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Doctor from Cumming to pay $20 million after health care fraud
doctor

A Forsyth County doctor who pleaded guilty to health care fraud in March and was sentenced in October has agreed to pay a $20 million consent judgment to resolve charges that he violated the False Claims Act.

On Thursday, Feb. 2, Robert Windsor, 55, of Cumming, agreed to the deal, which will require him to sell all but one of his residential and commercial properties and give the net profits to the government.

He will also have to sell other assets, including two boats and four jet skis, and give that money to the government.

The consent judgement is recompense for Windsor billing federal healthcare programs for surgical monitoring services that he did not perform and for medically unnecessary diagnostic tests.

For more than five years, between January 2008 and July 2013, Windsor, who was supposed to be monitoring the neurological health of patients undergoing surgery, “had an unqualified medical assistant monitor surgeries for him, using Windsor’s log-in credentials to make it appear as if he was monitoring the surgeries when he was not,” according to a Department of Justice news release.

Windsor, the release said, was responsible for providing a report at the end of each surgery, which American Neuromonitoring Associates P.C., and its sister company would then use to bill patients and health insurance companies.

The agreement was that Windsor would be paid a fee for each surgery monitored.

However, the assistant who did Windsor’s work was not a doctor and therefore not permitted to perform the monitoring services.

In addition to the false monitoring, Windsor submitted false claims to Medicare, the Georgia and Kentucky Medicaid programs, TRICARE and FEHBP for “medically unnecessary balance tests, nerve conduction and electromyography procedures and qualitative drug screens performed in Georgia and Kentucky during the period from Jan. 1, 2010 through June 30, 2014,” a separate DOJ news release said.

The FBI, the Department of Defense’s Defense Criminal Investigative Service and the Department of Health and Human Services’ Office of the Inspector General (HHS-OIG) investigated the case.

“Providing medically unnecessary services to a vulnerable population, such as Medicare beneficiaries, places patients at risk and jeopardizes millions of taxpayer dollars,” said Derrick Jackson, special agent in charge of HHS-OIG. “[The organization] is committed to safeguarding the federal health care programs and the patients receiving medical services. [Thursday’s] settlement should send a message to others who profit from schemes abusing patient safety that we will pursue justice for our beneficiaries and the programs.”