After a three-week federal jury trial, and 5 hours of jury deliberation, Anita Louise Jackson, 59, was found guilty on charges of adulterating medical devices for use on patients with intent to defraud and mislead, fabricating medical and healthcare records, paying illegal renumerations, mail fraud, and conspiracy. Jackson was convicted of using re-used devices to perform more than 1400 surgeries for Medicare patients between 2011 and the end of 2017. After the verdict, Jackson was taken into custody pending sentencing. Jackson was an Ear Nose and Throat doctor who operated Greater Carolina Ear, Nose, and Throat (GCENT), with offices in Raleigh, Lumberton and Rockingham. Between 2011 and the end of 2017, Jackson preformed 1,555 balloon sinuplasty surgeries on 919 Medicare beneficiary patients. Balloon sinuplasty is an in-office surgery to treat chronic sinusitis. The FDA has cleared the Entellus XprESS device to be used in the performance of balloon sinuplasty procedures, but only on one patient, during one surgery. After that, the device must to be discarded. But, between 2012 and 2017, Jackson obtained, at most, 36 new Entellus devices, despite being, at times, the top-paid Medicare provider of balloon sinuplasty services in the United States. The evidence showed that Jackson misled and did not inform her patients that they were receiving a procedure with an adulterated device. The evidence also showed, and the defendant admitted on cross-examination, that she had sufficient money to buy every patient a new device — but chose not to do so.
Jackson billed Medicare more than $46 million dollars for the balloon sinuplasty procedures between 2014 and 2018. She netted more than $4.79 Million from Medicare for these surgeries alone. That amount does not include any sinuplasty surgeries performed on patients with private healthcare insurance, other than Medicare, and monies received from Medicare prior to that time. The jury ordered forfeiture in the amount of $4,794,039.31 Million. Jackson was also convicted on 10 counts of illegally inducing her patients to receive the sinuplasty surgery, by failing to collect the portion of the surgery that the patient was required to pay — the co-pay. Jackson, through her employees, marketed the sinuplasty surgery as a “sinus spa.” In doing so, Jackson induced her patients to come to the office for a “free” sinus spa, induced her patients to receive a treatment they may not need, or may not have agreed to, had the full out-of-pocket cost to the patient been disclosed. In an effort to continue obtaining patients for the procedure, Jackson wrote-off, or otherwise hid, the full cost of the procedure on any bills sent to the patient after their visit to GCENT. The patient portion of the sinuplasty surgery could be as high as $1,500 for Medicare beneficiaries, which the jury found was not disclosed to patients.
