California Attorney General Rob Bonta this past week announced securing a guilty verdict against a San Joaquin County orthopedic surgeon for repeatedly defrauding the Medi-Cal and Medicare programs. From 2012 to 2016, Gary Wisner defrauded Medi-Cal and Medicare by administering excessive and medically unjustifiable X-rays to his patients. Following a two-week jury trial in Sacramento County Superior Court, Wisner was convicted on Thursday, June 16, of 10 felony counts of health care insurance fraud.
“When medical practitioners abuse their power, it’s always at the expense of patients under their care,” said Attorney General Bonta. “Gary Wisner abused the position he held as a healthcare provider by subjecting his patients to unnecessary procedures to secure additional profits. I want to express my gratitude to the San Joaquin County District Attorney’s Office who aided us throughout the course of this investigation. The California Department of Justice and our law enforcement partners will continue to hold accountable those who attempt to use the Medi-Cal program for personal gain, and to safeguard those it serves.”
In November 2016, representatives from the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse (DMFEA) were notified by multiple government offices of suspected fraud by Wisner in overbilling the Medi-Cal and Medicare programs. Wisner operated a medical clinic in Lodi. DMFEA’s investigation into Wisner’s alleged misconduct revealed Wisner would administer X-rays even in routine office visits and would X-ray multiple parts of a patient’s body — regardless of whether it had any relation to a patient’s medical condition. Evidence presented at trial showed that over the course of an approximate four-year period, Wisner subjected 10 individual patients to hundreds of unnecessary X-rays at his clinic.
This investigation was made possible through collaboration with the United States Department of Health and Human Services (HHS), the San Joaquin County District Attorney’s Office, and the California Department of Insurance.
Wisner is also the subject of an independent criminal complaint filed by the San Joaquin County District Attorney’s Office for worker’s compensation fraud. The case is still pending and Wisner is presumed innocent until proven guilty of those charges.
The California Department of Justice’s DMFEA protects Californians by investigating and prosecuting those who defraud the Medi-Cal program as well as those who commit elder abuse. These settlements are made possible only through the coordination and collaboration of governmental agencies, as well as the critical help from whistleblowers who report incidences of abuse or Medi-Cal fraud at oag.ca.gov/dmfea/reporting.
DMFEA receives 75 percent of its funding from HHS under a grant award totaling $50,522,020 for federal fiscal year 2021-2022. The remaining 25 percent is funded by the State of California. The federal fiscal year is defined as Oct. 1, 2021, through Sept. 30, 2022.