Iowa Doctor Convicted of Health Care Fraud

August 9, 2006

A Des Moines, Iowa doctor was convicted Monday of seeking reimbursement on medical procedures that were unnecessary or not performed.

Dr. Peter Boesen is awaiting sentencing on 82 counts of health care fraud relating to his practices at his ear, throat and nose clinic. Each charge is punishable by up to 10 years in prison. He could also forfeit almost $429,000 that prosecutors allege came from fraudulent activity.

Boesen and his brother were charged in December with fabricating patient notes and submitting inaccurate claims to receive more money from Medicare, Medicaid and Wellmark Blue Cross and Blue Shield of Iowa.

James Boesen, who’s clerical job at the clinic includes billing insurance companies, was accused of conspiring with his brother to seek the inflated reimbursements. A federal jury in Des Moines convicted James Boesen on Monday, but Judge James Gritzner overturned the decision based on what he considered insufficient evidence.

The lawsuit alleged the brothers conducted illegal activity between 1997 and 2002.

According to the indictment, Dr. Boesen scheduled patients for repeated appointments that were medically unnecessary. He also fabricated patient notes to justify procedures he performed.

The lawsuit alleges the doctor instructed nurses to contact pathology laboratories and request that his patients’ tissue samples be labeled “cholesteatoma,” an ear infection that sometimes requires surgical treatment.

Guy Cook, the doctor’s attorney, told The Associated Press in December that his client is innocent. Cook said Wellmark used its power as one of Iowa’s largest health insurance companies to influence the FBI’s investigation.

Cook and U.S. Attorney Matthew Whitaker could not immediately be reached for comment Monday night.

A sentencing date has not been set.

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