilbron agreed to pay restitution for all 24 charges. The court will determine the amount of restitution at a later date.
The Albuquerque Journal reported that that the New Mexico Medical Board suspended Heilbron’s medical license to practice in the state Feb. 19, 2016. The newspaper also mentioned that Heilbron had an active medical license in Florida, but he was not currently practicing there.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.