HAMMOND, Ind. — A former Indiana surgeon arrested on a snowy Italian mountainside after five years on the run was handed a stiff prison term Friday for billing insurers and patients for procedures he didn't perform, with the federal judge saying he used patients like an ATM machine.

Mark Weinberger was given a seven-year prison term, nearly double the recommendation under federal sentencing guidelines. U.S. District Judge Philip Simon said the more severe sentence was necessary because Weinberger – who disappeared just before he was charged – left a web of lawsuits, 401(k) problems for his 40 employees and health issues for patients at his nose and sinus clinic.

"The fallout from this is enormous," the judge said, noting that hundreds of patients couldn't access their medical records after Weinberger fled while vacationing in Greece.

"I am very certain he knew at the time his world was collapsing around him," Simon said. "Instead of addressing this collapsing, he fled from it."

Simon also said Weinberger ran his medical office like a "factory," saying he moved patients through in volume so he could earn more than $30 million in the three years before he fled.

The judge sentenced Weinberger nearly 18 months after rejecting a plea deal that called for a four-year prison sentence, saying he wasn't confident it took into account the magnitude of the crimes.

Weinberger pleaded guilty in July to 22 counts of health care fraud under a plea deal that called for no more than of 10 years in prison. However, normal recommended sentencing guidelines called for between three and four years in prison.

Weinberger's attorney initially asked that his client be sentenced to time served, but he changed his request during Friday's hearing to a four-year sentence. He said Weinberger had been a model inmate, volunteered as a cook and tutor for other inmates trying to earn their GEDs. He also started an inmate yoga program at the Chicago prison where he's being held and is running an anger management program.

Weinberger, dressed in an orange jumpsuit and his hair in a bun in the back – a sharp contrast to the shaved head at an earlier hearing in April 2011 – rocked in his chair with his hands to his mouth when Simon handed down the sentence. The shackles around Weinberger's feet clanked against his chair sporadically throughout the hearing.

He apologized earlier during Friday's hearing, saying he had no explanation.

"I'm sorry. I lied. I stole. I betrayed a sacred trust. I have no excuse. There is no excuse. I am sorry," Weinberger said.

He said he let many people down, listing his family, colleagues, employees, friends and patients, saying he wished he could make it up to them.

"The best I can do is spend every minute trying to redeem myself," he said. "Is redemption possible? I don't know. But please, your honor, let me try."

Several of his victims said they were satisfied with the sentence.

"It was all right," said Bill Boyer, of Gary, who won a $300,000 medical malpractice judgment against Weinberger but hasn't received any money because the case is being appealed. "I would have preferred 10, but I'll take seven."

Peggy Hood of Valparaiso, the sister of Phyllis Barnes, a patient Weinberger treated for sinus problems but didn't diagnose the advanced throat cancer that killed her, said she was pleased with the judge's decision.

"No sentence would be long enough to satisfy me or the rest of her family. But it turned out better than we hoped," she said.

Weinberger has already spent nearly three years behind bars. He was arrested in December 2009 arrest in Italy on a snowy mountainside where authorities said he had been living in a tent. He stabbed himself in the neck while being taken into custody and spent time recovering in a hospital before being returned to the U.S.

His attorney, Visvaldis Kupsis, said the sentence was fair. Kupsis' had argued the case as one of simple theft that had been blown up by the press.

"The judge took a lot of things into consideration. I was hoping he was going to give him less time. But I understand the logic behind it," he said.

Kupsis said Weinberger was "not displeased" by the sentence.

"He was hoping he was going to get less. But he was not displeased," he said.

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