Modesto Physician to Pay $175K in Restitution for Billing Scam

Monday, November 12, 2018 | 0

One of six Modesto, California, physicians who were charged last year with insurance fraud has pleaded guilty to a misdemeanor, and court hearings are scheduled for five others in December and January, the Modesto Bee reported Friday.

Dr. Robert Caton accepted a plea agreement in September, the newspaper said. He pleaded guilty to a misdemeanor charge of false and fraudulent claims, and guilty to accepting kickbacks. Prosecutors dropped 20 felony counts against him.

Caton was sentenced to three years' probation and agreed to pay $175,270 in restitution to insurance carriers. He also agreed to pay $18,000 to a victims witness emergency fund.

Caton was among 26 health care providers and business owners who were charged by the Orange County District Attorney’s Office with an alleged statewide kickback scheme allegedly masterminded by Tanya Moreland King and her husband, Christopher King, of Beverly Hills. They allegedly charged workers' compensation insurers more than $1 million for compound creams, paying kickbacks to providers in exchange for prescriptions.

Five other Modesto physicians, four of whom worked at the Stanislaus Orhopaedic and Sports Medicine Clinic, are awaiting trial and are scheduled for upcoming hearings, the Bee reported. They are Jonathan Louis Cohen, John Casey Jr., Mohamed Ibrahim, William Pistel and Jerome Robson.