Raleigh, NC Doctor Anita Louise Jackson guilty of using ‘unsanitary’ surgical devices in Medicare fraud scam: Justice Department

RALEIGH, NC– A North Carolina doctor was found guilty of reusing “unsanitary” equipment intended for single use on unsuspecting patients during surgeries, the Justice Department said Friday.

U.S. Attorneys said Anita Louise Jackson of Raleigh was also charged with tampering with medical devices used on patients with intent to defraud and mislead them, falsifying medical and medical records, paying illegal remuneration, mail fraud and conspiracy To be sentenced.

Jackson, who operated Greater Carolina Ear, Nose, and Throat with offices in Raleigh, Lumberton and Rockingham, was convicted on 20 counts after a three-week trial by a federal jury.

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Authorities said she used devices to perform balloon sinuplasty, an in-office surgery to treat chronic sinusitis, in more than 1,400 surgeries for Medicare patients between 2011 and 2017. Jackson used a device called the Entellus XprESS, which is FDA-approved for use on a patient during surgery and should then be discarded.

The numbers just didn’t add up — although Jackson had performed the procedure more than a thousand times, Jackson received at most 36 new Entellus devices between 2012 and 2017, officials said.

“This doctor put profit before patients, lured Medicare patients with free ‘sinus spas’ and risked infecting those patients by reusing the same disposable surgical equipment over and over again,” said Michael Easley, US Attorney for the East District of North Carolina. “If we allow doctors to trick Medicare to augment their profits by performing unsupported medical procedures, every single American taxpayer will bear the cost. But the damage will be felt most severely by victimized patients who deserve better and by older Americans who have received Medicare and are entitled to quality care. Jackson’s blatant disregard for the health of her patients has led to her conviction on multiple federal charges.”

Evidence during an investigation showed that Jackson misled her patients and failed to inform them that they were receiving a procedure with a counterfeit device, and that during cross-examination she stated that she had enough money to buy new devices for each patient, herself but against it decided so.

Federal prosecutors also said that between 2014 and 2018 Jackson used her practices to bill Medicare more than $46 million for the balloon sinuplasty procedures and more than $4.79 million for those surgeries alone taken from Medicare.

“FDA continues its commitment to aggressively prosecute those who deviate from prescribed medical device use standards,” said Special Agent in Charge Justin C. Fielder, FDA Office of Criminal Investigations Miami Field Office. “We will remain vigilant in our efforts to protect consumers from potentially dangerous products.”

Jackson was also convicted on 10 counts of illegally enticing her patients to undergo sinuplasty surgery by not collecting co-payments. In doing so, Jackson prompted her patients to come into the practice for a “free” sinus spa and receive treatments that they might not need or would not have consented to had the full cost price to the patient been disclosed.

She also wrote off or otherwise hid the full cost of the procedure on all bills sent to the patient after her visits, which could be as high as $1,500 for Medicare beneficiaries, officials said.

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Jackson was also convicted of three counts of false health care claims, two counts of aggravated identity theft and three counts of mail fraud.

“It’s troubling when scammers take advantage of vulnerable Medicare members and defraud federal health programs for personal gain,” said Tamala E. Miles, the US Department of Health’s Special Representative, Office of Inspector General.

Jackson faces a maximum prison term of 20 years for mail fraud, 10 years for paying illegal remuneration, five years for conspiracy and false testimony, and three years for tampering with intent to defraud or mislead. Aggravated identity theft carries a two-year prison sentence following any other sentence.

Jackson also faces fines in excess of $250,000 and the jury ordered $4,794,039.31 to be forfeited.

A federal civil suit is also pending against Jackson.

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