May 2, 2013: A Philadelphia dentist and his daughter are now facing up to 236 years in prison after a jury of their peers convicted them of Corrupt Organizations, Conspiracy, Insurance Fraud and other related offenses on Wednesday. 72-year-old Dr. Owen Rogal and 51-year-old Kim Rogal are also facing a maximum fine of close to half a (m) million dollars when they are sentenced in June. During the trial the jury heard from 9 prosecution witnesses, including experts in the field of medical billing and a neurosurgeon. In addition, the jurors reviewed approximately 40 exhibits. It took the jury less than two hours of deliberating before finding the Rogals guilty of all charges. They were each charged with one count of Corrupt Organizations, one count of Criminal Conspiracy, 11 counts of Insurance Fraud, 9 counts of Theft by Deception, and 8 counts of Attempted Theft by Deception.
The Rogals were arrested and charged by the District Attorney’s Insurance Fraud Unit in January of 2011 for submitting fraudulent medical bills to numerous private insurance companies worth close to 5 (m) million dollars. The charges were the result of a 15 month investigation by the Philadelphia County Investigating Grand Jury and the District Attorney’s Insurance Fraud Unit. The case was referred to the District Attorney’s Insurance Fraud Unit by the National Insurance Crime Bureau. The Grand Jury found that Dr. Rogal and Ms. Rogal used a legitimate business, The Pain Center, to systematically defraud 15 insurance companies by knowingly submitting falsified billing documents for reimbursement.
The Grand Jury investigation examined the Rogals’ billing practices covering a period from mid 2002 through the beginning of 2011. During the investigation, the Grand Jury heard from over twenty witnesses and reviewed hundreds of documents. The evidence presented established that doctors working for the Rogals at the PainCenter were performing a procedure that the Rogals referred to as Radio Frequency Surgery (RFS.) RFS, as performed at the PainCenter, is an intra-muscular procedure during which tissue is destroyed using heat generated by a radio signal. This was done by inserting a needle into the affected muscle, and the Rogals claimed that this procedure could alleviate chronic pain. Based on the testimony of experts the Grand Jury found that each RFS treatment had a maximum value of $800, but the Rogals routinely sought a minimum reimbursement of $4,800 for each RFS treatment. The Rogals then charged insurance companies by using a billing code for a delicate, high risk invasive procedure performed on a nerve bundle located in the brain. When the insurance companies challenged the Rogals billing practices, the Rogals responded that they were performing essentially the same procedure as defined by the brain surgery code and that the part of the body on which the procedure was performed was irrelevant to the amount billed.
The Grand Jury explicitly rejected this argument and found it to be part of the Rogals’ scheme to defraud insurance companies. The Grand Jury further found that the Rogals engaged in business practices that were designed to conceal the true nature of what they were doing in furtherance of this scheme. Of the more than 5 (m) million dollars billed to insurance companies, the Rogals were able to pocket more than 1 (m) million dollars in their personal accounts.
Assistant District Attorney John Doyle successfully prosecuted this case in court. Assistant District Attorney Vicki Markovitz and Detective Karl Supperer conducted the investigation into the Rogals. The Rogals are scheduled to be sentenced by the Honorable Earl W. Trent in courtroom 1002 on June 13, 2013. They are facing a maximum of 118 to 236 years in prison and a fine of $470,000.