Maui Doctor Pleads Guilty To Health Care Fraud

HONOLULU – Mark Lipetz, 50, owner and operator of the South Maui Clinic in Kihei, Maui, pleaded guilty today in federal court to two counts of health care fraud and one count of acquiring a controlled substance through misrepresentation, fraud, forgery, deception, or subterfuge. Sentencing is scheduled for December 5, 2019 before U.S. District Judge Leslie E. Kobayashi.

According to court documents and information presented in court, between January 2017 and June 2018, Lipetz, a licensed physician, wrote multiple prescriptions for medications using the names and addresses of actual patients. However, Lipetz did not intend to give the medications to the patients whose names appeared on the prescriptions. Instead, Lipetz filled the prescriptions and used the controlled substances for purposes other than the legitimate medical treatment of his patients. Such purposes included giving medications to patients other than those whose names appeared on the prescriptions or creating a stockpile from which he could provide “trial samples” to patients without writing them a prescription. Additionally, between May 2014 and July 2018, Lipetz engaged in a scheme to fraudulently obtain money from Medicare, Medicaid, Hawaii Medical Services Association, and United Healthcare by submitting more than 200 false claims for reimbursement. Each of the claims indicated that Lipetz had an in-person, face-to-face office visit with a patient, when in fact the office visits never occurred.

“The U.S. Attorney’s Office will continue its quest to root out fraud in the healthcare industry by working with the Drug Enforcement Administration (DEA) and other law enforcement entities dedicated to protecting patients,” stated U.S. Attorney Kenji M. Price for the District of Hawaii. “Our healthcare system relies upon the candor of physicians and other professionals who care for the vulnerable in our communities. Lipetz’s fraudulent behavior unlawfully steered precious funds towards his pockets and away from healthcare providers who serve the most vulnerable in our communities. We will continue to aggressively pursue physicians and other medical practitioners who, unlike the overwhelming majority of their colleagues, choose to violate federal law.”

“The DEA will continue to investigate illicit activity in the medical community,” said DEA Assistant Special Agent in Charge John Callery. “Dr. Lipetz is only one of several ongoing investigations throughout the state of Hawaii to shield our communities from the dangers of the Opioid Crisis that is crippling portions of the mainland. DEA is thankful to the U.S. Attorney’s Office for its outstanding assistance and partnership in this matter.”

This case was investigated by the DEA and the State of Hawaii Narcotics Enforcement Division. It was prosecuted by Assistant U.S. Attorney Michael Albanese.