Yellow Pages

Ohio D.C. Pleads Guilty to Medicare Fraud

Yellow Pages
Written by TAC Staff: Yellow Pages
Sunday, 25 November 2012 22:09
AKRON,OH — A Medina chiropractor has pleaded guilty to defrauding Medicare and insurance companies of more than $1.8 million. Dr. John N. Heary, 38, was accused of submitting fraudulent bills to Medicare, Anthem Blue Cross and Blue Shield, Medical Mutual of Ohio and the Ohio Bureau of Worker’s Compensation, according to the U.S. Attorney’s Office, Northern District of Ohio. Heary pleaded guilty Friday to seven counts of health care fraud. District Judge David D. Dowd Jr. allowed Heary to remain free on bond until his sentencing, scheduled for April 22. He could receive a maximum of 10 years in prison, and he likely will lose his medical license, said U.S. Attorney’s Office spokesman Mike Tobin. Heary was charged with 38 counts of health care fraud, nine counts of mail fraud and eight counts of paying illegal kickbacks. Tobin said 31 counts of health care fraud and all other counts were dropped as part of a plea bargain. The attorney’s office accused Heary of providing patients with medical treatments that were unnecessary to their health or were more expensive than required. Medicare and insurance companies reimbursed Heary more than $800,000, which he was ordered to repay, according to the U.S. Attorney’s Office. Heary operated out of his office at 433 W. Liberty St. He last resided in Westfield Township Source: The Medina County Gazzette Add new comment

CHARLESTON, WV. A new report says West Virginia needs to regulate chiropractors, but questions the performance of the agency assigned that task.

Lawmakers were told Tuesday that the Board of Chiropractic has failed to notify licensees about complaints pending against them. The people who file complaints have been left in the dark as well.

The report to House-Senate interim committees also said the board failed to discipline one chiropractor found to have violated professional standards.

The legislative auditors raise specific concerns about the board's handling of two recent cases. In one, it renewed the license of a chiropractor indicted on federal health care fraud charges.

The other involved a chiropractor who obtained 31 pain pill prescriptions from four different providers. The board contacted federal authorities, but took no internal actions.

A Matawan, N.J., chiropractor was indicted for allegedly stealing more than $13,000 by submitting numerous fraudulent claims to Horizon Blue Cross Blue Shield.

Charles Boas, 64, was charged with 60 counts of second-degree health care claims fraud and one count of third-degree theft by deception, according to the New Jersey Attorney General’s Office.

Between Oct. 9, 2006 and Aug. 13, 2009, Boas, who worked as a chiropractor in Bayonne, N.J., alleged submitted 60 fraudulent claims to Horizon Blue Cross Blue Shield for chiropractic services that he did not perform.

An investigation by the New Jersey Office of the Insurance Fraud Prosecutor determined that Boas allegedly made false statements and submitted false claims and that he allegedly requested that his patients identify family members and then he submitted fraudulent claims for purportedly treating those family members.

He allegedly received $13,626 from Horizon Blue Cross Blue Shield to which he was not entitled.

BLOOMINGTON, IN - 51-year-old Dennis Faulkner, the office manager at Faulkner Chiropractic and Acupuncture in Bloomington was arrested after police say he was wiring money from erroneous credit cards lines made in clients’ names. According to Bloomington Detective Christopher, Faulkner turned himself into police last week. According to police the business has a policy in place where a client may establish a line of credit where sessions could be charged. The activity never shows on the client's statements and no interest would accumulate as long as clients made the minimum payment. Police say Faulkner allegedly would create the fake accounts, rake in the cash and make the minimum payment. Police say Faulkner established a total of 48 credit lines, accumulating to $210,800 and made $43,000 in payments. At the time of the arrest, he had an outstanding balance of more than $167,000.

When questioned by police, Faulkner said his wife, the chiropractor of the practice, had no knowledge of the operation He also said the reason he began the operation was to supplement the cash flow of the business because of personal and financial difficulties. An anonymous caller tipped off the investigation back in early April after the credit company Care Credit contacted Bloomington police.

San Francisco, CA- A Phoenix woman will be serving time and paying fines after being found guilty of defrauding a health and life insurance company of almost $690,000. After making fake chiropractic claims, forty two year old Esther Obrzut is facing not only prison time and probation, but hefty restitution as well.

According to an announcement from Arizona Attorney General Tom Horne, Obrzut was sentenced to two and a half years in prison for forgery, and an additional five years for fraudulent schemes and artifices. She was also ordered to pay the Cigna Health and Life Insurance Company $650,000 in restitution.

According to the prosecutors, Obrzut billed the company over a million dollars for nearly forty-five hundred chiropractic treatments for herself, her two minor children, and her husband between the months of May of 2003 and February of 2011. Although the company paid out almost $685,000, the Arizona Department of Insurance Investigators determined that the family never received those treatments.

“Medical insurance fraud is a significant crime because it drains resources that insurers need to make sure that people who are truly sick get the treatment they need,” said Attorney General Tom Horne. He added, “My office is committed to vigorous prosecution of fraud and I am very pleased to see that the perpetrator in this case will not only pay restitution, but will spend time behind bars.”