Marc Blatstein

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 approximately two years in federal prison after pleading guilty to mail fraud in 2005. A former podiatrist who operated a solo practice in Fredericksburg, Virginia for over 30 years, Blatstein was convicted of fraudulently billing insurance companies for surgical facility fees through a fictitious entity called the Central Park Ambulatory Surgery Center. Following his release, Blatstein had his medical license reinstated in 2010 and founded Physician Presentence Report Service, LLC in 2011, becoming one of the few prison consultants with both medical credentials and personal experience in the federal Bureau of Prisons.

Summary

Dr. Marc Blatstein is a physician and prison consultant who works with white-collar defendants facing federal sentencing. His company, Physician Presentence Report Service (PPRSUS), specializes in preparing clients for their presentence interviews and sentencing hearings, with particular emphasis on medical documentation and facility placement requests.

Blatstein's background includes over 30 years of medical practice and personal experience in the federal prison system. His consulting work focuses on ensuring that defendants' medical records are properly documented in their presentence reports, which serve as the primary referral document for BOP medical care and facility placement.

His publications include co-authored chapters in an American Bar Association book on representing people with dementia, and articles in The Federal Lawyer addressing the availability of treatment and rehabilitation in federal prison. He has also contributed commentary to the California Business Journal on high-profile federal cases including those of former Congressman George Santos and attorney Thomas Che Goldstein.

Background

Early Life and Education

Marc Blatstein was born in Philadelphia, Pennsylvania, where he attended high school. He later attended George Washington University in Washington, D.C., where he worked part-time jobs to help offset the high costs of a college education. During his third year at GWU, he took an 11-month break to travel with a friend from Washington, D.C. to Lima, Peru, with side trips by train to Cusco in the Peruvian Andes, the Amazon, and other locations throughout South America. Upon returning, he completed his degree and graduated with a Bachelor of Arts in Psychology in 1977.

Blatstein attended the Ohio College of Podiatric Medicine (now Kent State University College of Podiatric Medicine) for his medical training, earning his Doctor of Podiatric Medicine degree in 1983. While studying there, he started "Pink Panther Bartenders" with his brother and two classmates as a side business to help cover the costs of higher education. He was also asked to participate in a gala for the Cleveland Opera during this time.

His clinical training included externships at Lutheran Hospital in Baltimore, Maryland (1982) and Atlanta Hospital & Medical Center in Atlanta, Georgia (1982-1983). He completed his surgical residency in Podiatric Medicine and Surgery at Lawndale Community Hospital in 1984.

Medical Career

Blatstein received his Virginia medical license in 1984 and began practicing as a solo podiatrist in the Fredericksburg area. He operated his primary practice from a strip mall location in Central Park, eventually expanding his services to three locations in the Fredericksburg area. Over the course of his career, he incorporated a medically oriented shoe store, wound care programs, and physical therapy services into his practice.

A significant part of his practice involved the use of The Circulator Boot, a treatment device used for lower extremity wound therapy that helps with bacterial control, increased blood supply, moisture management, and removal of dead or damaged tissues.

In 2001, Blatstein was fined $5,000, reprimanded, and ordered to take additional training in record keeping by the Virginia Board of Medicine following a hearing in Fredericksburg. The charges stemmed from his treatment of a patient for foot pain in 1999, in which he diagnosed a stress fracture and allegedly failed to properly treat or document the case. The patient later sought a second opinion from an orthopedist who determined the fracture was essentially healed. The board also found that some of his advertisements violated regulations and that certain treatments he advertised posed potential health dangers. Specific concerns included a "Chinese Treatment" for fungal nails and the use of a non-existent organization name, "Association of American College of Foot and Ankle Surgeons," in his advertisements.

Federal Investigation and Prosecution

Investigation

In 2001, one of Blatstein's patients filed a complaint with the Virginia State Police about her bill, initiating what would become a multi-year investigation. In May 2004, federal law enforcement officials, including agents from the FBI's Fredericksburg office, the U.S. Department of Health and Human Services, the U.S. Office of Personnel Management, and Virginia State Police, began formally investigating Blatstein's practice based on suspicion that he was fraudulently billing patients' health insurers.

On July 14, 2004, FBI Agent Jeffrey Howard sought search warrants for Blatstein's office and residence. The agent submitted an affidavit to a United States magistrate judge asserting probable cause to believe Blatstein had violated federal statutes prohibiting health care fraud (18 U.S.C. § 1347) and mail fraud (18 U.S.C. § 1341).

On July 27, 2004, federal authorities executed the search warrants, searching Blatstein's office and residence and discovering evidence of his billing scheme. According to Blatstein's own account, he responded one morning to 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 representatives from the local board of medicine.

The Billing Scheme

According to the federal investigation, Blatstein had billed his patients' insurers for the use of outpatient surgical facilities provided by an entity called the Central Park Ambulatory Surgical Center (CPASC), which had no physical existence and was not known to or licensed by the Commonwealth of Virginia.

The scheme operated as follows:

• In 1997, Blatstein opened his Central Park office and expanded it the following year 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 identification number for the surgery center, a separate telephone line, and a post office box at a Parcel Plus store near his office with a separate address (1285 Carl D. Silver Parkway).
• He instructed 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.
• He had patients sign preprinted forms stating they would be responsible for both a facility fee and a surgeon's fee.
• He personally completed all paperwork relating to surgical facility billing, while his employees handled billing for other procedures.
• 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.

Information in the FBI affidavit came from two former employees of Blatstein, designated as Cooperating Witnesses 1 and 2. CW-1 advised investigators that Blatstein billed surgical facility fees for procedures performed at his podiatry office despite repeated warnings that he could not legitimately charge such fees for procedures not performed at a physically separate facility. CW-1 first learned of CPASC not from Blatstein, but from someone who called a telephone line reserved for Blatstein's exclusive use and asked for the Central Park Ambulatory Surgery Center.

A particularly notable incident involved patient Lyndon Friend, for whom Blatstein had removed an ingrown toenail. Mr. Friend's wife, Katrina Friend, noticed a yellow carbon sheet behind paperwork her husband was signing. When she lifted the top sheet to see the carbon, a Blatstein employee demanded the paperwork back. Mrs. Friend refused, and when Blatstein himself attempted to physically wrestle the documents away from her, she ripped the paper into pieces and left the office with them. She later pieced together the torn documents and realized the top sheet bore the heading "Dr. Marc Blatstein, LPM, PC," while the carbon was headed "Central Park Ambulatory Surgery Center, Inc."

Indictment and Guilty Plea

On June 20, 2005, a federal grand jury in Virginia's Eastern District indicted Blatstein on one count of health care fraud (18 U.S.C. § 1347) and seven counts of mail fraud (18 U.S.C. § 1341). He faced a maximum penalty of 10 years in prison and a $250,000 fine for each count.

The next day, June 21, 2005, Blatstein moved to suppress all evidence seized in the searches of his business and residence and requested a Franks hearing to address his suppression contention. His attorney, David G. Barger of Williams Mullen, argued that Blatstein was falsely accused and did not intend to defraud anyone, noting that Virginia state law included an exemption for doctors who perform occasional surgeries in their offices.

On August 25, 2005, the district court issued an order denying Blatstein's motion to suppress and his request for a Franks hearing.

On October 5, 2005, Blatstein entered a conditional guilty plea to one count of mail fraud in contravention of 18 U.S.C. § 1341, reserving his right to appeal the court's denial of his suppression motion. The plea agreement between Blatstein and the prosecution provided that they would jointly recommend a sentence at the low end of his 24-30 month guidelines range.

The indictment alleged that the total bills submitted totaled $501,736, from which Blatstein received reimbursements of $272,704. The indictment acknowledged that Blatstein was entitled to professional fees for his treatment of patients but claimed he was not entitled to facility fees since his surgical room was not a state-licensed, free-standing surgery center.

Sentencing and Appeal

Initial Sentencing

On January 6, 2006, the probation officer submitted a presentence report to the district court advising that there were no factors that would warrant a sentence outside Blatstein's advisory guidelines range. On February 3, 2006, Blatstein filed a sentencing memorandum addressing his efforts to make restitution and the harm to his livelihood and health that had resulted from his misconduct and prosecution. Attached were letters from friends and family members, including his mother and brother, expressing concern over his situation. Significantly, the memorandum did not suggest that any of his circumstances called for a sentence outside his advisory guidelines range.

On February 8, 2006, U.S. District Court Judge Richard L. Williams conducted Blatstein's sentencing hearing. Pursuant to the plea agreement, both parties recommended that Blatstein be sentenced to 24 months' imprisonment, the bottom of his guidelines range. However, Judge Williams varied downward, sentencing Blatstein to a prison term of 12 months and one day—despite having failed to notify the parties of a possible downward variance as required by Federal Rule of Criminal Procedure 32(h).

In imposing the sentence, the court listed several reasons the longer term would be "counter productive": Blatstein's "early efforts to make amends for his wrong doing"; the effect of his offense on his health and profession; "his family"; and the fact that a shorter prison term would "save the United States... [money] that would be wasted by warehousing him for that period of time."

Judge Williams also ordered Blatstein to pay restitution of $272,704 to Humana, Aetna, Cigna, and the Federal Employees Health Benefits Program. Blatstein was ordered to report to a federal penitentiary in Florida by March 14, 2006, to begin serving his term.

Fourth Circuit Appeal

The government cross-appealed Blatstein's sentence, contending that the sentencing court erred in imposing a variance sentence without providing reasonable notice of its intent to do so. On appeal, the Fourth Circuit affirmed the denial of Blatstein's suppression motion but vacated his sentence and remanded for resentencing proceedings consistent with Rule 32.

The court found that the government, given a fair opportunity to prepare, could have raised meritorious objections to the grounds on which the court varied. The government presented forceful challenges to several of the factors on which the court relied in varying downward, including Blatstein's "early efforts to make amends," the impact on his profession and family, and the possible savings to the federal government from shortening his prison time.

The Fourth Circuit opinion, issued in 2007, was written by Judge King, in which Judge Michael and Senior Judge Hamilton concurred. The decision is reported as United States v. Blatstein, 482 F.3d 725 (4th Cir. 2007).

Resentencing

Blatstein was released from federal prison in March 2007 after serving his original sentence of one year and one day. However, following the Fourth Circuit's decision vacating his sentence, he was resentenced by Judge Williams and ordered to surrender to federal authorities by July 24, 2007, to begin another prison term of one year.

His attorney, David G. Barger, expressed disappointment with the resentencing decision.

Administrative Actions

Medical License

On or about February 24, 2006, Blatstein surrendered his medical license to the Virginia Board of Medicine as a result of his felony conviction.

By 2010, however, Blatstein successfully had his medical license reinstated. He has credited colleagues who supported him as he appeared before the local board of medicine, as well as those who encouraged him to pursue reinstatement, stating "that was something my soul needed, and I will be forever grateful." His Virginia license for Foot and Ankle Medicine and Surgery was active from 1985 to 2023, and records indicate licensure through 2026.

Medicare and Medicaid Exclusion

On November 30, 2006, the Inspector General of the Department of Health and Human Services notified Blatstein that he was being excluded from participating in Medicare and other federally funded health care programs pursuant to section 1128(a)(3) of the Social Security Act. The basis for exclusion was his felony conviction related to fraud in connection with the delivery of health care services. The I.G. imposed a 13-year exclusion based on the presence of aggravating factors.

Blatstein requested a hearing, which was held before Administrative Law Judge Alfonso J. Montano. In a decision dated August 23, 2007, Judge Montano sustained the 13-year exclusion. The ALJ found four aggravating factors:

• The acts resulted in a financial loss to Medicare and state health care programs exceeding $5,000 (total restitution of $272,704.05);
• The acts were committed over a period of 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 was subject to adverse action by other government agencies based on the same circumstances (surrender of medical license and five-year OPM debarment).

Blatstein argued that the 13-year exclusion was excessive and should be reduced to the statutory minimum of five years, noting that the Office of Personnel Management had reduced his suspension from seven years to five years after an in-person hearing on the same facts. However, the ALJ determined that he was not bound by OPM's actions and could not consider them as mitigating factors.

Blatstein offered several mitigating factors, including cooperation with government officials, substantial restitution payments that left him "virtually penniless and homeless," his actual time served, his voluntary license surrender, and the evolution of his conduct from legitimate efforts to set up an ambulatory surgery center. The ALJ found that none of these factors qualified under the regulatory definition of mitigating factors at 42 C.F.R. § 1001.102(c).

OPM Debarment

On July 18, 2006, the Office of Personnel Management debarred Blatstein for a five-year period based on his felony conviction.

Post-Release Career

Physician Presentence Report Service

In 2011, Blatstein founded Physician Presentence Report Service, LLC (PPRSUS), a prison consulting firm based in the Washington, D.C. metropolitan area.

The firm focuses on preparing defendants 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, which the Bureau of Prisons uses for medical care and facility placement decisions.

His medical background informs the firm's focus on BOP healthcare issues, including medication availability (on-formulary vs. non-formulary drugs), Care Level designations, and facility selection based on medical needs.

Publications

Blatstein has authored or co-authored several publications related to federal criminal defense and prison conditions:

• The Federal Lawyer (January/February 2021): Co-authored with Fay F. Spence, J.D., E.J. Hurst II, J.D., and Maureen Baird, the article "Availability of Treatment and Rehabilitation in Federal Prison: The Critical Role of the Presentence Report" addresses medical, mental health, and substance abuse programs in the federal Bureau of Prisons. The article discusses how the presentence report affects treatment availability for defendants.
• 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."
• California Business Journal (2025): Contributed commentary on high-profile federal cases, including analysis of Thomas Che Goldstein's tax fraud indictment and George Santos's sentencing.
• Substack: Maintains a newsletter called "White Collar Investigations" covering federal sentencing issues, BOP conditions, and case analysis.

Commentary on High-Profile Cases

Blatstein has provided commentary on several federal cases:

• George Santos: Analyzed the former Congressman's case, including commentary on sentencing considerations and acceptance of responsibility issues.
• Thomas Che Goldstein: Analyzed the case of the Supreme Court attorney and SCOTUSblog co-founder who faced tax fraud charges.

Terminology

• Presentence Report (PSR): A document prepared by a U.S. Probation Officer following an interview with a defendant, which 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.

• Allocution: A defendant's statement to the sentencing judge, typically expressing remorse and acceptance of responsibility. Blatstein emphasizes that allocution should begin with a "well-written narrative" and that failing to allocute is a "huge mistake."

• Care Level: The Bureau of Prisons classification system for inmate medical needs, ranging from Care Level I (minimal care, generally healthy inmates under 70) to Care Level IV (24/7 hospital-type care). Inmates are placed in facilities based on their designated care level.

• Federal Medical Center (FMC): One of seven BOP facilities providing specialized medical care, including FMC Butner (cancer center), FMC Carswell (women only), FMC Devens (dialysis), FMC Lexington (lower security), FMC Rochester (Mayo Clinic partnership), and FMC Springfield (higher security).

• 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.

• First Step Act: The 2018 federal criminal justice reform law that created earned time credits and expanded early release programs. Blatstein frequently writes about FSA implementation issues, including delays in calculating earned time credits and projected release dates.

• 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.

• Compassionate Release: A mechanism by which federal inmates may seek early release based on extraordinary and compelling circumstances, including terminal illness or serious medical conditions that the BOP cannot adequately treat.

• Section 1128 Exclusion: The provision of the Social Security Act under which individuals convicted of health care fraud-related felonies are excluded from participating in Medicare and other federally funded health care programs. Mandatory exclusions under section 1128(a)(3) require a minimum five-year period.

• 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).

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.

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.

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.

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.