North Carolina physician faces charges over $46M in Medicare billings

A North Carolina physician is facing several charges after billing Medicare more than $46 million for procedures used for the treatment of chronic sinusitis over a four-year period, according to the Justice Department

Anita Jackson, MD, allegedly performed more than 1,200 balloon sinuplasty procedures on more than 700 patients between 2014 and 2018. During that time, Dr. Jackson's practice billed Medicare more than $46 million for the services, and she was the top-paid provider of balloon sinuplasty services in the U.S., according to the Justice Department. 

Prosecutors allege that Dr. Jackson engaged in fraud and other crimes. She allegedly reused single-use balloon sinuplasty devices on patients, concealed from Medicare patients the amount they were obligated to pay for the services, fabricated medical records to thwart Medicare audits and billed Medicare based on cloned, missing or templated medical records. 

Dr. Jackson is charged with adulteration of medical devices, paying illegal remunerations, making false statements relating to healthcare benefits, aggravated identity theft, mail fraud and conspiracy. 

If convicted, Dr. Jackson faces a maximum prison term of 20 years for mail fraud, 10 years for paying illegal remunerations and five years for conspiracy and making false statements, according to the Justice Department.

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