RSSYakima doctor convicted on 8 of 15 counts
Yakima Herald-Republic
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By LEAH BETH WARD
YAKIMA HERALD-REPUBLIC
A federal jury on Thursday convicted Dr. Rosa Martinez, 55, of Yakima on eight out of 15 felony counts of health-care fraud but acquitted her or failed to reach an agreement on all six more serious charges of unlawful distribution of narcotics.
Martinez was indicted a year ago by federal prosecutors on 20 felony counts of scheming to defraud state and federal health insurance programs and practicing outside the scope of her medical license and without proper authorization by prescribing narcotics to patients who also had a history of drug addictions. One count of unlawful distribution was dismissed before trial.
During the 10-day trial, Martinez said she was treating her patients for pain, not their addictions. She also maintained that she billed properly for complex medical cases.
On each of the fraud counts, Martinez faces a maximum possible penalty of up to 10 years in prison, a $250,000 fine and three years of court supervision after prison, according to Joseph Harrington, the assistant U.S. attorney who prosecuted the case.
J.J. Sandlin, Martinez's lawyer, declined to comment on the verdict.
The 12-person jury deliberated four days before announcing the decision in federal court in Yakima.
Federal prosecutors say Martinez knowingly devised a scheme to defraud Medicare, Medicaid and the state worker's compensation system by claiming reimbursement for services not rendered.
She attempted to overbill, they argued, but auditors reviewing her requests for reimbursement reduced the final payout to what they determined was proper. From June 2001 through April 2004, Martinez billed $592,430 to Medicare, Medicaid and the state Department of Labor and
Industries. Auditors refused about $300,000 of the billings and reimbursed her for $293,005.
In a news release, Harrington said that "medical providers in the Eastern District of Washington will be investigated and prosecuted if they bill the programs for medical services not rendered." Such prosecutions, he said, are necessary to protect the programs that provide health care for the elderly, people with low incomes or disabilities, and those who sustain workplace injuries.
Martinez operates a family practice on West Spruce Street. She obtained a medical degree in 1975 from the University of Guadalajara in Mexico and was licensed by the state of Washington in 1993.
She remains licensed to practice medicine pending an appeal of a proposed suspension by the state Medical Quality Assurance Commission.
Prosecutors said they can retry on the counts where the jury failed to agree but haven't made a decision yet.
