LOUISA — A former Eastern Kentucky pain clinic owner conceded defeat last week in Lawrence County, admitting he would be found guilty of charges that he defrauded the Medicaid program.
Attorney General Jack Conway said last week that Dr. Lee Balaklaw entered an Alford plea in Lawrence Circuit Court on April 26, maintaining his innocence but conceding there was enough evidence to convict him of 10 misdemeanor counts of theft by deception under $300. Under Kentucky law, an Alford plea is considered the equivalent of a guilty plea.
Circuit Judge David Preston sentenced Balaklaw to 12 months in jail on each count, to run concurrently, which was suspended for two years providing he pays restitution in the amount of $140,105, including more than $135,000 in restitution to the Kentucky Medicaid program.
Dr. Balaklaw, an anesthesiologist from Louisa, is also excluded from participation in all federally-funded health programs, including Medicaid and Medicare, for a period of at least five years pursuant to federal regulations.
“I appreciate the hard work of my investigators and prosecutors in bringing this case to a successful close,” Conway said. “I am pleased that we’ve recovered money for a vital state program and excluded Dr. Balaklaw from participating in the Medicaid program.”
A Lawrence County grand jury indicted Balaklaw for Medicaid fraud in October 2011, following an investigation into his billing practices at Anesthesia Associates of Louisa, P.S.C. The indictment accused Balaklaw of intentionally or wantonly submitting fraudulent and false claims to Medicaid by claiming he treated multiple patients using pain treatment injections into the tendon.
The investigation showed Dr. Balaklaw was actually performing another injection treatment which entitled him to a smaller reimbursement from Medicaid. The charges allege that from January 2007 through July 2010, Balaklaw fraudulently billed $90,000 for the 29 patients.
In 2012, General Conway’s Medicaid Fraud Unit was named one of the most aggressive in the country by the nonprofit watchdog group Public Citizen.