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Saturday, August 25, 2012

Gambling Addict sentenced for $4M in bogus insurance charges





Originally published Friday, August 24, 2012
     

Man sentenced for $4M in bogus insurance charges

A Lake Forest Park surgical technologist who claimed a gambling addiction led him to bill insurance companies for more than $4 million in bogus charges over nearly a decade was sentenced to one year in jail on seven counts of theft.
 
A surgical technologist who claimed a gambling addiction led him to bill insurance companies for more than $4 million in bogus charges, sometimes falsely claiming to be a doctor, was sentenced Friday to one year in jail.

An attorney for Kenneth R. Welling, 45, of Lake Forest Park, had asked the judge to impose no jail time, saying that Welling was a first-time offender and had accepted responsibility for his crimes.

Attorney Collette Tvedt claimed her client deserved mercy because he had already "lost" his wife due to his financial crimes and gambling addiction, and could pay restitution faster if he were able to work.

Welling apologized to the judge, his family and others, saying a year of intensive therapy had shown him "it was my gambling addiction fueling my illegal behavior."

But Deputy Prosecuting Attorney Andrew Hamilton said Welling deserved to spend some time behind bars because his crimes were serious and had gone undetected for nearly a decade.

In meting out the yearlong jail sentence, Superior Court Judge Carol Schapira acknowledged the destructive nature of addictions but said Welling's crimes were neither small errors nor were they isolated.

Welling, who pleaded guilty to one count of first-degree theft and six counts of second-degree theft in June, was told to report into custody next week. He will be eligible for work release.

The investigation into Welling was launched last year by the state Office of the Insurance Commissioner's Special Investigation Unit after a woman contacted the office to say her insurer had been billed for surgeries never performed.

In his phony bills to insurance companies, Welling sometimes falsely claimed to be a doctor or a physician assistant, charging documents alleged.

Welling billed five insurance companies at least $4.1 million for services he did not provide and was paid $461,000, according to court documents.

Welling, who assisted physicians during surgery, billed the insurers through his company, Alpine Surgical Services of Shoreline, court documents say.

In one case, Welling billed $140,323 as assisting surgeon for nine surgeries that never took place.

Over a five-year period, he billed another woman's insurer 107 times for 51 different surgeries, listing himself as the primary doctor, according to the charges. Hospital records show she'd had surgery only twice.

"Part of the reason he got away with this for so long is that he'd rarely challenge an insurer who paid little or nothing," said state Insurance Commissioner Mike Kreidler. "He'd just send them the bills and hope they'd pay."

State Patrol Detective Sgt. Dan L. Sharp, who investigated the case for the insurance commissioner's office, said that Welling was prosecuted for only a portion of the criminal activities uncovered. In all, he had five different scams going, and falsely billed insurance companies for more than $7 million, he said.


http://seattletimes.nwsource.com/html/localnews/2018987731_fakedoctor24m.html

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