Tuesday, September 8, 2009

Former Cosmetic Surgery Owner Pleaded Guilty To Health Insurance Fraud In Manhattan Federal Court

In a case that has a lengthy history, on September 4, 2009, Arthur Kissel, a/k/a "Arthur Froom," a former cosmetic surgery clinic owner, pleaded guilty to a scheme to defraud health insurance companies of more than $900,000 in Manhattan federal court (the Southern District of New York). Mr. Kissel pleaded guilty to one count of conspiracy to commit mail fraud and health care fraud, and one count of mail fraud.

Mr. Kissel and his wife Sonia LaFontaine were originally indicted in March 1998. At that time, Mr. Kissel was in Canada where he and his wife ran another cosmetic surgery clinic. Ms. LaFontaine was arrested in the United States in 1998 and was found guilty on all charges on July 12, 2000, following a six-week jury trial. She was ultimately sentenced to ten years in prison. The United States initiated extradition proceedings against Mr. Kissel in 2000, which resulted in his August 2008 return from Canada on these charges.

According to the press release issued by the U.S. Attorney's Office which referenced the Indictment to which Mr. Kissel pleaded guilty; the evidence at the 2000 trial of Mr. Kissel's wife, Sonia LaFontaine, in the case; and statements made during Mr. Kissel's September 2008 bail hearing and his guilty plea proceeding before United States District Judge Denny Chin, the facts surrrounding this plea agreement are as follows:

Kissel and LaFontaine owned and operated LaFontaine Rish Medical Associates, a cosmetic surgery clinic located at 315 West 57 Street in Manhattan. LaFontaine—who had no medical license and was not acting under a physician's supervision—performed procedures which were billed as having been performed by licensed physicians.

Kissel and LaFontaine's clinic also billed cosmetic procedures, such as "tummy-tucks" and liposuction, in the guise of medically necessary procedures, such as hernia repairs and lesion removals. They also submitted claims to insurance companies for procedures that were never performed, and exaggerated insurance claims by increasing the number and complexity of procedures that were actually performed.

Mr. Kissel faces a maximum sentence of five years in prison on each count; a maximum fine of the greater of $250,000 or twice the gross gain or loss resulting from the crime on each count; and forfeiture of the proceeds of his crimes. Mr. Kissel is scheduled to be sentenced by Judge Chin on December 15, 2009.

Posted by Tracy Green. Any questions or comments should be directed to: tgreen@greenassoc.com or 213-233-2260. The firm website is: http://www.greenassoc.com/


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