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Mother Faces Prison Time, Probation & Fines for Chiropractic Fraud
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Written by TAC Staff: Yellow Pages   
Tuesday, 23 October 2012 21:55
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.”
British Physiotherapists and Podiatrists Become the First in World to Prescribe Medicines to Their Patients
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Written by TAC Staff: Yellow Pages   
Monday, 03 September 2012 23:58
UNITED KINGDOM--New legislation means they will no longer have to refer patients back to a General Physician (GP) or other healthcare workers if medications such as painkillers and anti-inflammatories are needed, the Department of Health (DH) said.  A DH spokesman said 'advanced practitioner' physiotherapists and podiatrists in the UK would be the first in the world to be able to independently prescribe medicines where 'clinically appropriate'.
Under the new legislation, physiotherapists will be able to prescribe medicines for issues such as chronic pain and respiratory diseases like asthma.  Podiatrists, who treat disorders of the foot, ankle and lower leg, will also be able to prescribe medication for their patients. The College of Podiatry said the move will particularly benefit diabetic patients with infections of the feet and people suffering from other infections such as wounds and ingrown toenails and fungal infections.  Health minister Lord Howe said: 'Physiotherapists and podiatrists are highly trained clinicians who play a vital role in ensuring patients receive integrated care that helps them recover after treatment or manage a long-term condition successfully.
Health Minister Lord Howe hopes the changes mean patients can get medicines more easily
'By introducing these changes, we aim to make the best use of their skills and allow patients to benefit from a faster and more effective service.' The Chartered Society of Physiotherapy (CSP) welcomed the move, saying it will mean that patients are offered quicker and more direct access to the medicines and treatment they need.
CSP chair Dr Helena Johnson said: 'Giving physiotherapists the opportunity to prescribe independently will hugely improve the care we can provide in the future.
'Patients will now receive a more streamlined and efficient service, meaning they get the medicines they need more immediately. 'An unnecessary burden will be removed from doctors, with physiotherapists taking full responsibility and accountability for the prescribing decisions they make.

'For patients, the chance of faster relief from pain or other symptoms will also mean many can benefit more quickly from their physiotherapy treatment.'
Alison Wishart, chair of the Society of Chiropodists and Podiatrists, said: 'Independent prescribing provides podiatrists with the opportunity to deliver more flexible services for patients - ensuring timely access to medicines, care closer to home and enabling innovation.'
The new legislation is expected to come into effect in April next year, with the first intake of podiatrists and physiotherapists to go into Health Professions Council-approved education programmes in autumn.
Source: Daily Mail
Chiropractor Faces 125 Fraud Counts
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Written by TAC Staff: Yellow Pages   
Monday, 03 September 2012 23:55
PATERSON, NJ--A chiropractor with offices in Paterson and Jersey City has been charged with 125 counts of insurance fraud for allegedly faking the claims of car accident victims so that they would appear to need continued care, the state attorney general said Tuesday.
Joseph Salomone, 44, a resident of Nutley who owned the Pain and Injury Center of North Jersey on Broadway in Paterson, allegedly stole more than $89,000 by filing false documentation to insurance companies.
He allegedly "kept the patients coming for months and months of chiropractic care by falsifying the results of examinations so that they always supported continued treatment — and continued billing," said Attorney General Jeffrey S. Chiesa. The case was brought by Ron Chillemi, the acting insurance fraud prosecutor for the state.
Besides the Paterson office, Salomone is president of Salomone Chiropractic in Jersey City and had run the now-defunct Pain Relief Health Center of New Jersey in East Orange, the Attorney General's Office said.

The indictment by a state grand jury said that between Aug. 16, 2007, and June 4, 2011, Salomone asked his office workers to fill in forms about the range-of-motion tests of 37 patients who were car accident victims with information that didn't come from actual assessments of the patients. Eleven of the patients were treated at the Paterson office, 14 in Jersey City and 12 in East Orange.
This fraudulent documentation was then submitted to Allstate Insurance Co., High Point Insurance Co., Liberty Mutual Insurance Co., New Jersey Manufacturer's Insurance Co. and United States Automobile Association as part of the billing process, the indictment alleges. Through this fraud, the indictment said, Salomone sought nearly $200,000 in reimbursements and received $89,283.
The maximum sentence for each second-degree crime is 10 years in state prison and a fine of up to $150,000. Salomone remains licensed as a chiropractor, a spokesman for the state Board of Chiropractic Examiners said.
Source:  The Record
Dallas Humble Pleads Guilty to Conspiracy and Distribution of Chinese HGH
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Written by TAC Staff: Yellow Pages   
Thursday, 30 August 2012 02:41
MONROE, LA. -- Dallas Humble, a chiropractor, and former practice manager plead guilty to conspiracy against the federal government and illegal distribution of the human growth hormone in the Federal Court building located in Schreveport, Louisiana, Wednesday, July 25th .  The plea deal included admitting guilt to 2 of 22 counts of federal law violations. "According to all the evidence that we saw, he was involved in ordering and also paying for the prescription managing." said Bob Noel, attorney for Dallas Humble.
The plea deal put an end to a week-long trial looking into Humble's role in illegal human growth hormone (HGH) purchases from China, along with two others, Doctor Linda Bunch and businessman Paul Temple, who both entered plea deals in 2010. The federal government says a clinic owned by Humble gave patients the drug for anti-aging reasons and other unapproved purposes.  The patients were never told the drugs were illegally imported from China. Noel insists only Dr. Bunch administered the drugs. "Mr. Humble has always held himself as a solid citizen, someone who conducts himself in an honorable fashion, and he is accepting responsibility for his actions. We're going to go forward from here." said Noel.
Now Humble must forfeit his property on Cypress Street to the government and along with Dr. Bunch he must also give back the money he earned from HGH sales, which totals over $500,000.00. Humble will be sentenced on December 6 of this year, he face up to 10 years in jail and hundreds of thousands of fines for charge 1 and 5.
Source: KNOE 8 News
State Farm Insurance on Trial for Inflammatory Accusations Against Chiropractor
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Written by TAC Staff: Yellow Pages   
Thursday, 30 August 2012 02:31
PA - A Pennsylvania chiropractor can proceed with a claim that State Farm Insurance defamed him in an attempt to ruin his business, a federal judge ruled. Peter Schatzberg, who has a doctorate in chiropractic, says State Farm arbitrarily began characterizing all soft-tissue injury claims as fraudulent, as part of its practice to treat "the entire chiropractic industry as fraudulent as well."
"If a claimant is a minority, an immigrant, or from a poor urban area, State Farm automatically looks on their claims as potentially fraudulent," according to the complaint Schatzberg filed in 2010.
The lawsuit claimed that State Farm defamed Schatzberg in letters to his office and to his attorney, accusing him of "professional impropriety," merely because he is a chiropractor who treats soft-tissue injuries.
State Farm falsely accused Schatzberg of having engaged in fraudulent business activity, created a false perception in the community that he engaged in professional impropriety, and engaged in a pattern of racketeering activity, according to the complaint. Through its Advancing Claims Excellence program, the insurer systematically paid significantly less than the legally required amount for treatment that Schatzberg provided to individuals insured by State farm insured, he said.
That program allegedly operated with help from a special investigations unit and outside counsel. Schatzberg claimed that Doug Babin, one of the adjusters with State Farm's special investigations unit, called current and former employees of the chiropractic practice, identified himself as a "fraud investigator," and asked about Schatzberg's billing practices in an "aggressive tone."
State Farm fired back that Schatzberg had failed to adequately state a claim, and said the entire case should be dismissed for lack of federal jurisdiction. But U.S. District Judge Gene E.K. Pratter said the allegations about Babin could support the defamation claim.
"While the court appreciates State Farm's argument that Mr. Babin's statements were made in the course of satisfying State farm's statutory mandate that, as a motor vehicle insurer, it maintain a motor vehicle insurance antifraud plan, based on the facts alleged, Mr. Babin's statements, coupled with his allegedly 'aggressive tone,' could lead one to believe ... that State Farm possessed facts or information that Dr. Schatzberg was engaging in or had engaged in fraudulent billing practices or criminal conduct," the decision states.
The letters sent to Schatzberg and his attorneys also support defamation allegations, Pratter found, despite noting that one of the implicated letter was just "barely" defamatory. Schatzberg did fail, however, to substantiate his claims of false light or invasion of privacy. The complaint makes no mention of a claim that State Farm published any of its investigators' alleged statements in a newspaper, periodical or other sort of publicly circulated medium, according to the decision. 

"Rather Dr. Schatzberg's claim centers on two primary contentions: (1) State farm spread false information about Dr. Schatzberg to particular individuals in the medical and legal communities via letter and phone call, and (2) State Farm deployed [ ] Goldberg in litigation for the purpose of sending a false message to the legal community that Dr. Schatzberg was engaged in wrongdoing," Pratter wrote. "Neither of these actions on the part of State Farm constitutes publicity for the purpose of a false light invasion of privacy action."
Schatzberg's RICO claim also failed to meet the bar, and Pratter refused to exercise supplemental jurisdiction over the state-law claims. 

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