Pittsburgh Physician Pleads Guilty to Health Care Fraud

Acting United States Attorney Robert S. Cessar announced today, January 12, 2010, that a Pittsburgh physician has pleaded guilty in federal court to a charge of health care fraud.

Dr. John D. Kristofic, age 61, pleaded guilty to the charge before United States District Judge Donetta W. Ambrose.

In connection with the guilty plea, Assistant United States Attorneys Phillip O’Connor and Shaun Sweeney advised the Court that, between January 2003, and August 2008, Dr. Kristofic submitted fraudulent claims to Medicare and to his patients’ health insurers for medical services which he never rendered. During that time, Dr. Kristofic was paid in excess of $1 million for the fraudulent claims which he had submitted. As part of the plea, Dr. Kristofic has agreed to pay $3,303,188 to the government, which is three times the amount of money paid to Kristofic for the fraudulent claims.

“The United States Attorney’s Office is committed to prosecuting all forms of health care fraud using both criminal and civil means,” said U.S. Attorney Cessar. “Health care dollars paid for fraudulently billed services to Medicare takes away from individuals who honestly need care.”

Judge Ambrose scheduled sentencing for May 7, 2010, at 11:00 a.m. The law provides for a total sentence of 10 years in prison, a fine of $250,000, or both. Under the Federal Sentencing Guidelines, the actual sentence imposed is based upon the seriousness of the offense and the criminal history, if any, of the defendant.

The Department of Health and Human Services - Office of Inspector General, the Federal Bureau of Investigation, the Department of Defense - Office of Inspector General, and the Office of Personnel Management - Office of Inspector General conducted the investigation that led to the prosecution of Dr. Kristofic.