Valley doc charged with Medicaid fraud

A physician specializing in addiction medicine and pain management is facing criminal charges of Medicaid fraud in what the state of Alaska alleges was a lab testing for profit scheme.

Charges announced by the Department of Law on Dec. 26 allege that Dr. John Zipperer and his corporation filed millions of dollars in claims for fraudulent laboratory urine tests performed from August 2013 through August 2015 at a Tennessee lab he personally owned.

Zipperer opened a clinic in Wasilla in 2012 and thereafter expanded to Fairbanks and Anchorage, and then in August of 2013 opened his own lab testing facility in Franklin, Tennessee. The state contends that Zipperer ordered dozens of unnecessary and duplicative tests on each urine sample and then billed Medicaid, private insurance companies, or cash-paying patients personally, at rates ranging from $3,000 to $8,000 per urine sample.

The state alleges that between August 2013 and September 2015 that Zipperer was reimbursed about $9 million for lab tests, an amount over 10 times greater than the combined total of all other providers in the Alaska Medicaid system, for lab test codes billed during that period.

In 2018, the case triggered a formal state audit review.

The state alleges that Zipperer failed to respond to repeated requests for supporting documentation for the claims he submitted in response to agency requests. That refusal itself is a criminal offense under Alaska law and Zipperer has been formally charged for that as well.

All charges noted are allegations and do not constitute evidence of guilt, and defendants are entitled to a trial at which the government must prove guilt beyond reasonable doubt.