Center City dentist charged in $5 million insurance fraud

A Center City dentist and his daughter have been charged with billing insurance companies for almost $5 million in fraudulent medical bills through the pain management clinic they operate together.

Owen Rogal, 71, who has been living and working in Center City for decades, runs the Pain Center at 12th and Lombard Streets. His 50-year-old daughter, Kim Rogal, of Delaware, works there as an office manager.

Since mid-2002, District Attorney Seth Williams said Wednesday, the Rogals have repeatedly billed 15 insurance companies $4,800 for a procedure that costs $800 at the most. The Rogals also characterized the routine, low-risk procedure as a delicate form of brain surgery, authorities said.

"This is a case that only happened because of greed," Williams said. "They didn't need to do what they were doing. He could have continued making a more comfortable living than probably 90 percent of all Americans, as a dentist. He saw this as an opportunity, and he took it."

Authorities believe the Rogals pocketed more than $1 million of the $5 million they billed in the scheme. They each face up to 317 years in prison and a fine of $613,000.

Doctors who worked at the Pain Center often performed radio frequency surgery (RFS), a procedure to treat chronic pain that involves inserting a needle into the affected muscle. When charging the insurance companies for RFS, Williams said, the Rogals used a code for an invasive procedure that is performed on cells in the brain.

"The procedure that they billed for is typically done in a hospital, by a highly skilled neurosurgeon, in a sterile environment, because the risks of the procedure are that you could die," Assistant District Attorney Vicki Markovitz said. "It's a last resort."

Computer systems assume that doctors and claims are honest, so many of the bills were paid, Markovitz said. Eventually, the companies caught on and asked the Rogals to stop using that code, but the billing continued.

The RFS treatment is advertised extensively on the website for the Pain Center. Some online reviews of Rogal's services are positive, with posts from former patients saying that they are pain-free after the procedure. But one reviewer posted in 2009 that Rogal had bilked insurance companies as a dentist, and another described him as "incompetent" and "a disgrace to the medical profession."

This is not the first time Rogal has landed in the spotlight. In 1989, Rogal, then a dentist specializing in treating chronic jaw-muscle pain, was profiled on an episode of the ABC News television show 20/20.

Part of the report criticized Rogal for diagnosing the pain syndrome in virtually all his patients, and recommending expensive treatments.

The show led Rogal to sue ABC for libel, arguing that he was unfairly portrayed as a charlatan, but a federal jury rejected his claims. A federal judge later slapped Rogal with more than $256,000 in sanctions for lying under oath during the trial. That penalty was later thrown out, but in 1996 Rogal agreed to pay $200,000 to the network.