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 podiatric physician, author, and prison consultant. He ran a podiatry practice in Fredericksburg, Virginia, for more than three decades. In 2005 he pleaded guilty to one count of mail fraud and served time in federal prison. The charge grew out of a billing scheme. Blatstein had charged insurers surgical-facility fees through an entity called the Central Park Ambulatory Surgery Center. That entity had no physical existence and held no Virginia license.

His sentence was unusual in its path. The trial judge first gave him 12 months and one day. The government appealed. The Fourth Circuit vacated the sentence on procedural grounds and sent the case back. On resentencing, Blatstein drew a 24-month term and returned to prison for a second stretch. He recovered his medical license in 2010. A year later he started Physician Presentence Report Service, LLC, a consulting firm for defendants headed into the federal system. The work draws on two things at once: his medical training and his own time inside the Bureau of Prisons.

Early Life and Education

Blatstein was born in Philadelphia and went to high school in the city. He enrolled at George Washington University in Washington, D.C., and worked part-time jobs to cover the cost. During his third year he took an 11-month break to travel with a friend. The trip ran from Washington, D.C., to Lima, Peru, then by train up to Cusco in the Andes, into the Amazon, and on to other parts of South America. He came back, finished his coursework, and graduated in 1977 with a Bachelor of Arts in psychology.

Podiatry came next. He attended the Ohio College of Podiatric Medicine, now the Kent State University College of Podiatric Medicine, and earned a Doctor of Podiatric Medicine degree in 1983. While in school he ran a side business called Pink Panther Bartenders with his brother and two classmates to help pay tuition. During the same period he was invited to take part in a Cleveland Opera gala.

His clinical training moved through several hospitals. He trained at Lutheran Hospital in Baltimore in 1982, then at Atlanta Hospital and Medical Center in Georgia from 1982 to 1983. He completed a surgical residency in podiatric medicine and surgery at Lawndale Community Hospital in 1984.

Medical Career

Blatstein obtained a Virginia medical license in 1984 and opened a solo podiatry practice near Fredericksburg. His main office sat in a strip mall in the Central Park area. He later opened two more locations in the region. Over the years he widened the practice. He added a medically oriented shoe store, wound-care programs, and physical therapy services.

The Circulator Boot featured heavily in his work. The device was used in lower-extremity wound therapy. It supported bacterial control, blood supply, moisture management, and the removal of dead or damaged tissue.

The Virginia Board of Medicine sanctioned him in 2001. The board fined him $5,000, issued a reprimand, and required additional training in record keeping. The action followed a hearing in Fredericksburg. The underlying issue dated to a 1999 patient he treated for foot pain. He diagnosed a stress fracture. The board found he had not properly treated or documented it, and an orthopedist who examined the patient later determined the fracture was essentially healed. The board also flagged his advertising. Some ads violated regulations. One promoted a "Chinese Treatment" for fungal nails that the board said posed potential health risks. Another used the name of an organization that did not exist, the "Association of American College of Foot and Ankle Surgeons."

Federal Investigation and Prosecution

Investigation

The matter began with a patient. In 2001 she filed a complaint about her bill with the Virginia State Police. Federal investigators picked it up in May 2004. FBI agents out of the Fredericksburg office worked alongside the Department of Health and Human Services, the Office of Personnel Management, and the Virginia State Police. Their suspicion was fraudulent billing of health insurers.

On July 14, 2004, FBI Agent Jeffrey Howard sought search warrants. His affidavit to a magistrate judge asserted probable cause that Blatstein had violated federal statutes covering healthcare fraud (18 U.S.C. § 1347) and mail fraud (18 U.S.C. § 1341).

Agents executed the warrants on July 27, 2004, at his office and his home. They found evidence of the billing scheme. Blatstein has described the day in his own words. A 6 a.m. knock came at his front door, where, he wrote, "a litany of Alphabet Law enforcement agencies greeted" him. Agents arrived at his office around 8 a.m., seized computers, and were accompanied by local board of medicine representatives.

The Billing Scheme

The structure of the fraud was simple. Blatstein billed patients' insurers for outpatient surgical facilities supposedly provided by the Central Park Ambulatory Surgical Center, or CPASC. CPASC had no physical existence. It held no Virginia license.

The mechanics played out over several years:

• In 1997 Blatstein opened his Central Park office. In 1998 he expanded it and added 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 carrying a different address (1285 Carl D. Silver Parkway).
• He directed employees to tell the Government Employees Hospital Association (GEHA) that the surgery center was a separate facility rather than part of his office.
• Patients signed preprinted forms stating they would owe both a facility fee and a surgeon's fee.
• Blatstein handled all paperwork for surgical-facility billing himself. Employees managed billing for other procedures.
• He submitted surgery-center bills to at least six insurers: Mail Handlers Benefit Plan, GEHA, Blue Cross/Blue Shield, Aetna, Humana, and Cigna.

Two former employees gave information to the FBI. The affidavit identifies them as Cooperating Witnesses 1 and 2. CW-1 told investigators that Blatstein billed surgical-facility fees for procedures done at his podiatry office. CW-1 said he had warned Blatstein repeatedly that such fees were not legitimate for procedures performed outside a physically separate facility. CW-1 first learned of CPASC after someone called a telephone line reserved for Blatstein's exclusive use and asked for the Central Park Ambulatory Surgery Center.

One episode stood out in the record. A patient named Lyndon Friend came in to have an ingrown toenail removed. His wife, Katrina Friend, noticed a yellow carbon sheet tucked behind the paperwork her husband was signing. She lifted the top sheet to read what lay underneath. An employee demanded the papers back. She refused. Blatstein then tried to wrestle the documents away from her. She tore them up and left. Later she pieced the fragments together. The top sheet was headed "Dr. Marc Blatstein, LPM, PC." The carbon copy beneath it read "Central Park Ambulatory Surgery Center, Inc."

Indictment and Guilty Plea

A federal grand jury in the Eastern District of Virginia returned an indictment on June 20, 2005. It charged one count of healthcare fraud (18 U.S.C. § 1347) and seven counts of mail fraud (18 U.S.C. § 1341). Each count carried a maximum of 10 years and a $250,000 fine.

The next day, June 21, 2005, Blatstein's attorney, David G. Barger of Williams Mullen, moved to suppress all seized evidence and requested a Franks hearing. Barger argued that his client never intended to defraud anyone and had been falsely accused. He pointed to a provision of Virginia law that exempted doctors performing occasional surgeries in their own offices.

The district court denied the motion on August 25, 2005.

Blatstein entered a conditional guilty plea on October 5, 2005. He pleaded to a single count of mail fraud (18 U.S.C. § 1341) and preserved his right to appeal the denial of his suppression motion. Under the plea agreement, both sides agreed to recommend a sentence at the low end of his 24-to-30-month guidelines range.

The billing figures were laid out in the indictment. Total bills submitted came to $501,736. Blatstein received $272,704 in reimbursements. The indictment acknowledged that he was entitled to professional fees for treating patients. He was not entitled to facility fees, because his surgical room was not a state-licensed, free-standing surgery center.

Sentencing and Appeal

Initial Sentencing

The probation officer filed a presentence report on January 6, 2006. It found no factors that called for a sentence outside the advisory guidelines range. On February 3, 2006, Blatstein filed a sentencing memorandum. He described his restitution efforts and the harm the case had done to his livelihood and his health. He attached letters from friends and family, including his mother and brother. The memorandum did not argue for a sentence below the guidelines range.

U.S. District Judge Richard L. Williams held the sentencing hearing on February 8, 2006. Both sides asked for 24 months, the bottom of the range. Judge Williams went lower. He imposed 12 months and one day. He did so without first telling the parties that he was considering a downward variance, a step Federal Rule of Criminal Procedure 32(h) requires.

The court listed reasons it considered a longer term "counter productive." It cited Blatstein's "early efforts to make amends for his wrong doing." It cited the effect on his health and his profession. It cited "his family." A shorter term, the court added, would "save the United States ... [money] that would be wasted by warehousing him for that period of time."

Judge Williams ordered $272,704 in restitution to Humana, Aetna, Cigna, and the Federal Employees Health Benefits Program. Blatstein was directed to report to a federal facility in Florida by March 14, 2006.

Fourth Circuit Appeal

The government cross-appealed. Its argument was procedural. The sentencing court had imposed a variance without giving reasonable notice. The Fourth Circuit affirmed the denial of the suppression motion. It vacated the sentence and remanded for resentencing consistent with Rule 32.

The appeals court reasoned that the government, given a fair opportunity, could have raised meritorious objections to the grounds for the variance. It noted the government had strong challenges to several of the factors the trial court relied on, among them Blatstein's "early efforts to make amends," the impact on his profession and family, and the projected savings to the federal government.

Judge King wrote the opinion in 2007. 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 had already served the original 12-month-and-one-day term. He was released in March 2007. The Fourth Circuit's ruling reopened the matter. Judge Williams resentenced him and ordered him to surrender by July 24, 2007, for another year behind bars.

His attorney, David G. Barger, said of the resentencing, "Obviously, we're disappointed."

Administrative Actions

Medical License

Blatstein surrendered his Virginia medical license to the state Board of Medicine on or about February 24, 2006, a consequence of his felony conviction.

He recovered it by 2010. Colleagues backed him when he went before the local board of medicine, and others urged him to seek reinstatement. He later described the moment in personal terms: "that was something my soul needed, and I will be forever grateful." According to his firm, his Virginia license for foot and ankle medicine and surgery was active from 1985 to 2023, with records indicating licensure through 2026.

Medicare and Medicaid Exclusion

The HHS Inspector General notified Blatstein on November 30, 2006, that he was excluded from Medicare and other federally funded health care programs. The exclusion came under section 1128(a)(3) of the Social Security Act. The basis was a felony conviction tied to healthcare fraud. The Inspector General set the term at 13 years, citing aggravating factors.

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

• The financial loss to Medicare and state health care programs topped $5,000. Total restitution was $272,704.05.
• The conduct ran for more than a year, from January 1999 to roughly December 2003.
• The sentence included incarceration, originally 12 months and one day and later increased to 24 months on resentencing.
• Other government agencies had taken adverse action on the same facts, including the license surrender and a five-year OPM debarment.

Blatstein called the 13-year exclusion excessive. He wanted it cut to the five-year statutory minimum. He pointed out that the Office of Personnel Management had reduced his suspension from seven years to five after an in-person hearing on the same facts. The ALJ held that he was not bound by OPM's actions and could not treat them as mitigating.

He offered several mitigating points. He cited his cooperation with government officials. He cited substantial restitution payments that, he said, had left him "virtually penniless and homeless." He cited time served, his voluntary license surrender, and what he framed as a good-faith effort to set up an ambulatory surgery center that drifted into criminal conduct. The ALJ found that none of these met the regulatory definition of mitigating factors at 42 C.F.R. § 1001.102(c).

OPM Debarment

The Office of Personnel Management debarred Blatstein for five years on July 18, 2006, based on his felony conviction.

Post-Release Career

Physician Presentence Report Service

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

The firm prepares defendants for presentence interviews and sentencing hearings. Its services cover personal narratives, character-letter guidance, release-plan development, allocution preparation, and facility-placement requests. Blatstein stresses one point in particular: getting a client's medical records documented properly in the presentence report. The Bureau of Prisons leans on those records when it decides medical care and facility placement.

His medical background shapes the firm's emphasis on BOP healthcare. Medication availability matters. So do Care Level designations and facility selection driven by medical need.

Publications

Blatstein has written or co-written several pieces 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 surveys medical, mental health, and substance-abuse programs in the federal Bureau of Prisons. It examines how the presentence report shapes treatment availability for defendants.
• American Bar Association (2022): He co-authored two chapters of "Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers" with Faye Spence, Esq. Chapter 1 addresses "What Is Dementia?" Chapter 13 covers "Jail and Prison Conditions."
• California Business Journal (2025): He contributed commentary on high-profile federal cases, including an analysis of the tax-fraud indictment of attorney Thomas Che Goldstein and of former Congressman George Santos's sentencing.
• Substack: He maintains a newsletter, "White Collar Investigations," covering federal sentencing, BOP conditions, and case analysis.

Commentary on High-Profile Cases

Blatstein has analyzed several federal cases through his firm's site:

• George Santos: He examined the former congressman's case, including sentencing considerations and questions about acceptance of responsibility.
• Thomas Che Goldstein: He analyzed the case of the Supreme Court attorney and SCOTUSblog co-founder who faced tax-fraud charges.

Terminology

• Presentence Report (PSR): A document a U.S. Probation Officer prepares after interviewing a defendant. It gives the sentencing judge background on the defendant's history, criminal record, and offense conduct. It also serves as the primary referral document for BOP placement and medical-care decisions.

• Allocution: A defendant's statement to the sentencing judge, usually expressing remorse and acceptance of responsibility. Blatstein advises that allocution should open with a "well-written narrative" and calls a failure to allocute a "huge mistake."

• Care Level: The Bureau of Prisons classification for inmate medical needs. Care Level I covers generally healthy inmates under 70 who need minimal care. Care Level IV covers inmates needing 24-hour hospital-type care. Placement follows the assigned care level.

• Federal Medical Center (FMC): One of seven BOP facilities providing specialized medical care. FMC Butner functions as a cancer center. FMC Carswell serves women only. FMC Devens provides dialysis. FMC Lexington runs at lower security. FMC Rochester partners with the Mayo Clinic. FMC Springfield runs at higher security.

• Variance: A sentence that departs 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. The Fourth Circuit later vacated it for procedural error.

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

• RDAP (Residential Drug Abuse Program): A Bureau of Prisons treatment program that can take up to one year off the sentence of an eligible inmate who completes it.

• Compassionate Release: A path for federal inmates to seek early release based on extraordinary and compelling circumstances, including terminal illness or serious medical conditions the BOP cannot adequately treat.

• Section 1128 Exclusion: The Social Security Act provision under which people convicted of healthcare-fraud felonies are barred from Medicare and other federally funded health care programs. Mandatory exclusions under section 1128(a)(3) run for at least five years.

• Good Time Credit (GTC): Time taken off a federal sentence for good behavior, calculated at roughly 54 days per year of the sentence imposed rather than 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 podiatric physician, author, and prison consultant. He pleaded guilty to mail fraud in 2005 and served time in federal prison. He now runs Physician Presentence Report Service, LLC, which prepares defendants for federal sentencing.

Q: What did Marc Blatstein do?

Blatstein pleaded guilty to mail fraud. He had billed insurers for surgical-facility fees through a fictitious entity, the Central Park Ambulatory Surgery Center, which had no physical existence and no Virginia license.

Q: How long was Marc Blatstein's prison sentence?

The trial judge first imposed 12 months and one day. After the government's successful appeal, Blatstein was resentenced to 24 months and returned to prison for a second term.

Q: Is Marc Blatstein the same person as Bart Blatstein?

No. Marc J. Blatstein is a podiatric physician and prison consultant who practiced in Fredericksburg, Virginia. He is a separate individual from Bart Blatstein, the Philadelphia real estate developer.

Q: What does Marc Blatstein do now?

Blatstein founded Physician Presentence Report Service, LLC (PPRSUS) in 2011. The firm prepares defendants for presentence interviews and sentencing hearings, with a focus on medical documentation and facility-placement requests.

Q: Was Marc Blatstein's medical license restored?

Yes. He surrendered his Virginia medical license in 2006 after his conviction. He had it reinstated in 2010 after appearing before the Virginia Board of Medicine with the support of colleagues.