MedscapeToday.com
Robert Lowes
September 10, 2014
The dramatic federal bust in April 2013 of a Chicago hospital and some of its physicians yielded its first prison term last week, and a light one at that.
A federal district judge sentenced 74-year-old urologist Subir Maitra, MD, to 6 months behind bars after he pleaded guilty earlier this year to receiving kickbacks for referring Medicare patients to the now-defunct hospital and bilking a private insurer for bladder tests in a separate criminal case.
Federal prosecutors had sought a prison term 4 to 5 times that long. However, the judge may have been swayed by the defense attorney’s plea for mercy for his client, whom he characterized in a court filing as an elderly “broken man in very poor physical and mental health” and a “full-blown alcoholic” who was once a good physician.
“Dr. Maitra’s criminal conduct can better be seen as part of his tragically unravelling life, which was marked by divorce, severe alcoholism, bankruptcy, numerous medical problems, and the lack of judgment these issues brought upon him late in his career,” wrote defense attorney Thomas Durkin in a sentencing memorandum to the court.
Dr. Maitra was one of four physicians charged in the Sacred Heart Hospital case, which federal investigators built with the help of wired colleagues who recorded incriminating conversations. According to court records, the physicians received monthly stipends for admitting patients to the hospital. Dr. Maitra’s kickback of $2000 per month ostensibly was for teaching medical students at Sacred Heart. In his plea declaration, Dr. Maitra said the $2000 payment significantly exceeded the value of the occasional teaching he did. The physician received a total of $68,000 in kickbacks from June 2010 through April 2013, prosecutors said in their sentencing memorandum.
The other Sacred Heart defendants, who include the hospital’s owner and chief executive officer as well as other executives, have pleaded not guilty and await trial. The 119-bed facility shut its doors in July 2013 and filed for bankruptcy.
Dr. Maitra’s guilty plea in a separate fraud case involved cystometrogram studies. The invasive test uses a catheter-mounted sensor to evaluate the bladder’s capacity to contract and excrete urine. Dr. Maitra admitted to billing Blue Cross Blue Shield of Illinois for cystometrogram studies at roughly $500 apiece that were never performed, as well as studies “that were not performed in a medically appropriate manner for reimbursement.” The scheme, carried out from 2006 through 2009, generated $61,070 in revenue.
Supported a 96-Year-Old Mother in Calcutta
In seeking mercy from the court, defense attorney Thomas Durkin argued that alcoholism had impaired Dr. Maitra’s judgment and exacerbated his other medical problems, such as depression. His client, he said, “drank to intoxication on a daily basis” from at least 2008 to October 2013, when he entered an inpatient substance abuse and mental health program.
“[The] defendant’s alcoholism is the most important factor that helps provide some insight into why Dr. Maitra — a respected physician who loved his profession and lived to help others — ended up engaging in 2 fraudulent schemes,” wrote Durkin. “Dr. Maitra should have sought help long ago and should have considered taking a break from practicing medicine until he received the necessary treatment for his alcoholism and depression.”
The physician’s recovery has been rocky, he noted. In July 2014, Dr. Maitra was hospitalized for acute alcohol intoxication.
The litany of woes for Dr. Maitra includes divorces from his first and second wives in 2004 and 2010, respectively; a bankruptcy; a run-in with the IRS; and medical problems ranging from heart disease to degenerative joint disease, according to Durkin.
The Illinois Department of Financial & Professional Regulation suspended Dr. Maitra’s license in September 2013 after determining that his physical condition rendered him unfit to practice medicine. His medical license in Indiana expired last year as well.
The physician’s life has not been all dark, however. Dr. Maitra was dedicated to his family, Durkin said, financially supporting his 96-year-old mother in Calcutta, India, on a monthly basis. Friends, colleagues, and relatives attested in letters to the court that Dr. Maitra’s generosity extended to charities and patients who lacked health insurance. “Dr. Maitra…has a compassionate heart,” wrote one nurse.
Dr. Maitra’s story justified a sentence of home confinement, community service, and outpatient treatment for alcoholism and depression, Durkin wrote. Federal prosecutors disagreed, saying that a prison sentence of 24 to 30 months was needed to deter other physicians from going down Dr. Maitra’s path.
They said in their sentencing memorandum that Dr. Maitra’s crime of fraudulent billings was aggravated by his use of radio advertisements to drum up patients for urological procedures. The physician also knew what he was doing in the pay-for-referral scheme at Sacred Heart Hospital, they said. When he picked up one of his $2000 kick-back checks in March 2013, Dr. Maitra told a company executive in a recorded conversation that he had brought in five “insurance cases” that week, outpacing his normal production of three to four cases per month.
Dr. Maitra’s alcoholism was another aggravating factor.
“For a period of 5 years, [Dr.] Maitra was drinking daily to intoxication while also treating patients, performing delicate urological procedures and making medical decisions about patients,” they wrote.
“Maitra’s patients should not have been exposed to such risks.”
Dr. Maitra is scheduled to begin his 6-month sentence on November 4 in a federal prison to be determined. In addition, US District Judge Matthew Kennelly ordered him to pay $61,070 in restitution to Blue Cross Blue Shield of Illinois.