Daily Independent (Ashland, KY)

Local News

May 1, 2013

Ex-pain clinic owner pleads no contest

FRANKFORT — Attorney General Jack Conway on Tuesday announced the no-contest plea of a former eastern Kentucky pain clinic owner to charges he defrauded the Medicaid program.

Dr. Lee Balaklaw entered an Alford Plea in Lawrence Circuit Court on April 26 to 10 misdemeanor counts of theft by deception under $300. In so doing, he did not admit guilt, but acknowledged there was enough evidence to convict him.  

Circuit Judge David Preston sentenced Balaklaw to 12 months in jail on each count to run concurrently. The sentence was suspended for two years providing the defendant pays restitution of $140,105, which includes more than $135,000 in restitution to the Kentucky Medicaid program.

 Additionally, Balaklaw, an anesthesiologist from Louisa, is 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.

 The investigation and resulting prosecution were conducted by Conway’s Office of Medicaid Fraud and Abuse Control.

 “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 Doctor 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 PSC. 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 Balaklaw was actually performing another injection treatment that entitled him to a smaller reimbursement from Medicaid. Between January 2007 and July 2010, Balaklaw fraudulently billed $90,000 for the 29 patients included in the indictment.

 The case was referred to the Attorney General’s Office by the Department of Medicaid Services.

 Since Conway took office in January 2008, his Office of Medicaid Fraud and Abuse Control has recovered or been awarded more than $300 million for the state and federal Medicaid programs. The cases range from lawsuits and settlements against pharmaceutical companies to cases against individual providers.

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