Santa Fe doctor admits health care, wire fraud
A Santa Fe cardiologist could spend two years in federal prison after entering a plea agreement Friday related to charges that he committed health care and wire fraud by submitting false claims to Medicare and other health benefit programs.
Dr. Roy G. Heilbron, 53, pleaded guilty to one count of submitting false claims for medical services from a 24-count indictment that was handed down in June 2015.
“I believe I was fraudulent in my billing and this is a resolution to what I did,” Heilbron told Judge William “Chip” Johnson in federal court in Albuquerque before he pleaded guilty.
The two-year sentence, to be followed by a term of supervised release, was part of his plea agreement, but the court will not impose a specific sentence until after a sentencing hearing.
Heilbron also agreed to pay restitution based on all the charges in the indictment, an amount that will be determined by the court after arguments, according to a news release from the U.S. Attorney’s Office.
His medical license to practice in New Mexico has been suspended since Feb. 19, 2016, when a previous November temporary suspension was continued indefinitely for the New Mexico Medical Board, according to documents on its website. The Florida Board of Medicine as of Friday still showed that Heilbron had an active license there, but mentioned that he was not currently practicing medicine in that state.
Heilbron said in court Friday that he still lives in Santa Fe.
The indictment alleged that Heilbron performed unnecessary tests on patients, submitted false diagnoses with billings, listed false symptoms on patients’ records and inserted false documentation for tests that were not performed or to justify unneeded tests, and used that false information in submitting claims for reimbursement from health insurers.
The charges applied to a period from January 2010 to May 2011, when Heilbron provided “holistic cardiology” services through A Well for Health Church Inc., a medical clinic at 1530 Bishops Lodge Road in Santa Fe.
Heilbron also has had some troubles with the state Medical Board.
In June 2014, the board suspended his license for three months, and ordered him to complete an ethics program and a record-keeping seminar. This followed allegations that Heilbron was arrested in Albuquerque for aggravated DWI in 2013 and failed to report that incident to the Medical Board, and also that he failed to report within the required 30-day period that Blue Cross Blue Shield revoked its medical services agreement with him based on allegations of “excessive, unjustified and fraudulent billing practices for numerous patients.”
The second license suspension, first issued in November 2015, was based on allegations, later supported by the board’s findings, that Heilbron diagnosed and treated a patient for a blocked coronary artery, but the treatments he ordered were not consistent with generally accepted guidelines for the diagnosis and that the diagnosis itself was wrong.