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Physician with specialized training in anesthesiology, John H. Johnson and his physician wife, Paula Z. Johnson, both age 62, of Hollidaysburg, were sentenced for committing fraud by U.S. District Court Judge Christopher C. Conner on Tuesday, Sept. 17, as detailed in the USDOJ release.
Dr. John Johnson received a sentence of 97 months in prison, followed by three years of supervised release. Dr. Paula Johnson received a sentence of three years of probation, including six months of home detention with location monitoring, and was ordered to immediately pay $249,301.36 in restitution, fines, and assessments — but the total amount is in the millions, according to the USDOJ and federal court documents obtained by Daily Voice.
It is unclear if Johnson lost his medical licenses as a result of the conviction.
The sentencing comes eight years after the Johnsons "entered into an agreement with other individuals to defraud health insurance programs by billing them illegally for expensive tests known as 'urine drug tests,'" United States Attorney Gerard M. Karam wrote in the release.
Rodney L. Yentzer of Cumberland County, PA, pleaded guilty to defrauding Medicare and Medicaid by submitting medically unnecessary urine drug tests for patients at clinics he controlled, including a group of pain clinics known as Pain Medicine of York or “PMY” (also known as All Better Wellness) on Thursday, March 24, 2022, according to an earlier USDOJ release. PMY was absorbed Lighthouse Medical in 2017, and PMY closed permanently in November 2019 after law enforcement agents executed search warrants at its various locations.
Yentzer and Johnson got Critical Access Hospital at the Alabama, Florida border to give them $900 in kicks for each test through Medicare billing fraud, officials wrote.
In total, the owners of the hospital billed others, including private insurers, approximately $1.4 billion for various laboratory testing services that were not medically necessary. The majority of this amount was due to the urine drug tests. Lighthouse Medical received $2,341,775 in kickback payments over a four-month time period, with 85% of this amount going to John H. Johnson and his wife, and the remaining amount going to Rodney L. Yentzer, the USDOJ explained.
Mr. Dr. Johnson was previously sentenced to an 84-month term of imprisonment for the various offenses and was also ordered to repay to the U.S. Government over $3 million in restitution payments for fraudulent health care billing and unpaid taxes in 2017.
Johnson and Yentzer remained in close contact through phone and in-person visits, but their coded conversations lead the FBI to discover the additional frauds, such as Yentzer purchasing a car for the Johnsons’ son and leased an Audi Q5 for Paula Z. Johnson, at her request. Yentzer also made $28,000 in contributions to their children’s 529 college savings accounts, paid over $40,000 in legal bills for “asset and estate planning,” made over $40,000 in payments toward personal loans, and covered other large bills.
Under the terms of his plea agreement, John H. Johnson will also be required to pay over $2.3 million in restitution to defrauded health insurance companies. The restitution order against John H. Johnson is expected to be finalized within the next sixty days.
The case was investigated by the U.S. Department of Health and Human Services Office of Inspector General, Federal Bureau of Investigation, Drug Enforcement Administration Diversion Control Division, and Pennsylvania Office of Attorney General. Assistant U.S. Attorney Ravi Romel Sharma prosecuted the case.
“Ensuring the integrity of health care programs in this age of rising costs is paramount to our mission,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General. “We will continue to work with federal, state, and local partners to hold providers accountable for misconduct that exploits the programs.”
“Healthcare fraud is not a victimless crime. In this case, the defendants caused taxpayers' hard-earned dollars to be diverted from patients who needed care, and instead served their own interests,” said Wayne A. Jacobs, Special in Agent in Charge of FBI Philadelphia. “Today’s sentencing demonstrates the FBI and our partners’ commitment to rooting out fraud and pursuing those who conspire to exploit our healthcare systems for financial gain."
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