ATLANTA — A doctor from Forsyth County has pleaded guilty to health care fraud for filing claims for surgical monitoring services he didn’t perform.
According to the U.S. Attorney’s Office for the Northern District of Georgia, 54-year-old Robert E. Windsor of Cumming entered the plea Friday before U.S. District Court Judge Amy Totenberg. His sentencing is scheduled for June 3.
According to the U.S. Attorney’s Office, the charges and other information presented in court, investigators uncovered Windsor’s fraud through analysis of Medicare billing data and complaints.
In total, after collecting reimbursements from insurers, Windsor was reportedly paid more than $1.1 million for monitoring services he did not perform between at least January 2010 through July 2013.
In a statement, U.S. Attorney John Horn said Windsor “put patients at risk by passing the surgical monitoring work he was paid to perform to an unauthorized medical assistant and then lied about it.”
“This doctor’s scam left patients without a qualified physician monitoring their neurological health during surgery and cheated other health care providers out of over $1 million,” Horn said.
J. Britt Johnson, FBI special agent in charge, described Windsor’s conduct as “not only criminal, it was reckless and irresponsible.”
“While [Windsor's] repeated and extensive practice of falsely billing for services that he himself did not render is at the heart of these federal charges, the potential risk and harm to those many patients who were not getting the required services should not be overlooked,” Johnson said.
According to the U.S. Attorney’s Office, Windsor entered into a contract with American Neuromonitoring Associates, a Maryland-based corporation, to provide a medical service called intra-operative monitoring.
In this medical procedure, a physician monitors a patient’s nerve and spinal cord activity during surgery to reduce potential adverse effects to the patient.
The contract stated that Windsor would provide real-time monitoring services for patients in surgery via an online platform with technologists in the operating room, according to the U.S. Attorney’s office.
Windsor was responsible for providing a final monitoring report at the conclusion of each surgery, and ANA and its sister company would bill patients and health care benefit programs, including private health insurance companies, for the monitoring.
Windsor was paid a fee for each surgery monitored.
But during that three-year span, Windsor instead assigned the monitoring to a medical assistant who impersonated him by using his log-in credentials in the online platform.
The medical assistant was not a doctor and was not permitted to perform the monitoring under the contract with ANA, according to the U.S. Attorney’s Office.
Windsor submitted final monitoring reports falsely stating that he had conducted the monitoring, which ANA and its sister company relied upon in billing health care benefit programs for his services.
On several occasions, Windsor billed ANA for monitoring services he purportedly performed when he was actually traveling on an international flight.
“This guilty plea will hold [Windsor] accountable for his greed-based criminal conduct,” said Johnson with the FBI.