Former Elko Physician Charged with Health Care Fraud
Reno, Nev. - A physician who practiced in Elko, Nevada, between 1999 and 2002, was indicted Wednesday by the Federal Grand Jury in Reno on federal health care and mail fraud charges, announced Daniel G. Bogden, United States Attorney for the District of Nevada.
MARK CAPENER, M.D., age 45, a resident of Idaho Falls, Idaho, is charged with 38 counts of health care fraud, 13 counts of mail fraud, and one count of making a false statement to a federal agent. If convicted, he faces up to 10 years in prison and $250,000 fine on each health care fraud charge; up to 20 years in prison and a $250,000 fine on each mail fraud charge; and up to five years in prison and a $250,000 fine on the False Statement charge.
According to the court records, DR. CAPENER attended medical school in Virginia and participated in a residency program at the University of Mississippi. He worked in various emergency rooms and ultimately moved his practice to northeast Nevada. DR. CAPENER specializes in ear, nose and throat medicine (Otolaryngology).
Beginning in July 1999 and continuing until February 13, 2002, DR. CAPENER practiced medicine in Elko, Nevada. It is alleged that during that period, DR. CAPENER devised and executed a scheme to defraud the various health care benefit programs of money by billing for services not rendered; billing for surgeries not required by the patient; billing for surgeries that were not supported by documentation; "up-coding" or charging for more expensive service than actually provided; and using the postal service to mail the bills to the health care benefit programs.
Specifically, the Indictment alleges that DR. CAPENER fraudulently billed numerous health care programs for 38 unnecessary nasal surgeries and did not submit proper documentation for the surgeries to the programs. It is also alleged that on two occasions, DR. CAPENER billed programs for surgeries that were never performed, including the removal of a tumor. In furtherance of his scheme to defraud and for the purposes of increasing his income, DR. CAPENER unnecessarily exposed some patients to the risks of general anesthesia and surgery. Additionally, on or about March 8, 2002, it is alleged that DR. CAPENER knowingly and willfully made a false statement to an FBI Special Agent who was questioning him regarding his billing practices.
DR. CAPENER was summoned to appear in court for an arraignment and plea on August 4, 2005, at 3:00 p.m. before U.S. Magistrate Judge Robert A. McQuaid, Jr. The case is being investigated by the FBI and Nevada Attorney General's Office, and prosecuted by Assistant United States Attorney Ronald C. Rachow and Special Assistant United States Attorney Ronda Clifton.
The public is reminded that an indictment contains only charges and is not evidence of guilt. The defendant is presumed innocent and entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.