Philly doctor, daughter face 236 years in prison for pain clinic fraud
It took a jury less than two hours on Wednesday to convict a Philadelphia dentist and his daughter of criminal conspiracy, insurance fraud, theft by deception, attempted theft by deception and corrupt organizations for submitting fraudulent medical bills for procedures they performed at The Pain Center.
Dr. Owen Rogal, 72, and his daughter Kim Rogal, 51, face a sentence of up to 236 years in prison and a fine of nearly $500,000.
The Rogals were arrested in January 2011 after a 15-month investigation by a grand jury and the District Attorney’s Insurance Fraud Unit found the duo submitted nearly $5 million in fraudulent medical bills to 15 separate private insurance companies through The Pain Center between 2002 and 2011.
The two are accused of pocketing more than $1 million of the fraudulent proceeds in their personal accounts.
An investigating grand jury reviewed evidence from over 20 witnesses and hundreds of documents alleging the Rogals were performing an intra-muscular procedure to alleviate chronic pain called Radio Frequency Surgery, which destroyed tissue using heat generated by a radio signal.
The grand jury found each RFS treatment had a maximum value of $800, but the Rogals routinely sought a minimum reimbursement of $4,800 per treatment.
The Rogals charged insurance companies for RFS treatments using a billing code for a delicate, high-risk and invasive procedure performed on a nerve bundle in the brain.
They claimed the practice was appropriate because the procedure being performed was essentially the same as brain surgery, just on a different part of the body, but the grand jury rejected the argument and found the Rogals were consciously scheming to defraud insurance companies.
The prosecution during the trial presented about 40 exhibits and nine witnesses, including medical billing and neurosurgery experts.
The Rogans will be sentenced June 13.
They face a 118-to-236-year jail sentence and $470,000 fine.