SANTA FE – A former self-described “holistic” cardiologist in Santa Fe was sentenced to more than 4 years in prison Tuesday for health care billing fraud and obstruction of justice.
Roy G. Heilbron also was ordered to pay $623,477 in restitution. He pleaded guilty last year to cheating Medicare and other health care benefit programs by submitting false and inflated claims.
The obstruction count against Heilbron was for faking medical documents about himself, which purported to show a doctor in Costa Rica was to treat him for cancer, in an effort to postpone or avoid his sentencing for fraud. He pleaded guilty to the obstruction count in February.
Chief U.S. District Judge William P. “Chip” Johnson of Albuquerque sentenced Heilbron, 54, to 24 months on a single health care fraud count and 27 months for obstruction. He will be on supervised release for three years after completing his prison sentence.
A federal grand jury indicted Heilbron in June 2015.
According to the indictment, Heilbron had billed for unnecessary tests on new patients and submitted false diagnoses with billing claims he made to insurers; inserted false symptoms and other bad information into patients’ medical charts to support unneeded tests; double-billed for some procedures; and misused billing codes to increase his rate of reimbursement.
When he pleaded guilty to a single fraud charge in February 2017, he admitted to a scheme at his A Well for Health Church medical clinic in Santa Fe to defraud health benefit programs including Medicare and Blue Cross and Blue Shield New Mexico.
“I believe I was fraudulent in my billing and this is a resolution to what I did,” Heilbron told Judge Johnson then.
He was arrested the following August, while awaiting sentencing, after federal agents determine that he had faked documents that purported to show he had been diagnosed with cancer by another doctor and was scheduled to undergo chemotherapy in Costa Rica. He submitted the fake records to a probation officer in support of a request to postpone his sentencing hearing on the fraud count. He also claimed that a delay in treatment could result in his death.
When he pleaded guilty to obstruction in February, he admitted that when he made the request for a postponement, he was actually on vacation in Europe “with no intention of beginning chemotherapy treatments in Costa Rica,” according to information from the U.S. Attorney’s Office in Albuquerque.
The state Medical Board placed Heilbron’s medical license on “inactive” status last year and permanently barred him from reapplying to practice medicine in New Mexico.