“Medical professionals who put profit over patient care and defraud our government programs must be held accountable. This investigation is an example of local, state and federal investigators combining their resources to investigate, arrest and assist in the prosecution of a medical professional fraudulently collecting money.” – CSLEA President Alan Barcelona
OAKLAND – On September 2, 2022, a San Joaquin County orthopedic surgeon was sentenced to seven years in prison for repeatedly defrauding Medi-Cal and Medicare programs. From 2012 to 2016, Gary Wisner defrauded the Medi-Cal and Medicare programs by administering excessive and medically unjustifiable X-rays to his patients. In June, Wisner was convicted of 10 felony counts of health care insurance fraud. He was sentenced by the Sacramento Superior Court.
According to the California Department of Justice, in November 2016, representatives from the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse (DMFEA) were notified by multiple government offices of suspected fraud by Wisner in overbilling the Medi-Cal and Medicare programs. Wisner operated a medical clinic in Lodi where he had 26,000 patients under his care. In DMFEA’s investigation into Wisner’s alleged misconduct, investigators randomly selected the files of five Medi-Cal patients and five Medicare patients — these 10 files became the basis of the 10 felony charges Wisner was convicted of in June.
DMFEA’s investigation revealed Wisner would administer X-rays even in routine office visits and would X-ray multiple parts of a patient’s body — regardless of whether it had any relation to a patient’s medical condition. Over the course of an approximate four-year period, evidence collected showed Wisner subjected ten individual patients to hundreds of unnecessary X-rays at his clinic.
The investigation included the United States Department of Health and Human Services (HHS), the San Joaquin County District Attorney’s Office, and the California Department of Insurance.
Gary Wisner is also the subject of an independent criminal complaint filed by the San Joaquin County District Attorney’s Office for workers’ compensation fraud. The case is still pending and Gary Wisner is presumed innocent until proven guilty of those charges.
“Gary Wisner used both his patients and state resources to line his own pockets,” said Attorney General Rob Bonta. “Due to his dishonest behavior, patients at his clinic had to undergo unnecessary medical tests so he could steal from the state’s Medi-Cal funds. This sentence reaffirms what we know to be true: Abuse of power by medical practitioners will never be tolerated within our state’s healthcare system. Thank you to our partners at the San Joaquin County District Attorney’s Office for their help throughout the course of this investigation. The California Department of Justice will continue to protect our state’s critical health resources from bad actors.”