Ohio Pain Management Specialist Scams Insurers for $60 Million

November 15, 2006

Patients often came to Dr. Jorge Martinez screaming in agony from chronic pain.

The Ohio pain-management specialist was their last hope. He exploited their misery to shake down insurers for an incredible $60 million in fraudulent billings, actually receiving $12 million. Martinez peddled narcotic-drug prescriptions to his desperate patients only if they submitted to cursory medical tests. The tests lasted just a few minutes, but Wexler billed insurers for elaborate tests he never gave. He soaked insurers for hundreds of thousands of dollars per patient visit.

Some patients grew addicted to the OxyContin, Zoloft, Valium and other drugs, and Martinez was their dealer. He ignored their addictive symptoms, and kept dangling the drugs to force them to take the fraudulent exams.

Martinez barely bothered to hide his insurance scheme. He routinely billed insurers for more than 100 patients a day for nearly six years.

Blair Scott Knight died of a massive drug overdose the same day Martinez handed him a prescription for OxyContin and other narcotics. Martinez gave John Lancaster Zoloft in his office, and prescriptions for five other drugs. Lancaster became unconscious in Martinez offices, and died in the hospital from an overdose of multiple drugs.

Assistant U.S. Attorney Virginia Hearey lashed out at Jorge Martinez during his trial.

“He pumped people full of pills, jabbed them with needles and lied to insurers solely to get rich,” she said. “And people died.”

Martinez was sentenced to lift in prison.

Source: Coalition Against Insurance Fraud