The United States Attorney's Office

FORMER DOCTOR TO PAY MORE THAN $2,000,000 TO SETTLE CIVIL ALLEGATIONS OF DEFRAUDING MEDICARE PROGRAM

Paul A. Lessler, a former doctor, has agreed to pay the United States $2,180,000 to resolve allegations that he allowed his Medicare provider numbers to be used to bill the Medicare program for fraudulent respiratory therapy treatments.  Lessler has agreed to pay the settlement to resolve civil allegations under the False Claims Act.  He previously pled guilty to criminal conspiracy and health care fraud for the same conduct in a related criminal case in the Central District of California, United States v. Paul Arnold Lessler, et al., SA CR 07-21-JVS.

Lessler is a former Orange County anesthesiologist and pain management specialist and was the owner of a medical practice group, University Pain Specialists.  He and the practice group also were participating Medicare providers subject to the rules and regulations governing Medicare reimbursement.  Under the Medicare program, certain respiratory therapy treatments are reimbursable only if they are performed by respiratory therapists acting under the direct supervision of a doctor and only if they are performed in a doctor’s office.  In addition, it is illegal for a Medicare provider to pay kickback payments for the referral of Medicare patients for treatments.

Lessler has admitted that, from 2002 to 2006, he caused false claims for respiratory therapy treatments to be submitted to the Medicare program under his and his medical practice group’s Medicare provider numbers.  These claims were false for one or more of the following reasons:  (1) neither Lessler nor any other doctor was present when the treatments were performed, but the claims falsely represented that he (or another doctor) was present and thus able to directly supervise the treatments; (2) the treatments were performed at a board and care facility, but the claims falsely represented that the treatments were performed in a doctor’s office; and/or (3) Lessler paid illegal kickbacks (30% of the Medicare reimbursement for each claim) to the “coordinator” or marketer who recruited the Medicare patients that received the treatments.

The Office of the Inspector General for the U.S. Department of Health and Human Services also has excluded Lessler from participating in the Medicare program for 15 years.  Lessler surrendered his medical license to State authorities in June 2008.

This investigation was handled by the United States Attorney’s Office in Los Angeles and Santa Ana.  These offices received assistance from the Federal Bureau of Investigation, the United States Postal Inspection Service, and the Internal Revenue Service.

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Release No. 08-158
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