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'''Dr. Marc J. Blatstein''' is an American physician, author, and [[Prison_Consultants|prison consultant]] who served | '''Dr. Marc J. Blatstein''' is an American physician, author, and [[Prison_Consultants|prison consultant]] who served roughly two years in federal prison after pleading guilty to mail fraud in 2005.<ref name="justia-appeal">United States v. Blatstein, 482 F.3d 725 (4th Cir. 2007), https://law.justia.com/cases/federal/appellate-courts/F3/482/725/497343/.</ref> He ran a podiatry practice in Fredericksburg, Virginia for over 30 years before getting convicted of fraudulently billing insurance companies. The scheme involved a fake entity called the Central Park Ambulatory Surgery Center, which didn't actually exist.<ref name="fls-indictment">The Free Lance-Star, "Doctor faces U.S. fraud charges," May 2005, https://fredericksburg.com/local/doctor-faces-u-s-fraud-charges/article_613c3af4-99db-59a8-9af4-029546b19e38.html.</ref> After his release, Blatstein got his medical license back in 2010 and started Physician Presentence Report Service, LLC in 2011. He's become one of the few prison consultants with both medical training and firsthand experience in the federal [[Index_of_Federal_Prison_Facilities|Bureau of Prisons]].<ref name="pprsus-about">Physician Presentence Report Service, "About Dr. Marc Blatstein," https://pprsus.com/about-dr-marc-blatstein/.</ref> | ||
== Summary == | == Summary == | ||
Marc Blatstein works with white-collar defendants facing federal sentencing. His firm, Physician Presentence Report Service (PPRSUS), prepares clients for presentence interviews and sentencing hearings. The work emphasizes medical documentation and facility placement requests, which matter far more than most defendants realize.<ref name="pprsus-about" /> | |||
His background speaks for itself: over 30 years of medical practice plus time spent in the federal prison system. Blatstein's consulting focuses on making sure defendants' medical records are properly documented in their presentence reports. These reports are how the BOP decides medical care and facility placement.<ref name="federal-lawyer">Marc Blatstein et al., "Availability of Treatment and Rehabilitation in Federal Prison: The Critical Role of the Presentence Report," The Federal Lawyer, January/February 2021, https://www.pprsus.com/treatment-and-rehabilitation-in-federal-prison-the-critical-role-of-the-presentence-report/.</ref> | |||
He's published work with the American Bar Association on representing people with dementia, and he's written for The Federal Lawyer about treatment availability in federal prison.<ref name="aba-dementia">American Bar Association, "Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers," 2022, https://www.americanbar.org/products/inv/book/426832634/.</ref> The California Business Journal has featured his commentary on high-profile federal cases, including those involving former Congressman George Santos and attorney Thomas Che Goldstein.<ref name="cbj-goldstein">California Business Journal, "Thomas Che Goldstein's Fall from Grace," February 2025, https://calbizjournal.com/thomas-che-goldsteins-fall-from-grace/.</ref> | |||
== Background == | == Background == | ||
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=== Early Life and Education === | === Early Life and Education === | ||
Blatstein was born in Philadelphia, Pennsylvania and went to high school there.<ref name="pprsus-bio">Physician Presentence Report Service, "Marc Blatstein," https://pprsus.com/more-about-marc-blatstein/.</ref> He attended George Washington University in Washington, D.C., working part-time jobs to afford it. During his third year at GWU, he took an 11-month break to travel with a friend. They went from Washington, D.C. to Lima, Peru, then traveled by train to Cusco in the Peruvian Andes, the Amazon, and other South American locations. Back at GWU, he finished his degree and graduated with a Bachelor of Arts in Psychology in 1977.<ref name="pprsus-bio" /> | |||
Podiatric medicine came next. He attended the Ohio College of Podiatric Medicine (now Kent State University College of Podiatric Medicine) and earned his Doctor of Podiatric Medicine degree in 1983.<ref name="pprsus-bio" /> While there, he started "Pink Panther Bartenders" with his brother and two classmates, a side business to help pay for school. He was also invited to participate in a Cleveland Opera gala during that time.<ref name="pprsus-bio" /> | |||
His clinical training | His clinical training took him to several places. Lutheran Hospital in Baltimore, Maryland in 1982. Then Atlanta Hospital & Medical Center in Georgia from 1982 to 1983. He finished his surgical residency in Podiatric Medicine and Surgery at Lawndale Community Hospital in 1984.<ref name="pprsus-bio" /> | ||
=== Medical Career === | === Medical Career === | ||
Blatstein | Blatstein got his Virginia medical license in 1984 and started a solo podiatry practice in the Fredericksburg area.<ref name="fls-board">The Free Lance-Star, "Board punishes podiatrist," 2001, https://fredericksburg.com/board-punishes-podiatrist/article_616319cc-918b-5fca-bbea-4729025e3b44.html.</ref> He ran his main practice from a strip mall location in Central Park and eventually opened two more locations in the Fredericksburg area. Over time he added a medically oriented shoe store, wound care programs, and physical therapy services to his practice.<ref name="pprsus-bio" /> | ||
The Circulator Boot was a major part of his work. This treatment device helped with lower extremity wound therapy, bacterial control, blood supply, moisture management, and removal of dead or damaged tissues.<ref name="pprsus-bio" /> | |||
In 2001, | In 2001, things changed. The Virginia Board of Medicine fined him $5,000, reprimanded him, and ordered additional training in record keeping following a hearing in Fredericksburg. The issue involved his 1999 treatment of a patient for foot pain. He'd diagnosed a stress fracture but allegedly didn't properly treat or document it. An orthopedist who later examined the patient determined the fracture was essentially healed. The board also found problems with his advertisements. Some violated regulations. Others for treatments like a "Chinese Treatment" for fungal nails posed potential health risks. He'd also used a non-existent organization name, "Association of American College of Foot and Ankle Surgeons," in his ads.<ref name="fls-board" /> | ||
== Federal Investigation and Prosecution == | == Federal Investigation and Prosecution == | ||
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=== Investigation === | === Investigation === | ||
A patient complaint filed with Virginia State Police in 2001 about her bill became the spark.<ref name="fls-indictment" /> In May 2004, federal investigators got involved. FBI agents from the Fredericksburg office worked with officials from the Department of Health and Human Services, the Office of Personnel Management, and Virginia State Police. They suspected fraudulent billing of health insurers.<ref name="justia-appeal" /> | |||
On July 14, 2004, FBI Agent Jeffrey Howard | On July 14, 2004, FBI Agent Jeffrey Howard requested search warrants. He submitted an affidavit to a magistrate judge claiming probable cause that Blatstein had violated federal statutes on healthcare fraud (18 U.S.C. § 1347) and mail fraud (18 U.S.C. § 1341).<ref name="justia-appeal" /> | ||
July 27, 2004 brought the raid. Federal authorities executed the search warrants at his office and residence, finding evidence of his billing scheme. Blatstein himself recalled the experience: a 6 a.m. knock at his front door where "a litany of Alphabet Law enforcement agencies greeted" him, followed by an 8 a.m. visit to his office where agents seized computers and were accompanied by local board of medicine representatives.<ref name="pprsus-about" /> | |||
=== The Billing Scheme === | === The Billing Scheme === | ||
The investigation revealed a straightforward fraud. Blatstein had billed patients' insurers for outpatient surgical facilities provided by the Central Park Ambulatory Surgical Center (CPASC). The problem? CPASC had no physical existence and wasn't licensed by Virginia.<ref name="justia-appeal" /> | |||
How it worked:<ref name="fls-indictment" /><ref name="justia-appeal" /> | |||
* In 1997, Blatstein opened his Central Park office | * In 1997, Blatstein opened his Central Park office, expanding it in 1998 to add a room for podiatric surgical procedures. | ||
* In 1999, he incorporated the Central Park Ambulatory Surgery Center at the same address as his podiatry office. | * In 1999, he incorporated the Central Park Ambulatory Surgery Center at the same address as his podiatry office. | ||
* In 2000, he obtained a separate tax | * In 2000, he obtained a separate tax ID for the surgery center, a separate telephone line, and a post office box at a Parcel Plus store with a different address (1285 Carl D. Silver Parkway). | ||
* He | * He told employees to falsely tell the Government Employees Hospital Association (GEHA) insurance company that the surgery center was a separate facility, not part of his office. | ||
* | * Patients signed preprinted forms stating they'd be responsible for both a facility fee and a surgeon's fee. | ||
* | * Blatstein personally completed all paperwork for surgical facility billing, while employees handled other procedure billing. | ||
* He submitted bills for surgery center fees to at least six insurance companies: Mail Handlers Benefit Plan, GEHA, Blue Cross/Blue Shield, Aetna, Humana, and Cigna. | * He submitted bills for surgery center fees to at least six insurance companies: Mail Handlers Benefit Plan, GEHA, Blue Cross/Blue Shield, Aetna, Humana, and Cigna. | ||
Two former employees provided information to the FBI. They're called Cooperating Witnesses 1 and 2 in the affidavit. CW-1 told investigators that Blatstein billed surgical facility fees for procedures at his podiatry office despite repeated warnings. He couldn't legitimately charge such fees for procedures not done at a physically separate facility. CW-1 first learned about CPASC when someone called a telephone line reserved for Blatstein's exclusive use asking for the Central Park Ambulatory Surgery Center.<ref name="justia-appeal" /> | |||
One incident stood out. Patient Lyndon Friend came in for an ingrown toenail removal. His wife, Katrina Friend, noticed a yellow carbon sheet behind paperwork her husband was signing. She lifted the top sheet to see what was under it, and a Blatstein employee demanded the papers back. She refused. When Blatstein himself tried to physically wrestle the documents away from her, she ripped them into pieces and left. Later she pieced together the torn documents. The top sheet bore the heading "Dr. Marc Blatstein, LPM, PC." The carbon underneath was headed "Central Park Ambulatory Surgery Center, Inc."<ref name="justia-appeal" /> | |||
=== Indictment and Guilty Plea === | === Indictment and Guilty Plea === | ||
On June 20, 2005, a federal grand jury in Virginia's Eastern District | On June 20, 2005, a federal grand jury in Virginia's Eastern District handed down an indictment. One count of healthcare fraud (18 U.S.C. § 1347) and seven counts of mail fraud (18 U.S.C. § 1341).<ref name="justia-appeal" /> He faced a maximum of 10 years per count and a $250,000 fine per count.<ref name="fls-indictment" /> | ||
The next day, June 21, 2005, Blatstein | The next day, June 21, 2005, Blatstein's attorney David G. Barger of Williams Mullen filed a motion to suppress all seized evidence and requested a Franks hearing. Barger argued that his client was falsely accused and never intended to defraud anyone. Virginia state law, he noted, included an exemption for doctors who perform occasional surgeries in their offices.<ref name="fls-indictment" /> | ||
The district court denied the motion on August 25, 2005.<ref name="justia-appeal" /> | |||
On October 5, 2005, Blatstein entered a conditional guilty plea to one count of mail fraud | On October 5, 2005, Blatstein entered a conditional guilty plea to one count of mail fraud (18 U.S.C. § 1341), preserving his right to appeal the court's denial of his suppression motion. The plea agreement said prosecution and defense would jointly recommend a sentence at the low end of his 24-30 month guidelines range.<ref name="justia-appeal" /> | ||
Total bills allegedly submitted came to $501,736. Blatstein received reimbursements of $272,704. The indictment acknowledged he was entitled to professional fees for treating patients but not to facility fees since his surgical room wasn't a state-licensed, free-standing surgery center.<ref name="fls-indictment" /> | |||
== Sentencing and Appeal == | == Sentencing and Appeal == | ||
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=== Initial Sentencing === | === Initial Sentencing === | ||
On January 6, 2006, the probation officer submitted a [[The_Presentence_Report_(PSR)|presentence report]] | On January 6, 2006, the probation officer submitted a [[The_Presentence_Report_(PSR)|presentence report]] saying no factors warranted a sentence outside the advisory guidelines range. On February 3, 2006, Blatstein filed a sentencing memorandum describing his efforts toward restitution and the harm to his livelihood and health. Attached were letters from friends and family members, including his mother and brother, expressing concern. Notably, the memorandum didn't suggest circumstances calling for a sentence outside his advisory guidelines range.<ref name="justia-appeal" /> | ||
On February 8, 2006, U.S. District Court Judge Richard L. Williams | On February 8, 2006, U.S. District Court Judge Richard L. Williams held the sentencing hearing. Both parties recommended 24 months' imprisonment, the bottom of his guidelines range. But Judge Williams went lower. He sentenced Blatstein to 12 months and one day. This happened without notifying the parties of a possible downward variance as Federal Rule of Criminal Procedure 32(h) required.<ref name="justia-appeal" /> | ||
Several reasons, the court said, made the longer term "counter productive": Blatstein's "early efforts to make amends for his wrong doing." The effect on his health and profession. "His family." A shorter prison term would also "save the United States... [money] that would be wasted by warehousing him for that period of time."<ref name="justia-appeal" /> | |||
Judge Williams | Judge Williams ordered restitution of $272,704 to Humana, Aetna, Cigna, and the Federal Employees Health Benefits Program.<ref name="hhs-exclusion">Department of Health and Human Services, Departmental Appeals Board, Civil Remedies Division, Decision No. CR1638, Docket No. C-07-245, August 23, 2007, https://www.hhs.gov/sites/default/files/static/dab/decisions/alj-decisions/2007/cr1638.pdf.</ref> Blatstein was ordered to report to a federal penitentiary in Florida by March 14, 2006.<ref name="podiatry-sentencing">Podiatry Management Online, "Fredericksburg Podiatrist Sentenced in Billing Scam," 2006, https://www.podiatrym.com/search3.cfm?id=8886.</ref> | ||
=== Fourth Circuit Appeal === | === Fourth Circuit Appeal === | ||
The government cross-appealed | The government didn't accept the sentence. They cross-appealed, saying the sentencing court erred in imposing a variance without providing reasonable notice. The Fourth Circuit affirmed the denial of Blatstein's suppression motion but vacated his sentence and sent it back for resentencing consistent with Rule 32.<ref name="justia-appeal" /> | ||
The court found that the government, given | The court found that the government, given fair opportunity, could have raised meritorious objections to the grounds for variance. The government presented strong challenges to several factors the court had relied on: Blatstein's "early efforts to make amends," the impact on his profession and family, and the possible savings to the federal government.<ref name="justia-appeal" /> | ||
Judge King wrote the Fourth Circuit opinion in 2007. Judge Michael and Senior Judge Hamilton concurred. It's reported as United States v. Blatstein, 482 F.3d 725 (4th Cir. 2007).<ref name="justia-appeal" /> | |||
=== Resentencing === | === Resentencing === | ||
Blatstein was released | Blatstein was released in March 2007 after serving his original sentence of one year and one day. But the Fourth Circuit's decision changed things. Judge Williams resentenced him and ordered him to surrender by July 24, 2007, for another year in prison.<ref name="podiatry-resentencing">Podiatry Management Online, "VA Podiatrist Ordered to Serve an Additional Year in Prison," 2007, https://www.podiatrym.com/search3.cfm?id=14677.</ref> | ||
His attorney | His attorney David G. Barger expressed disappointment with the resentencing.<ref name="podiatry-resentencing" /> | ||
== Administrative Actions == | == Administrative Actions == | ||
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=== Medical License === | === Medical License === | ||
On or about February 24, 2006, Blatstein surrendered his medical license to the Virginia Board of Medicine | On or about February 24, 2006, Blatstein surrendered his medical license to the Virginia Board of Medicine due to his felony conviction.<ref name="hhs-exclusion" /> | ||
By 2010, | By 2010, he'd gotten it back. Colleagues supported him when he appeared before the local board of medicine, and others encouraged him to pursue reinstatement. He said: "that was something my soul needed, and I will be forever grateful."<ref name="pprsus-about" /> His Virginia license for Foot and Ankle Medicine and Surgery was active from 1985 to 2023, with records indicating licensure through 2026.<ref name="pprsus-bio" /> | ||
=== Medicare and Medicaid Exclusion === | === Medicare and Medicaid Exclusion === | ||
On November 30, 2006, the Inspector General of the Department of Health and Human Services notified Blatstein that he was | On November 30, 2006, the Inspector General of the Department of Health and Human Services notified Blatstein that he was excluded from Medicare and other federally funded health care programs. This came under section 1128(a)(3) of the Social Security Act. The reason? A felony conviction related to healthcare fraud. The I.G. imposed a 13-year exclusion based on aggravating factors.<ref name="hhs-exclusion" /> | ||
Blatstein requested a hearing | Blatstein requested a hearing before Administrative Law Judge Alfonso J. Montano. In an August 23, 2007 decision, Judge Montano upheld the 13-year exclusion. The ALJ identified four aggravating factors:<ref name="hhs-exclusion" /> | ||
* | * Financial loss to Medicare and state health care programs exceeded $5,000 (total restitution was $272,704.05) | ||
* The acts | * The acts continued over more than one year (January 1999 to approximately December 2003) | ||
* The sentence included incarceration (originally 12 months and one day, increased to 24 months on resentencing) | * The sentence included incarceration (originally 12 months and one day, increased to 24 months on resentencing) | ||
* Blatstein | * Blatstein faced adverse action by other government agencies on the same circumstances (license surrender and a five-year OPM debarment) | ||
Blatstein argued | Blatstein argued the 13-year exclusion was excessive. He wanted it reduced to the statutory minimum of five years. The Office of Personnel Management had reduced his suspension from seven years to five years after an in-person hearing on the same facts. But the ALJ said he wasn't bound by OPM's actions and couldn't consider them as mitigating factors.<ref name="hhs-exclusion" /> | ||
He offered several mitigating factors: cooperation with government officials, substantial restitution payments that left him "virtually penniless and homeless," time served, voluntary license surrender, and the evolution of his conduct from legitimate efforts to set up an ambulatory surgery center. The ALJ found none of these qualified under the regulatory definition of mitigating factors at 42 C.F.R. § 1001.102(c).<ref name="hhs-exclusion" /> | |||
=== OPM Debarment === | === OPM Debarment === | ||
On July 18, 2006, the Office of Personnel Management debarred Blatstein for | On July 18, 2006, the Office of Personnel Management debarred Blatstein for five years based on his felony conviction.<ref name="hhs-exclusion" /> | ||
== Post-Release Career == | == Post-Release Career == | ||
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=== Physician Presentence Report Service === | === Physician Presentence Report Service === | ||
Blatstein founded Physician Presentence Report Service, LLC (PPRSUS) in 2011, a prison consulting firm based in the Washington, D.C. metropolitan area.<ref name="pprsus-about" /><ref name="zoominfo">ZoomInfo, "Physician Presentence Report Service," https://www.zoominfo.com/pic/physician-presentence-report-service-llc/404444973.</ref> | |||
The firm | The firm helps defendants prepare for presentence interviews and sentencing hearings. Services include assistance with personal narratives, character letter guidance, release plan development, allocution preparation, and facility placement requests. Blatstein emphasizes proper documentation of clients' medical records in presentence reports. The [[Index_of_Federal_Prison_Facilities|Bureau of Prisons]] uses these for medical care and facility placement decisions.<ref name="pprsus-about" /> | ||
His medical background | His medical background shapes the firm's focus on BOP healthcare. Medication availability matters. So do Care Level designations and facility selection based on medical needs.<ref name="pprsus-about" /> | ||
=== Publications === | === Publications === | ||
Blatstein has authored or co-authored several publications | Blatstein has authored or co-authored several publications on federal criminal defense and prison conditions: | ||
* '''The Federal Lawyer (January/February 2021):''' | * '''The Federal Lawyer (January/February 2021):''' He co-authored "Availability of Treatment and Rehabilitation in Federal Prison: The Critical Role of the Presentence Report" with Fay F. Spence, J.D., E.J. Hurst II, J.D., and Maureen Baird. The article covers medical, mental health, and substance abuse programs in the federal Bureau of Prisons and discusses how the presentence report affects treatment availability for defendants.<ref name="federal-lawyer" /> | ||
* '''American Bar Association (2022):''' Co-authored two chapters in "Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers" with Faye Spence, Esq. Chapter 1 addresses "What Is Dementia?" and Chapter 13 covers "Jail and Prison Conditions."<ref name="aba-dementia" /> | * '''American Bar Association (2022):''' Co-authored two chapters in "Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers" with Faye Spence, Esq. Chapter 1 addresses "What Is Dementia?" and Chapter 13 covers "Jail and Prison Conditions."<ref name="aba-dementia" /> | ||
* '''California Business Journal (2025):''' Contributed commentary on high-profile federal cases, | * '''California Business Journal (2025):''' Contributed commentary on high-profile federal cases, analyzing Thomas Che Goldstein's tax fraud indictment and George Santos's sentencing.<ref name="cbj-goldstein" /> | ||
* '''Substack:''' Maintains a newsletter called "White Collar Investigations" covering federal sentencing issues, BOP conditions, and case analysis.<ref name="substack">White Collar Investigations Substack, https://whitecollarinvestigations.substack.com/.</ref> | * '''Substack:''' Maintains a newsletter called "White Collar Investigations" covering federal sentencing issues, BOP conditions, and case analysis.<ref name="substack">White Collar Investigations Substack, https://whitecollarinvestigations.substack.com/.</ref> | ||
=== Commentary on High-Profile Cases === | === Commentary on High-Profile Cases === | ||
He's analyzed several federal cases: | |||
* '''George Santos:''' | * '''George Santos:''' Blatstein examined the former Congressman's case, including commentary on sentencing considerations and acceptance of responsibility issues.<ref name="santos">Physician Presentence Report Service, "George Santos Eventually Chose to Plead Guilty," https://pprsus.com/george-santos-plea-is-he-capable-of-accepting-responsibility/.</ref> | ||
* '''Thomas Che Goldstein:''' | * '''Thomas Che Goldstein:''' He analyzed the case of the Supreme Court attorney and SCOTUSblog co-founder who faced tax fraud charges.<ref name="cbj-goldstein" /> | ||
== Terminology == | == Terminology == | ||
* '''[[The_Presentence_Report_(PSR)|Presentence Report (PSR)]]''': A | * '''[[The_Presentence_Report_(PSR)|Presentence Report (PSR)]]''': A U.S. Probation Officer prepares this document following an interview with a defendant. It provides the sentencing judge with information about the defendant's background, criminal history, and offense conduct. The PSR serves as the primary referral document for BOP placement and medical care decisions.<ref name="federal-lawyer" /> | ||
* '''Allocution''': A defendant's statement to the sentencing judge, typically expressing remorse and acceptance of responsibility. Blatstein | * '''Allocution''': A defendant's statement to the sentencing judge, typically expressing remorse and acceptance of responsibility. Blatstein says allocution should begin with a "well-written narrative" and that failing to allocute is a "huge mistake."<ref name="pprsus-about" /> | ||
* '''Care Level''': The [[Index_of_Federal_Prison_Facilities|Bureau of Prisons]] classification system for inmate medical needs | * '''Care Level''': The [[Index_of_Federal_Prison_Facilities|Bureau of Prisons]] classification system for inmate medical needs. Care Level I means minimal care, generally healthy inmates under 70. Care Level IV means 24-hour hospital-type care. Inmates are placed in facilities based on their designated care level.<ref name="pprsus-about" /> | ||
* '''Federal Medical Center (FMC)''': One of seven BOP facilities providing specialized medical care | * '''Federal Medical Center (FMC)''': One of seven BOP facilities providing specialized medical care. FMC Butner is a cancer center. [[FMC_Carswell_(medical_facility)|FMC Carswell]] is for women only. [[FMC_Devens_(medical_facility)|FMC Devens]] provides dialysis. [[FMC_Lexington_(medical_facility)|FMC Lexington]] is lower security. [[FMC_Rochester_(medical_facility)|FMC Rochester]] partners with Mayo Clinic. FMC Springfield is higher security.<ref name="pprsus-about" /> | ||
* '''Variance''': A sentence that deviates from the advisory [[Federal_Sentencing_Guidelines_and_Offense_Enhancements|federal sentencing guidelines]] range. In Blatstein's original case, Judge Williams imposed a downward variance from 24 months to 12 months and one day, which was later vacated by the Fourth Circuit for procedural error.<ref name="justia-appeal" /> | * '''Variance''': A sentence that deviates from the advisory [[Federal_Sentencing_Guidelines_and_Offense_Enhancements|federal sentencing guidelines]] range. In Blatstein's original case, Judge Williams imposed a downward variance from 24 months to 12 months and one day, which was later vacated by the Fourth Circuit for procedural error.<ref name="justia-appeal" /> | ||
* '''[[First_Step_Act:_Overview_and_Implementation|First Step Act]]''': The 2018 federal criminal justice reform law | * '''[[First_Step_Act:_Overview_and_Implementation|First Step Act]]''': The 2018 federal criminal justice reform law created earned time credits and expanded early release programs. Blatstein writes frequently about FSA implementation issues, including delays in calculating earned time credits and projected release dates.<ref name="pprsus-about" /> | ||
* '''[[Residential_Drug_Abuse_Program_(RDAP)|RDAP (Residential Drug Abuse Program)]]''': A Bureau of Prisons treatment program that can provide eligible inmates with up to one year off their sentence upon successful completion.<ref name="pprsus-about" /> | * '''[[Residential_Drug_Abuse_Program_(RDAP)|RDAP (Residential Drug Abuse Program)]]''': A Bureau of Prisons treatment program that can provide eligible inmates with up to one year off their sentence upon successful completion.<ref name="pprsus-about" /> | ||
* '''[[Compassionate_Release_Policies|Compassionate Release]]''': A mechanism | * '''[[Compassionate_Release_Policies|Compassionate Release]]''': A mechanism allowing federal inmates to seek early release based on extraordinary and compelling circumstances, including terminal illness or serious medical conditions that the BOP can't adequately treat.<ref name="pprsus-about" /> | ||
* '''Section 1128 Exclusion''': The | * '''Section 1128 Exclusion''': The Social Security Act provision under which individuals convicted of healthcare fraud-related felonies are excluded from Medicare and other federally funded health care programs. Mandatory exclusions under section 1128(a)(3) require a minimum five-year period.<ref name="hhs-exclusion" /> | ||
* '''[[Federal_Good_Time_Credit_Policies|Good Time Credit (GTC)]]''': Time off a federal sentence earned by inmates who maintain good behavior, calculated at approximately 54 days per year of the sentence imposed (not time served).<ref name="santos" /> | * '''[[Federal_Good_Time_Credit_Policies|Good Time Credit (GTC)]]''': Time off a federal sentence earned by inmates who maintain good behavior, calculated at approximately 54 days per year of the sentence imposed (not time served).<ref name="santos" /> | ||
Latest revision as of 18:23, 23 April 2026
| Marc J. Blatstein | |
|---|---|
| |
| Born: | Philadelphia, Pennsylvania |
| Charges: | Mail fraud (18 U.S.C. § 1341) |
| Sentence: | 24 months (after resentencing) |
| Facility: | |
| Status: | Released |
Dr. Marc J. Blatstein is an American physician, author, and prison consultant who served roughly two years in federal prison after pleading guilty to mail fraud in 2005.[1] He ran a podiatry practice in Fredericksburg, Virginia for over 30 years before getting convicted of fraudulently billing insurance companies. The scheme involved a fake entity called the Central Park Ambulatory Surgery Center, which didn't actually exist.[2] After his release, Blatstein got his medical license back in 2010 and started Physician Presentence Report Service, LLC in 2011. He's become one of the few prison consultants with both medical training and firsthand experience in the federal Bureau of Prisons.[3]
Summary
Marc Blatstein works with white-collar defendants facing federal sentencing. His firm, Physician Presentence Report Service (PPRSUS), prepares clients for presentence interviews and sentencing hearings. The work emphasizes medical documentation and facility placement requests, which matter far more than most defendants realize.[3]
His background speaks for itself: over 30 years of medical practice plus time spent in the federal prison system. Blatstein's consulting focuses on making sure defendants' medical records are properly documented in their presentence reports. These reports are how the BOP decides medical care and facility placement.[4]
He's published work with the American Bar Association on representing people with dementia, and he's written for The Federal Lawyer about treatment availability in federal prison.[5] The California Business Journal has featured his commentary on high-profile federal cases, including those involving former Congressman George Santos and attorney Thomas Che Goldstein.[6]
Background
Early Life and Education
Blatstein was born in Philadelphia, Pennsylvania and went to high school there.[7] He attended George Washington University in Washington, D.C., working part-time jobs to afford it. During his third year at GWU, he took an 11-month break to travel with a friend. They went from Washington, D.C. to Lima, Peru, then traveled by train to Cusco in the Peruvian Andes, the Amazon, and other South American locations. Back at GWU, he finished his degree and graduated with a Bachelor of Arts in Psychology in 1977.[7]
Podiatric medicine came next. He attended the Ohio College of Podiatric Medicine (now Kent State University College of Podiatric Medicine) and earned his Doctor of Podiatric Medicine degree in 1983.[7] While there, he started "Pink Panther Bartenders" with his brother and two classmates, a side business to help pay for school. He was also invited to participate in a Cleveland Opera gala during that time.[7]
His clinical training took him to several places. Lutheran Hospital in Baltimore, Maryland in 1982. Then Atlanta Hospital & Medical Center in Georgia from 1982 to 1983. He finished his surgical residency in Podiatric Medicine and Surgery at Lawndale Community Hospital in 1984.[7]
Medical Career
Blatstein got his Virginia medical license in 1984 and started a solo podiatry practice in the Fredericksburg area.[8] He ran his main practice from a strip mall location in Central Park and eventually opened two more locations in the Fredericksburg area. Over time he added a medically oriented shoe store, wound care programs, and physical therapy services to his practice.[7]
The Circulator Boot was a major part of his work. This treatment device helped with lower extremity wound therapy, bacterial control, blood supply, moisture management, and removal of dead or damaged tissues.[7]
In 2001, things changed. The Virginia Board of Medicine fined him $5,000, reprimanded him, and ordered additional training in record keeping following a hearing in Fredericksburg. The issue involved his 1999 treatment of a patient for foot pain. He'd diagnosed a stress fracture but allegedly didn't properly treat or document it. An orthopedist who later examined the patient determined the fracture was essentially healed. The board also found problems with his advertisements. Some violated regulations. Others for treatments like a "Chinese Treatment" for fungal nails posed potential health risks. He'd also used a non-existent organization name, "Association of American College of Foot and Ankle Surgeons," in his ads.[8]
Federal Investigation and Prosecution
Investigation
A patient complaint filed with Virginia State Police in 2001 about her bill became the spark.[2] In May 2004, federal investigators got involved. FBI agents from the Fredericksburg office worked with officials from the Department of Health and Human Services, the Office of Personnel Management, and Virginia State Police. They suspected fraudulent billing of health insurers.[1]
On July 14, 2004, FBI Agent Jeffrey Howard requested search warrants. He submitted an affidavit to a magistrate judge claiming probable cause that Blatstein had violated federal statutes on healthcare fraud (18 U.S.C. § 1347) and mail fraud (18 U.S.C. § 1341).[1]
July 27, 2004 brought the raid. Federal authorities executed the search warrants at his office and residence, finding evidence of his billing scheme. Blatstein himself recalled the experience: a 6 a.m. knock at his front door where "a litany of Alphabet Law enforcement agencies greeted" him, followed by an 8 a.m. visit to his office where agents seized computers and were accompanied by local board of medicine representatives.[3]
The Billing Scheme
The investigation revealed a straightforward fraud. Blatstein had billed patients' insurers for outpatient surgical facilities provided by the Central Park Ambulatory Surgical Center (CPASC). The problem? CPASC had no physical existence and wasn't licensed by Virginia.[1]
- In 1997, Blatstein opened his Central Park office, expanding it in 1998 to add a room for podiatric surgical procedures.
- In 1999, he incorporated the Central Park Ambulatory Surgery Center at the same address as his podiatry office.
- In 2000, he obtained a separate tax ID for the surgery center, a separate telephone line, and a post office box at a Parcel Plus store with a different address (1285 Carl D. Silver Parkway).
- He told employees to falsely tell the Government Employees Hospital Association (GEHA) insurance company that the surgery center was a separate facility, not part of his office.
- Patients signed preprinted forms stating they'd be responsible for both a facility fee and a surgeon's fee.
- Blatstein personally completed all paperwork for surgical facility billing, while employees handled other procedure billing.
- He submitted bills for surgery center fees to at least six insurance companies: Mail Handlers Benefit Plan, GEHA, Blue Cross/Blue Shield, Aetna, Humana, and Cigna.
Two former employees provided information to the FBI. They're called Cooperating Witnesses 1 and 2 in the affidavit. CW-1 told investigators that Blatstein billed surgical facility fees for procedures at his podiatry office despite repeated warnings. He couldn't legitimately charge such fees for procedures not done at a physically separate facility. CW-1 first learned about CPASC when someone called a telephone line reserved for Blatstein's exclusive use asking for the Central Park Ambulatory Surgery Center.[1]
One incident stood out. Patient Lyndon Friend came in for an ingrown toenail removal. His wife, Katrina Friend, noticed a yellow carbon sheet behind paperwork her husband was signing. She lifted the top sheet to see what was under it, and a Blatstein employee demanded the papers back. She refused. When Blatstein himself tried to physically wrestle the documents away from her, she ripped them into pieces and left. Later she pieced together the torn documents. The top sheet bore the heading "Dr. Marc Blatstein, LPM, PC." The carbon underneath was headed "Central Park Ambulatory Surgery Center, Inc."[1]
Indictment and Guilty Plea
On June 20, 2005, a federal grand jury in Virginia's Eastern District handed down an indictment. One count of healthcare fraud (18 U.S.C. § 1347) and seven counts of mail fraud (18 U.S.C. § 1341).[1] He faced a maximum of 10 years per count and a $250,000 fine per count.[2]
The next day, June 21, 2005, Blatstein's attorney David G. Barger of Williams Mullen filed a motion to suppress all seized evidence and requested a Franks hearing. Barger argued that his client was falsely accused and never intended to defraud anyone. Virginia state law, he noted, included an exemption for doctors who perform occasional surgeries in their offices.[2]
The district court denied the motion on August 25, 2005.[1]
On October 5, 2005, Blatstein entered a conditional guilty plea to one count of mail fraud (18 U.S.C. § 1341), preserving his right to appeal the court's denial of his suppression motion. The plea agreement said prosecution and defense would jointly recommend a sentence at the low end of his 24-30 month guidelines range.[1]
Total bills allegedly submitted came to $501,736. Blatstein received reimbursements of $272,704. The indictment acknowledged he was entitled to professional fees for treating patients but not to facility fees since his surgical room wasn't a state-licensed, free-standing surgery center.[2]
Sentencing and Appeal
Initial Sentencing
On January 6, 2006, the probation officer submitted a presentence report saying no factors warranted a sentence outside the advisory guidelines range. On February 3, 2006, Blatstein filed a sentencing memorandum describing his efforts toward restitution and the harm to his livelihood and health. Attached were letters from friends and family members, including his mother and brother, expressing concern. Notably, the memorandum didn't suggest circumstances calling for a sentence outside his advisory guidelines range.[1]
On February 8, 2006, U.S. District Court Judge Richard L. Williams held the sentencing hearing. Both parties recommended 24 months' imprisonment, the bottom of his guidelines range. But Judge Williams went lower. He sentenced Blatstein to 12 months and one day. This happened without notifying the parties of a possible downward variance as Federal Rule of Criminal Procedure 32(h) required.[1]
Several reasons, the court said, made the longer term "counter productive": Blatstein's "early efforts to make amends for his wrong doing." The effect on his health and profession. "His family." A shorter prison term would also "save the United States... [money] that would be wasted by warehousing him for that period of time."[1]
Judge Williams ordered restitution of $272,704 to Humana, Aetna, Cigna, and the Federal Employees Health Benefits Program.[9] Blatstein was ordered to report to a federal penitentiary in Florida by March 14, 2006.[10]
Fourth Circuit Appeal
The government didn't accept the sentence. They cross-appealed, saying the sentencing court erred in imposing a variance without providing reasonable notice. The Fourth Circuit affirmed the denial of Blatstein's suppression motion but vacated his sentence and sent it back for resentencing consistent with Rule 32.[1]
The court found that the government, given fair opportunity, could have raised meritorious objections to the grounds for variance. The government presented strong challenges to several factors the court had relied on: Blatstein's "early efforts to make amends," the impact on his profession and family, and the possible savings to the federal government.[1]
Judge King wrote the Fourth Circuit opinion in 2007. Judge Michael and Senior Judge Hamilton concurred. It's reported as United States v. Blatstein, 482 F.3d 725 (4th Cir. 2007).[1]
Resentencing
Blatstein was released in March 2007 after serving his original sentence of one year and one day. But the Fourth Circuit's decision changed things. Judge Williams resentenced him and ordered him to surrender by July 24, 2007, for another year in prison.[11]
His attorney David G. Barger expressed disappointment with the resentencing.[11]
Administrative Actions
Medical License
On or about February 24, 2006, Blatstein surrendered his medical license to the Virginia Board of Medicine due to his felony conviction.[9]
By 2010, he'd gotten it back. Colleagues supported him when he appeared before the local board of medicine, and others encouraged him to pursue reinstatement. He said: "that was something my soul needed, and I will be forever grateful."[3] His Virginia license for Foot and Ankle Medicine and Surgery was active from 1985 to 2023, with records indicating licensure through 2026.[7]
Medicare and Medicaid Exclusion
On November 30, 2006, the Inspector General of the Department of Health and Human Services notified Blatstein that he was excluded from Medicare and other federally funded health care programs. This came under section 1128(a)(3) of the Social Security Act. The reason? A felony conviction related to healthcare fraud. The I.G. imposed a 13-year exclusion based on aggravating factors.[9]
Blatstein requested a hearing before Administrative Law Judge Alfonso J. Montano. In an August 23, 2007 decision, Judge Montano upheld the 13-year exclusion. The ALJ identified four aggravating factors:[9]
- Financial loss to Medicare and state health care programs exceeded $5,000 (total restitution was $272,704.05)
- The acts continued over more than one year (January 1999 to approximately December 2003)
- The sentence included incarceration (originally 12 months and one day, increased to 24 months on resentencing)
- Blatstein faced adverse action by other government agencies on the same circumstances (license surrender and a five-year OPM debarment)
Blatstein argued the 13-year exclusion was excessive. He wanted it reduced to the statutory minimum of five years. The Office of Personnel Management had reduced his suspension from seven years to five years after an in-person hearing on the same facts. But the ALJ said he wasn't bound by OPM's actions and couldn't consider them as mitigating factors.[9]
He offered several mitigating factors: cooperation with government officials, substantial restitution payments that left him "virtually penniless and homeless," time served, voluntary license surrender, and the evolution of his conduct from legitimate efforts to set up an ambulatory surgery center. The ALJ found none of these qualified under the regulatory definition of mitigating factors at 42 C.F.R. § 1001.102(c).[9]
OPM Debarment
On July 18, 2006, the Office of Personnel Management debarred Blatstein for five years based on his felony conviction.[9]
Post-Release Career
Physician Presentence Report Service
Blatstein founded Physician Presentence Report Service, LLC (PPRSUS) in 2011, a prison consulting firm based in the Washington, D.C. metropolitan area.[3][12]
The firm helps defendants prepare for presentence interviews and sentencing hearings. Services include assistance with personal narratives, character letter guidance, release plan development, allocution preparation, and facility placement requests. Blatstein emphasizes proper documentation of clients' medical records in presentence reports. The Bureau of Prisons uses these for medical care and facility placement decisions.[3]
His medical background shapes the firm's focus on BOP healthcare. Medication availability matters. So do Care Level designations and facility selection based on medical needs.[3]
Publications
Blatstein has authored or co-authored several publications on federal criminal defense and prison conditions:
- The Federal Lawyer (January/February 2021): He co-authored "Availability of Treatment and Rehabilitation in Federal Prison: The Critical Role of the Presentence Report" with Fay F. Spence, J.D., E.J. Hurst II, J.D., and Maureen Baird. The article covers medical, mental health, and substance abuse programs in the federal Bureau of Prisons and discusses how the presentence report affects treatment availability for defendants.[4]
- American Bar Association (2022): Co-authored two chapters in "Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers" with Faye Spence, Esq. Chapter 1 addresses "What Is Dementia?" and Chapter 13 covers "Jail and Prison Conditions."[5]
- California Business Journal (2025): Contributed commentary on high-profile federal cases, analyzing Thomas Che Goldstein's tax fraud indictment and George Santos's sentencing.[6]
- Substack: Maintains a newsletter called "White Collar Investigations" covering federal sentencing issues, BOP conditions, and case analysis.[13]
Commentary on High-Profile Cases
He's analyzed several federal cases:
- George Santos: Blatstein examined the former Congressman's case, including commentary on sentencing considerations and acceptance of responsibility issues.[14]
- Thomas Che Goldstein: He analyzed the case of the Supreme Court attorney and SCOTUSblog co-founder who faced tax fraud charges.[6]
Terminology
- Presentence Report (PSR): A U.S. Probation Officer prepares this document following an interview with a defendant. It provides the sentencing judge with information about the defendant's background, criminal history, and offense conduct. The PSR serves as the primary referral document for BOP placement and medical care decisions.[4]
- Allocution: A defendant's statement to the sentencing judge, typically expressing remorse and acceptance of responsibility. Blatstein says allocution should begin with a "well-written narrative" and that failing to allocute is a "huge mistake."[3]
- Care Level: The Bureau of Prisons classification system for inmate medical needs. Care Level I means minimal care, generally healthy inmates under 70. Care Level IV means 24-hour hospital-type care. Inmates are placed in facilities based on their designated care level.[3]
- Federal Medical Center (FMC): One of seven BOP facilities providing specialized medical care. FMC Butner is a cancer center. FMC Carswell is for women only. FMC Devens provides dialysis. FMC Lexington is lower security. FMC Rochester partners with Mayo Clinic. FMC Springfield is higher security.[3]
- Variance: A sentence that deviates from the advisory federal sentencing guidelines range. In Blatstein's original case, Judge Williams imposed a downward variance from 24 months to 12 months and one day, which was later vacated by the Fourth Circuit for procedural error.[1]
- First Step Act: The 2018 federal criminal justice reform law created earned time credits and expanded early release programs. Blatstein writes frequently about FSA implementation issues, including delays in calculating earned time credits and projected release dates.[3]
- RDAP (Residential Drug Abuse Program): A Bureau of Prisons treatment program that can provide eligible inmates with up to one year off their sentence upon successful completion.[3]
- Compassionate Release: A mechanism allowing federal inmates to seek early release based on extraordinary and compelling circumstances, including terminal illness or serious medical conditions that the BOP can't adequately treat.[3]
- Section 1128 Exclusion: The Social Security Act provision under which individuals convicted of healthcare fraud-related felonies are excluded from Medicare and other federally funded health care programs. Mandatory exclusions under section 1128(a)(3) require a minimum five-year period.[9]
- Good Time Credit (GTC): Time off a federal sentence earned by inmates who maintain good behavior, calculated at approximately 54 days per year of the sentence imposed (not time served).[14]
See also
- Prison Consultants
- The Presentence Report (PSR)
- Insurance Fraud
- Federal Sentencing Guidelines and Offense Enhancements
Frequently Asked Questions
Q: Who is Marc Blatstein?
Marc J. Blatstein is an American physician, author, and prison consultant who served approximately two years in federal prison after pleading guilty to mail fraud in 2005. He now runs Physician Presentence Report Service, LLC, helping defendants prepare for federal sentencing.
Q: What did Marc Blatstein do?
Blatstein was convicted of mail fraud for fraudulently billing insurance companies for surgical facility fees through a fictitious entity called the Central Park Ambulatory Surgery Center. The scheme involved billing for facilities that had no physical existence.[1]
Q: How long was Marc Blatstein's prison sentence?
Blatstein was initially sentenced to 12 months and one day, but after the government's successful appeal, he was resentenced and served approximately two years total in federal prison.[1]
Q: What does Marc Blatstein do now?
Blatstein founded Physician Presentence Report Service, LLC (PPRSUS) in 2011, a prison consulting firm that helps defendants prepare for presentence interviews and sentencing hearings, with particular emphasis on medical documentation and facility placement requests.[3]
Q: Was Marc Blatstein's medical license restored?
Yes. Blatstein surrendered his medical license in 2006 following his conviction, but successfully had it reinstated in 2010 after appearing before the Virginia Board of Medicine with colleagues who supported him.[3]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 United States v. Blatstein, 482 F.3d 725 (4th Cir. 2007), https://law.justia.com/cases/federal/appellate-courts/F3/482/725/497343/.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 The Free Lance-Star, "Doctor faces U.S. fraud charges," May 2005, https://fredericksburg.com/local/doctor-faces-u-s-fraud-charges/article_613c3af4-99db-59a8-9af4-029546b19e38.html.
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 Physician Presentence Report Service, "About Dr. Marc Blatstein," https://pprsus.com/about-dr-marc-blatstein/.
- ↑ 4.0 4.1 4.2 Marc Blatstein et al., "Availability of Treatment and Rehabilitation in Federal Prison: The Critical Role of the Presentence Report," The Federal Lawyer, January/February 2021, https://www.pprsus.com/treatment-and-rehabilitation-in-federal-prison-the-critical-role-of-the-presentence-report/.
- ↑ 5.0 5.1 American Bar Association, "Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers," 2022, https://www.americanbar.org/products/inv/book/426832634/.
- ↑ 6.0 6.1 6.2 California Business Journal, "Thomas Che Goldstein's Fall from Grace," February 2025, https://calbizjournal.com/thomas-che-goldsteins-fall-from-grace/.
- ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 Physician Presentence Report Service, "Marc Blatstein," https://pprsus.com/more-about-marc-blatstein/.
- ↑ 8.0 8.1 The Free Lance-Star, "Board punishes podiatrist," 2001, https://fredericksburg.com/board-punishes-podiatrist/article_616319cc-918b-5fca-bbea-4729025e3b44.html.
- ↑ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 Department of Health and Human Services, Departmental Appeals Board, Civil Remedies Division, Decision No. CR1638, Docket No. C-07-245, August 23, 2007, https://www.hhs.gov/sites/default/files/static/dab/decisions/alj-decisions/2007/cr1638.pdf.
- ↑ Podiatry Management Online, "Fredericksburg Podiatrist Sentenced in Billing Scam," 2006, https://www.podiatrym.com/search3.cfm?id=8886.
- ↑ 11.0 11.1 Podiatry Management Online, "VA Podiatrist Ordered to Serve an Additional Year in Prison," 2007, https://www.podiatrym.com/search3.cfm?id=14677.
- ↑ ZoomInfo, "Physician Presentence Report Service," https://www.zoominfo.com/pic/physician-presentence-report-service-llc/404444973.
- ↑ White Collar Investigations Substack, https://whitecollarinvestigations.substack.com/.
- ↑ 14.0 14.1 Physician Presentence Report Service, "George Santos Eventually Chose to Plead Guilty," https://pprsus.com/george-santos-plea-is-he-capable-of-accepting-responsibility/.