The Associated Press State & Local Wire
February 20, 2003
LR doctor accused of billing for visits that never occurred
Dr. James C. Dilday, 46, of Little Rock, has pleaded innocent to theft and insurance fraud charges. After entering the pleas Friday in Little Rock District Court, Dilday was released on $50,000 bond.
Dilday’s attorney, Jack Lassiter of Little Rock, declined comment.
Dilday was the unsuccessful Democratic nominee for lieutenant governor in 1998, losing to Republican Win Rockefeller. Last year, Dilday sought the office again, but was beaten in the Democratic primary by lawyer Ron Sheffield.
An Insurance Department investigator, in documents prepared in support of 12 counts each of theft of property and insurance fraud, listed 234 office visits and 39 operations that never occurred. An affidavit also says that Dilday is not licensed by the state Medical Board to perform any operations.
According to those documents, Dilday received more than $127,000 from insurance companies on those claims.
In more than 80 pages of sworn affidavits, investigator Monty Vickers outlined the scope of the allegations. The affidavits list 12 patients whose insurance companies were billed for procedures that the affidavits say were not performed. The monetary value of the claims ranged from $462 to almost $44,000.
“Dr. Dilday intentionally filed a claim for payment with (the patient’s insurance company) representing that he was the treating physician for sixteen surgical procedures that were never performed,” Vickers wrote in an affidavit in support of one of the insurance-fraud charges.
“As a result of Dr. Dilday’s actions, (the insurance company) paid Dr. Dilday $43,961.52 in professional fees to which he was not entitled,” the affidavit said.
Dilday claimed that he had performed seven operations on the patient for “direct repair of aneurysm,” six procedures characterized as “3 coronary venous grafts,” and other operations for a ruptured aneurysm, arthrodesis and a craniectomy, according to the affidavit. The procedures all supposedly occurred in the period from Oct. 15, 2001, to June 27, 2002.
On another count, Dilday billed another patient for 73 office visits that never occurred, according to an affidavit.
In a 1998 profile when he was the Democratic nominee for lieutenant governor, Dilday identified health-care reform as his main concern.
“We’re constantly being shackled by a system that doesn’t want to pay what people have already bought,” Dilday said. “You’ve already paid your premiums. Why don’t you get the care you need? Why can’t you see the doctors you need or want to? Why can’t you get the medications you need? Because a well-financed, managed-care, health-care system has bought off every Republican politician in this country.”
Rockefeller defeated Dilday that year by a 2-to-1 margin. Last year, Sheffield beat Dilday in the Democratic primary by better than 3-to-1.