Nick S. Pomonis, D.O., CR No. 396 (1995)

$05:Exclusion Case

Department of Health and Human Services

DEPARTMENTAL APPEALS BOARD

Civil Remedies Division

In the Case of:

Nick S. Pomonis, D.O.,

Petitioner,

- v. -

The Inspector General.

DATE: September 28, 1995
Docket No. C-95-090
Decision No. CR396

DECISION

By letter dated January 19, 1995, Nick S. Pomonis, D.O., Petitioner
herein, was notified by the Inspector General (I.G.) of the U.S.
Department of Health & Human Services (DHHS), that it had been
decided to exclude him, for a period of five years, from
participation in the Medicare program and from participation in the
Medicaid, Maternal and Child Health Services Block Grant and Block
Grants to States for Social Services programs, which are referred
to hereinafter collectively as "Medicaid." The I.G.'s rationale
was that exclusion, for at least five years, is mandated by
sections 1128(a)(1) and 1128(c)(3)(B) of the Act because Petitioner
had been convicted of a criminal offense related to the delivery of
an item or service under Medicaid.

Petitioner filed a timely request for review of the I.G.'s action
by an administrative law judge of the Departmental Appeals Board
(DAB). The I.G. moved for summary disposition.

Because I determined that there are no facts of decisional
significance genuinely in dispute, and that the only matters to be
decided are the legal implications of the undisputed facts, I have
granted the I.G.'s motion and decided the case on the basis of the
parties' written submissions.

As the I.G. has proven that Petitioner was convicted of a criminal
offense related to the delivery of an item or service under the
Medicaid program, within the meaning of section 1128(a)(1) of the
Social Security Act (Act), I find no reason to disturb the I.G.'s
determination to exclude Petitioner from participation in the
Medicare and Medicaid programs for a period of five years.


APPLICABLE LAW

Sections 1128(a)(1) and 1128(c)(3)(B) of the Act make it mandatory
for any individual who has been convicted of a criminal offense
related to the delivery of an item or service under Medicare to be
excluded from participation in Medicare and Medicaid for a period
of at least five years. 1/


PETITIONER'S ARGUMENT AND OBJECTIONS
TO THE I.G.'s EXHIBITS

Petitioner contends that he was not convicted of any offense under
State law. Accordingly, Petitioner contends that the I.G. had no
basis to exclude him for the five year mandatory period under
section 1128(a)(1) of the Act.

The I.G. submitted 15 exhibits (marked as I.G. Ex. 1 through 15) in
conjunction with her motion for summary disposition. Petitioner
submitted six exhibits (marked as P. Exs. 1 through 6) in
conjunction with his opposition to the I.G.'s motion for summary
disposition. Petitioner has objected to I.G. Exs. 2, 3, 5, 9, and
13. The I.G. has not objected to any of Petitioner's exhibits.
The I.G. submitted four additional exhibits, marked as I.G. Exs. 16
- 19, with her reply brief. Petitioner has filed no objection to
I.G. Exs. 16 - 19. Although the I.G. submitted I.G. Exs. 16 - 19
untimely, I find that she had good cause for doing so, as these
exhibits specifically address issues that were first raised by
Petitioner in his response brief. See 42 C.F.R. 1005.4; 42
C.F.R. 1005.8; 42 C.F.R. 1005.15.
I overrule all of Petitioner's objections to the I.G.'s exhibits.
Petitioner has not argued that I should exclude the I.G.'s exhibits
because they are either irrelevant or immaterial. 42 C.F.R.
1005.17(b). Nor has Petitioner suggested that any of these
exhibits unfairly prejudice or confuse the issues before me. 42
C.F.R. 1005.17(d). While Petitioner suggests that I apply the
Federal Rules of Evidence and reject the above I.G. exhibits, I am
not bound by the Federal Rules in the context of this
administrative proceeding. 42 C.F.R. 1005.17.

As to I.G. Exs. 2 and 15, Petitioner contends that these exhibits
contains unsworn and incorrect allegations and conclusions that are
directly contradicted by his affidavit. That objection is not
proper in this administrative forum. The fact that I.G. Exs. 2 and
15 are at odds with Petitioner's sworn statement is not relevant to
the exhibits' admissibility, but to the weight I assign to these
exhibit. Moreover, neither Petitioner's affidavits nor any of his
exhibits contradict the vital points contained in I.G. Exs. 2 and
15.

The record as a whole establishes that Petitioner's plea of nolo
contendere was the direct result of Petitioner's submission of a
claim for reimbursement in the amount of $177.72 for Medicaid
services that were not in fact provided as claimed by Petitioner.
I.G. Exs. 1 - 8, 10 - 19; P. Exs. 1 - 4. Petitioner's contention
that the patients he saw on December 18, 1991 had other insurance
is not relevant to my determination here, nor does Petitioner's
exhibit support these contentions. The documentation submitted by
Petitioner contains nothing which contradicts that Medicaid
recipient PCN-511369544 was a Medicaid recipient on December 18,
1991, the date she allegedly received treatment at his office. Nor
does anything in the record contradict that Petitioner's submission
of a claim for reimbursement to provide Medicaid services to
recipient PCN-511368544 in the amount of $177.72 formed the basis
for Petitioner's conviction. I.G. Exs. 2, 3; P. Exs. 4, 5.

Additionally, Petitioner objects to the characterization contained
in I.G. Ex. 5. This objection is specious. The I.G. is entitled
to argue as to the meaning of I.G. Ex. 5. It is my function as the
finder of fact to determine what interpretation that exhibit
ultimately has in the context of this case. I have done that in
the context of this Decision. The record as a whole supports that
the events described in I.G. Ex. 5 did occur in the context of
Petitioner's criminal case. Petitioner has offered nothing
substantive to contradict this evidence.
Petitioner objects to I.G. Ex. 9, which is a copy of the letter
notifying Petitioner of the I.G.'s determination to exclude him.
The basis for Petitioner's objection is that the exclusion directed
and imposed against Petitioner by the I.G. is unreasonable. I take
this argument to mean that since the five-year exclusion of
Petitioner is unreasonable, the notice letter which the I.G. sent
to Petitioner, and which informed Petitioner of his exclusion, is
merely a self-serving, unsupported statement by the I.G. I do not
find I.G. Ex. 9 particularly helpful to me in my determination in
this case, but I do not reject it for the reasons argued by
Petitioner. In my prehearing order dated March 15, 1995, I told
the parties not to submit the notice letter as an exhibit.
Accordingly, I reject I.G. Ex. 9.

Petitioner objects to I.G. Ex. 13 because he received it after he
received notice of his exclusion. This exhibit is a letter
informing Petitioner that the I.G. has considered additional
information provided by Petitioner and remains convinced that
Petitioner should be excluded under the mandatory exclusion
provisions. Again, while I do not find this exhibit particularly
helpful to me in making my Decision, there is nothing prejudicial
to Petitioner contained in this letter. The letter merely states
the I.G.'s position.

Accordingly, I admit I.G. Exs. 1 - 8 and 10 - 19 and P. Exs. 1
through 6 into evidence for purposes of my Decision in this case.


FINDINGS OF FACT AND CONCLUSIONS OF LAW 2/

1. During the period relevant herein, Petitioner was an
osteopathic physician licensed in the state of Texas. I.G. Ex. 1.


2. On December 13, 1993, Petitioner was charged by the State of
Texas with committing deceptive business practices, a misdemeanor
under Texas law. I.G. Exs. 1, 5, 10 at 2.

3. Specifically, the State alleged that Petitioner claimed
reimbursement from Medicaid for services he did not actually
provide to patients. I.G. Exs. 1, 2, 3, 19.
4. On December 14, 1993, Petitioner pled nolo contendere to the
misdemeanor charge of deceptive business practices, as contained in
the charging document, and the plea was accepted by the court.
I.G. Exs. 1, 3, 5, 10 at 2; P. Ex. 4.

5. The judge receiving Petitioner's plea issued a "Deferred
Adjudication Order," requiring Petitioner to be placed on probation
for 6 months, pay a fine, and pay restitution in an unspecified
amount. I.G. Exs. 3, 4, 5; P. Exs. 2, 4.

6. Petitioner's plea of nolo contendere is a conviction for
purposes of section 1128(a)(1) of the Act. Act, section
1128(i)(3). Finding 4.

7. Petitioner's participation in a deferred adjudication program
is a conviction for purposes of section 1128(a)(1) of the Act.
Act, section 1128(i)(4). Finding 5.

8. Petitioner's conviction for deceptive business practices was
based on his claiming to have provided $177.72 of Medicaid services
which he did not in fact provide. I.G. Exs. 1, 2, 3; Findings 6,
7.

9. Inasmuch as (1) Petitioner's plea of nolo contendere was
accepted by the court; (2) the offense to which Petitioner pled was
related to his delivery of an item or service under Medicaid; and
(3) Petitioner participated in a formal deferred adjudication
program, Petitioner's conviction satisfies the criteria set forth
in section 1128(a)(1) of the Act. Findings 4 - 8; Act, section
1128(a)(1).

10. On or about June 3, 1994, Petitioner satisfied the deferred
adjudication requirements imposed by the court, whereupon the court
terminated his probation, permitted him to withdraw his plea, and
dismissed the charges against him. P. Ex. 2; I.G. Exs. 8, 19.

11. Prior to the June 3, 1994 action by the State court, on April
25, 1994, the court entered an order dismissing the criminal
complaint against Petitioner because he fulfilled the terms of his
probation. P. Ex. 2; I.G. Exs. 6, 19.

12. On May 6, 1994, the State court granted Petitioner's motion
for a new trial in Petitioner's misdemeanor case. P. Ex. 1; I.G.
Ex. 6, 19. 3/

13. In an order dated June 1, 1994, the State court vacated its
May 6 order granting Petitioner a new trial, and set aside its
April 25, 1994 order. I.G. Ex. 19; Findings 11 - 12.

14. On April 20, 1995, the State court dismissed separate felony
indictments against Petitioner. I.G. Ex. 19.

15. The State court's dismissal of Petitioner's felony indictments
did not affect the misdemeanor charge of deceptive business
practices to which Petitioner pled nolo contendere. I.G. Ex. 19.

16. Federal law is controlling in determining whether an
individual has been "convicted" for purposes of section 1128(a)(1).
Act, section 1128(i).

17. Petitioner was properly excluded pursuant to the mandatory
five year exclusion provision contained in the Act. Act, sections
1128(a)(1), 1128(c)(3)(B). Findings 1 - 16.

18. I have no authority to reduce the five-year exclusion that the
I.G. has directed and imposed upon Petitioner. Act, sections
1128(a)(1), 1128(c)(3)(B); 42 C.F.R. 1001.102, 1005.4.
Findings 1 - 17.


DISCUSSION

The law relied upon by the I.G. to exclude Petitioner requires,
initially, that the person to be excluded have been convicted of a
crime.

Section 1128(i) provides that an individual will be deemed to have
been "convicted" of a crime under any of the following
circumstances:

(1) when a judgment of conviction has been entered against the
individual or entity by a federal, State, or local court,
regardless of whether there is an appeal pending or whether the
judgment of conviction or other record relating to criminal conduct
has been expunged;

(2) when there has been a finding of guilt against the
individual or entity by a Federal, State, or local court;

(3) when a plea of guilty or nolo contendere by the
individual or entity has been accepted by a federal, State, or
local court; or

(4) when the individual or entity has entered into
participation first offender, deferred adjudication, or other
arrangement or program where formal judgement of conviction is
withheld in order to give a defendant an opportunity to correct his
conduct or make restitution, in the hope that this will convince
the judge that no formal finding of guilt is necessary.

In the case at hand, Petitioner, an osteopath, was charged with
intentionally billing the Medicaid program for services he did not,
in fact, render as claimed. He entered a plea of nolo contendere
to the charges and a State judge sentenced him to a fine and
probation, imposed in the context of deferred adjudication.
Finding 5. The I.G. argues that Petitioner has been convicted of
a criminal offense for purposes of the exclusion statute because
his nolo plea was accepted by the court and because he was placed
on deferred adjudication as part of sentencing. Findings 6, 7.

It is well established in numerous DAB and federal court decisions
that a criminal conviction based on filing false claims for
reimbursement from Medicare or Medicaid mandates exclusion under
1128(a)(1). Jack W. Greene, DAB CR19, aff'd DAB 1078 (1989), aff'd
sub nom. Greene v. Sullivan, 731 F. Supp. 835 (E.D. Tenn. 1990).
Therefore, Petitioner's submission of documents to Medicaid in
which he claimed reimbursement from Medicaid for services that were
not provided as claimed constitutes financial misconduct related to
the delivery of Medicaid services.

Petitioner, however, has a very different analysis of the question
of whether he was convicted. He argues that, in Texas, when a prior
court decision is vacated, and/or a new trial ordered, the case "is
restored to its position before any former trial and/or plea or
holding by the court." Consequently, since he sought and was
granted a new trial in his criminal case, his plea and the court's
holdings become nullities. Since his conviction no longer existed,
Petitioner contends, there was no legal basis for excluding him.

However, contrary to Petitioner's argument, the DAB has concluded
that a determination of whether an individual has been convicted
within the meaning of section 1128(i) of the Act is a matter of
federal law, and that a State court's determination is not
controlling. Michael P. Hiotis, DAB CR316 (1994). The federal
courts, too, have held that what constitutes a conviction under the
Medicaid Act is determined by federal law not State law. Dickerson
v. New Banner Institute Inc., 460 U.S. 103, 110 (1983).

The federal law which controls this case is section 1128(i) of the
Act, quoted above. It has been held by this office, and affirmed
by an appellate panel of the DAB, that Congress intended mandatory
exclusion to apply to all situations in which a person is convicted
of a program-related offense, and that a conviction remains a
conviction, with regard to section 1128(a), even if it is
subsequently expunged from the defendant's record. Carlos E.
Zamora, DAB CR22, aff'd DAB 1104 (1989). The legislative intent of
the Act could not be clearer than that expressed by the
congressional committee that drafted the 1986 amendments to the
exclusion law:

The principal criminal disposition to which the exclusion
remedy [currently] does not apply are the "first offender" and
"deferred adjudication" dispositions. It is the Committee's
understanding that States are increasingly opting to dispose of
criminal cases through such programs, where judgment of conviction
is withheld. The Committee is informed that State first offender
or deferred adjudication programs typically consist of a procedure
whereby an individual pleads guilty or nolo contendere to criminal
charges, but the court withholds the actual entry of a judgment of
conviction against them and instead imposes certain conditions of
probation, such as community service or a given number of months of
good behavior. If the individual successfully complies with these
terms, the case is dismissed entirely without a judgment of
conviction ever being entered.

These criminal dispositions may well represent rational
criminal justice policy. The Committee is concerned, however, that
individuals who have entered guilty or nolo [contendere] pleas to
criminal charges of defrauding the Medicaid program are not subject
to exclusion from either Medicare or Medicaid. These individuals
admitted that they engaged in criminal abuse against a Federal
health program and, in the view of the Committee, they should be
subject to exclusion. If the financial integrity of Medicare and
Medicaid is to be protected, the programs must have the prerogative
not to do business with those who have pleaded to charges of
criminal abuse against them.

H.R. Rep. No. 727, 99th Cong., 2d Sess. 75 (1986), reprinted in
1986 U.S.C.C.A.N. 3607, 3665.

Consequently, Texas law does not control the outcome here. The
case law and statutory intent both support that Petitioner was
convicted by pleading nolo contendere and by his participation in
a deferred adjudication program, irrespective of the fact that the
charges were dismissed before a conviction was entered. Findings
6, 7.

The second requirement of section 1128(a)(1) is that the conviction
must be related to the delivery of an item or service under
Medicare or Medicaid.

Petitioner has submitted an affidavit in which he states that he
did not commit the offense to which he pled nolo contendere. P.
Ex. 5. Petitioner further states in his affidavit that it was not
his understanding that he was being charged with deceptive business
practices related to the Medicare or Medicaid program. P. Ex. 5.
Petitioner has also submitted an affidavit from an employee that,
in part, attacks the Medicaid fraud investigator's report (I.G. Ex.
15). P. Ex. 6. However, as I stated in overruling Petitioner's
objection to I.G. Ex. 5, nothing in either P. Ex. 5 or P. Ex. 6
contradicts the evidence of record that Petitioner's plea of nolo
contendere was the direct result of Petitioner's submission of a
claim for reimbursement for Medicaid services in the amount of
$177.72 that were not in fact provided as claimed by Petitioner.
I.G. Exs. 1 - 8, 10 - 19; P. Exs. 1 - 4. 4/ The I.G.'s contention
that Medicaid recipient PCN-511369544 was a Medicaid recipient on
December 18, 1991 is undisputed, even by a generous reading of
Petitioner's exhibits. Petitioner's statement that it was never
his understanding that the charge of committing deceptive business
practices was related to Medicare or Medicaid is irrelevant. P.
Ex. 5 at 2.

The fact remains that the I.G. has submitted a statement from the
prosecuting attorney, who has personal knowledge of the nature of
the charges against Petitioner, that the charge to which Petitioner
pled nolo contendere was based on Petitioner's failure to provide
services to Medicaid recipient PCN-5511368544. I.G. Exs. 5, 19.
Petitioner has offered nothing to contradict that the investigation
conducted by the Texas Medicaid Fraud Bureau found that Petitioner
had submitted a claim for reimbursement for Medicaid services that
were not provided as claimed and formed the basis for the charge of
deceptive business practices to which Petitioner ultimately pled.
I.G. Exs. 1 - 5, 19. Nor does anything in the record contradict
that Petitioner's submission of a claim for reimbursement to
provide Medicaid services to recipient PCN-511368544 in the amount
of $177.72 formed the basis for Petitioner's conviction. I.G. Ex.
2, 3; P. Ex. 4, 5.

The affidavits that Petitioner contends cast doubt upon the I.G.'s
assertion that Petitioner's nolo contendere plea is program related
simply fail to do so. P. Ex. 5. Petitioner states in his
affidavit that the charges against him do not state that they
involved Medicare or Medicaid and further states that it was not
his understanding that he was being charged with an offense related
to Medicare or Medicaid. These statements do nothing to contradict
the evidence against Petitioner. Whether Petitioner understood
that the charges to which he pled nolo contendere involved Medicare
or Medicaid is irrelevant to my Decision in this case.
Furthermore, it is well established that having the words Medicare
or Medicaid within the conviction documents is not a prerequisite
to a finding that the conviction is program related. Napoleon S.
Maminta, M.D., DAB 1135 (1990); Robert C. Greenwood, N.A., DAB 1423
(1993).

The affidavit submitted by Petitioner's nurse likewise fails to
cast doubt upon the program related nature of Petitioner's offense.
P. Ex. 6. The affidavit's primary focus is the accuracy of the
I.G. investigator's report contained at I.G. Ex. 15. However, the
affidavit does not address the accuracy of the report contained at
I.G. Ex. 2, which states that the basis for the charge to which
Petitioner pled nolo contendere was Petitioner's failure to provide
services to a Medicaid recipient. I.G. Ex. 2; P. Ex. 6. Nor does
the affidavit contained at P. Ex. 6 contradict any of the evidence
on the critical issues of whether Petitioner was convicted and
whether that conviction is program related.

Finally, Petitioner has requested oral argument for the purpose of
presenting his arguments and evidence. I deny Petitioner's
request. Petitioner has no inherent right to an oral argument. 42
C.F.R. 1005.3, 1005.4. The regulations grant me the discretion
to grant or deny any motion by either party, including a motion for
oral argument. 42 C.F.R. 1005.3, 1005.4. I exercise that
discretion here and deny Petitioner's request for oral argument.

Petitioner has already submitted his argument and evidence through
his briefs and exhibits, as well as a sworn statement on his own
behalf and an affidavit from his nurse. P. Exs. 5, 6. Both of
these exhibits contain denials stating that Petitioner did nothing
wrong. However, as I stated above, these affidavits are not
probative of the critical aspects of this case, that is, whether
Petitioner was convicted of a criminal offense and whether that
conviction is related to the delivery of an item or service under
Medicaid. To the extent that Petitioner's affidavit contains a
denial of his conviction, it amounts to a collateral attack upon
his conviction, which I cannot consider in the context of this
case. Petitioner cannot use this forum to collaterally attack his
conviction. Ian C. Klein, D.P.M., DAB CR177 (1992); Olufemi
Okunoren, M.D., DAB CR150 (1991). Whether Petitioner knew that his
conviction in State court would result in an exclusion from
Medicare and Medicaid is also irrelevant. Thomas Malik, DAB CR357
(1995); Douglas Schram, R.Ph., DAB CR215 (1992), aff'd DAB 1372
(1992).

As I find above, it is Petitioner's plea of nolo contendere, and
the fact that the conduct to which Petitioner pled nolo contendere
is program related that triggers the mandatory exclusion. The
statute requires only a common sense connection between the
criminal offense and the delivery of items or services under
Medicare or Medicaid. Berton Siegel, D.O., DAB 1467, at 5 (1994);
Thelma Walley, DAB CR207 (1992); Boris Lipovsky, M.D., DAB 1363
(1992). The I.G. has more than met her burden to establish a
common sense connection between Petitioner's plea of nolo
contendere and the Medicaid program. The record as a whole
establishes that Petitioner's plea of nolo contendere to the charge
of deceptive business practices was the result of his not providing
services to a Medicaid recipient as he claimed to have done.

Under the law and regulations governing this case, Petitioner must
be excluded for a mandatory five-year period once it is established
that the offense to which he pled nolo contendere is program
related. Act, section 1128(a)(1); 42 C.F.R. 1001.101, 1001.102.
Petitioner has not made any showing that an oral argument is
necessary in this case, nor has Petitioner made any proffer that
oral argument would be helpful to me in deciding this case. I am
not permitted to consider any factors Petitioner may have to offer
in mitigation unless the exclusion imposed and directed by the I.G.
is for more than the five-year mandatory period and the I.G. has
alleged an aggravating factor. 42 C.F.R. 1001.101, 1001.102.
I have no authority to reduce Petitioner's exclusion based on any
mitigating factors that Petitioner may allege at oral argument.

I have considered the statement made to me by Petitioner in his
affidavit, but nothing in that statement can serve as a basis from
which I can reduce his exclusion below the five-year mandatory
period. The evidence in this case establishes that Petitioner was
convicted within the meaning of section 1128(i) and that his
conviction is program related under section 1128(a)(1). These are
the only issues before me in this case. The regulations do not
permit me to assess mitigating factors in this case of mandatory
exclusion.


CONCLUSION

Sections 1128(a)(1) and 1128(c)(3)(B) of the Act make it mandatory
for the Petitioner who has been convicted of a criminal offense
related to the delivery of an item or service under Medicare or
Medicaid to be excluded from participation in such programs for a
period of at least five years. Accordingly, because the I.G. has
established that Petitioner has been convicted and has further
shown that Petitioner's conviction is related to the delivery of
Medicaid items or services, I have no discretion but to uphold the
mandatory five-year exclusion imposed and directed against
Petitioner by the I.G.

________________________
Joseph K. Riotto
Administrative Law Judge

1. Section 1128(a)(1) of the Act mandates that the Secretary of
the Department of Health and Human Services (Secretary) exclude
individuals and entities convicted of program related criminal
offenses from participation in Medicare and shall direct that such
individuals and entities be excluded from participation in
Medicaid.

2. I cite to the parties' briefs and my Findings of Fact and
Conclusions of Law as follows:

Petitioner's Brief . . . . . . P. Br. (page)
I.G.'s Brief . . . . . . . . . . I.G. Br. (page)
Petitioner's Exhibit . . . . . . P. Ex. (number)
I.G.'s Exhibit . . . . . . . . . I.G. Ex. (number)
My Findings of Fact and
Conclusions of Law . . . . . . . Finding (number)

3. P. Ex. 1 and I.G. Ex. 6 are identical copies of Petitioner's
May 2, 1994 motion for new trial.

4. Although the evidence of record establishes that Petitioner
paid $19,886 in restitution to the Texas Attorney General's
Medicaid Fraud Control Unit, the I.G. has not alleged the
aggravating factor at 42 C.F.R. 1001.102(b)(2) [acts resulting
in conviction, or similar acts, resulted in financial loss to
Medicare and Medicaid of $1,500 or more]. I.G. Exs. 5, 15.
Moreover, the evidence indicates that most, if not all, of the
restitution of $19,886 was paid for offenses which are not related
to the offense to which Petitioner pled nolo contendere, because
the affidavit from the prosecuting attorney states that the $19,886
in restitution was for many offenses that were allegedly outside
the statute of limitations. I.G. Exs. 2, 3, 4, 5. Obviously, any
offense that Petitioner allegedly committed outside of the criminal
statute of limitations was not the basis for Petitioner's plea of
nolo contendere. I.G. Exs. 2, 3, 4, 5.

The court documents do not state with specificity the amount of
restitution that Petitioner was required to pay. However, the
record as a whole does reflect that Petitioner pled guilty to one
count of deceptive business practices, where Medicaid services
totalling $177.72 were not provided as claimed by Petitioner. I.G.
Exs. 2, 3. However, I am unable to make any conclusions regarding
the amount of restitution Petitioner was made to pay as a result of
his pleading nolo contendere to the charge of deceptive business
practices, nor is it necessary for me to do so in this case. I.G.
Exs. 2, 3.