A federal appeals court has upheld the conviction of Anita Jackson, a Raleigh, N.C.-based otolaryngologist, who was sentenced to 25 years in prison and three years of supervised release for her role in a $46 million Medicare fraud scheme, NBC affiliate WCNC reported Jan. 26.
Dr. Jackson, 63, was found guilty in 2023 on charges of device adulteration, fraud, conspiracy and identity theft. The charges stem from a scheme in which she reused single-use surgical devices on more than 1,500 Medicare patients.
Between 2011 and 2017, Dr. Jackson performed 1,555 balloon sinuplasty surgeries on 919 Medicare patients using, at most, only 36 new Entellus XprESS devices — disposable instruments intended for single use. Despite her limited inventory of new devices, she billed Medicare more than $46 million for these procedures from 2014 to 2018, becoming the nation's top-paid Medicare provider for balloon sinuplasty services during that time.
Dr. Jackson also advertised endoscopic chronic sinusitis treatments as "free sinus spa" services. However, Medicare only covers 80% of the procedure’s cost, and she reportedly failed to disclose out-of-pocket expenses to patients, allowing her to collect millions in improper payments.
Further allegations revealed that Dr. Jackson fabricated medical records, backdated documents and forged patient signatures to deceive Medicare.
In November, Dr. Jackson appealed her conviction, arguing her case before the federal appeals court. However, on Jan. 21, the court rejected her arguments and upheld the conviction.