Written by TAC Staff: Yellow Pages
Monday, 04 June 2007 15:04
TAC Publisher Pleads Guilty to sale of Unregistered Security
ALABAMA: Dr. Richard E. Busch, Jr., pleaded guilty on May 30 to one count of conspiracy to sell unregistered securities in the state of Alabama.
Richard E. Busch Jr., of the Republic of Panama, acknowledged before a U.S. District Judge that he participated in the conspiracy. "Apparently, I did," he said. "It’s been a long time."
Busch was one of the directors and the chief trader of The Millennium Fund, a Belizean investment fund created in 1996 to offer investors the opportunity to take advantage of the fluctuations inherent in the markets.
Under the "conspiracy" charge, Dr. Busch is guilty by law of the "sale of unregistered securities" since he and his then partner, John R. La Tourette Jr. of Costa Rica, contracted a marketing firm in the Republic of Panama, who then subcontracted an Alabama-resident to promote the fund. Busch’s attorney, Tommy Spina states "had these securities been registered, there never would have been a crime committed".
Others involved in this case were William Amos Jr. and Commercial Business Trading Corp., Alablama businessman James Michael Hanks, former Alabama quarterback Brian Burgdorf, and Stephen Bowden of Alabama. Hanks, Burgdorf and Bowden pleaded guilty earlier to their roles in the offense. Each received probation and was ordered to pay restitution.
Busch, has been held in federal custody since his March arrest in Panama by the FBI. Adjudication in this matter should be within the next six weeks and The American Chiropractor staffs hopes to have its publisher back soon.
The Birmingham News & TAC
Connecticut Makes Chiropractors’
Malpractice Records Public
CONNECTICUT: On May 12, the Connecticut House of Representatives unanimously approved legislation which would—for the first time in Connecticut—make chiropractor malpractice records public information. This follows the unanimous approval by the state Senate on April 11th. The bill now goes to the desk of Governor M. Jodi Rell for her signature. The bill would require insurance companies to inform the state insurance commissioner whenever there has been a settled malpractice claim so that the information can be published for the public to make informed decisions about picking a chiropractor, just as been the case for years regarding medical doctors.
"We are delighted that legislators agree the people of our state have a right to make informed decisions about their health care," said Janet Levy, president of Victims of Chiropractic Abuse.
Chiropractor Wins the PWHF
Senator Hugh Farley Award
NEW JERSEY: The Professional Wrestling Hall of Fame and Museum (PWHF) presented Dr. William "Billy" Darnell with the Senator Hugh Farley Award at the PWHF’s Sixth Annual Induction Weekend held in Amsterdam, New York on May 18-19, 2007. The Farley honoree is chosen by committee and is based upon two criteria: wrestling achievements and significant contributions to society outside of the squared circle. Dr. Darnell’s service to his fellow man through his chiropractic career was a decisive factor in his selection. During his career, Billy wrestled in the U. S., Canada, Mexico and even Cuba. He once held the Junior Heavyweight title while wrestling in California and he and Bill Melby were World Tag Team Champions during the mid-1950’s.
Billy knew that his wrestling career would not last forever and began preparing for his second profession by entering the Los Angeles College of Chiropractic in 1957. He continued his mat activities in California but, after two years, it was time to change territories. He transferred to the Lincoln College of Chiropractic in Indianapolis and graduated with his Doctor of Chiropractic degree in 1961. He wrestled for a short time afterwards but had his last match in 1961.
As a chiropractor, Billy has treated patients for over forty-five years. He continues to treat loyal patients who refuse to let him fully retire. He is a past member of the American Chiropractic Association and the New Jersey Chiropractic Association. He uses modern and traditional methods including electrotherapy, Nimmo Receptor Tonus Technique, hypnosis and continually updates his knowledge of new techniques and incorporates them into his practice.
Chiropractor Gets Probation, Fine,
Suspension in Insurance Scam
NEW JERSEY: A Fair Lawn chiropractor who admitted bilking an insurance company of nearly $10,000 was sentenced in late April to a year’s probation and suspension of his license for three years. Marc Centrelli, 46, of Sparta, had pleaded guilty Jan. 11 to over-billing Selective Insurance Co.
Centrelli admitted submitting $9,725 in claims for sessions that didn’t occur between April 30, 2003, and Feb. 11, 2004, according to the New Jersey Attorney General’s Office.
Superior Court Judge William C. Meehan ordered Centrelli to pay $14,805 in fines and restitution. He must complete an ethics course before resuming his practice.
Written by TAC Staff: Yellow Pages
Thursday, 08 July 2004 21:54
The Advent of a New Era in Management Consulting?
WEST VIRGINIA: The prosecution of Ron Halstead, DC, and two other chiropractors who scammed more than $2.8 million from Medicare and private insurers sends a message that health care fraud will not be tolerated, federal authorities say.
William C. Filcheck, of Morgantown, WV, Scott Taylor, of Mannington, WV, and Ronald L. Halstead, of Scottsdale, AZ., were sentenced on June 4, in U.S. District Court in Clarksburg for their roles in the scheme. Halstead, 65, received a 10-year, one-month sentence while Filcheck and Taylor were each sentenced to three years and one month.
U.S. District Judge Irene M. Keeley also ordered Filcheck and Taylor to forfeit $1.9 million.
“The significant prison sentences in this case reflect how seriously the federal criminal justice system treats health care fraud of this magnitude,” said Robert H. McWilliams, Jr., criminal chief for the U.S. Attorney’s Office for the Northern District.
Dr. Robert B. Burns, Jr., the owner of the Morgantown clinic where the chiropractors worked also has been charged, but is in Ireland. His expedition is pending, U.S. Attorney Thomas Johnston’s office says.
“This is a message to all medical practitioners that health care fraud is on the radar screen of IRS Criminal Investigation as well as other law enforcement agencies,” said Charles Jenkins, special agent in charge with the Internal Revenue Service Criminal Investigation field office in Louisville, KY.
Filcheck, Taylor and Halstead were convicted in February 2003 of engaging in a conspiracy from September 1993 to May 1997 in connection with the operation of a clinic employing both medical doctors and chiropractors.
The indictment said the men submitted or caused to be submitted false claims to private insurance companies and Medicare for tests, treatments and other services they said were performed by medical doctors who determined medical necessity, but the services were performed by chiropractors trying to evade some health care benefit programs’ limits on chiropractic care, federal authorities say.
Halstead, a consultant, advised the other defendants.
The three were also found guilty of 14 counts of executing the scheme. In addition, Halstead was found guilty of engaging in a money-laundering, conspiracy and 10 counts of specific money-laundering transactions.
- Rob Sherman
Chiropractors Sue Blue Cross, Claiming Discrimination Enough!
MICHIGAN: Some chiropractors claim that Blue Cross Blue Shield of Michigan is discriminating against them by unfairly limiting the number of visits for which a person can get reimbursed. In some cases, chiropractors who allow and bill for too many patient visits even get dropped from the Blue Cross network, The Daily Oakland Press has reported. The result, the chiropractors contend, has been financial loss for doctors and poor health care for patients.
Chiropractor Eric B. Herfert, and an associate, Dr. J.R. McCanse, have filed a lawsuit in Circuit Court seeking financial relief as well as an order requiring Blue Cross to halt its practices.
Meanwhile, in March of this year, the Michigan Chiropractic Association filed a separate suit in Ingham County with similar claims.
Blue Cross officials say the lawsuits are groundless and are adding needless costs to health care.
“They (the lawsuits) have nothing to do with health care but are merely an example of ongoing efforts by some chiropractors to maximize their reimbursement from Blue Cross Blue Shield of Michigan,” says a Blue Cross spokeswoman.
Herfert says the insurer is trying to control how patients are treated.
“(Blue Cross) is trying to prevent me and other chiropractors from properly examining and caring for our patients by restricting how they pay for various chiropractic procedures,” Herfert says. “Chiropractic care is all about restoring proper function to the nervous system and allowing your body’s own healing powers to work without interference."
Herfert and McCanse were dropped from the Blue Cross network. They seek to return to the Blue Cross program as health care providers, to get paid for money lost and to change how Blue Cross treats patients who seek chiropractic care.
“Chiropractic care provides an alternative to medicine that many times is more effective and costs less,” Herfert says.
The association lawsuit has similar complaints, but officials stress it is a separate legal action.
“As a profession we’ve been discriminated against by Blue Cross for years,” says Ken Hughes, DC, president of the association. “All we want is a level playing field and to have Blue Cross stop messing with our patients.”
- Associated Press
Chiropractor Wins $7.6 Million Appeal
CALIFORNIA: A federal appeals court upheld $7.6 million in damages in late June for a Berkeley chiropractor who said she lost her home and went on welfare when her benefits were cut off by the world’s largest disability insurer after she was no longer able to work.
Joan Hangarter’s lawyers say her case helped expose UnumProvident Corp.’s nationwide practice of boosting its profits by terminating legitimate disability claims from policyholders who were usually too weak to fight back.
A company spokesman for the insurance carrier called that assertion “hogwash’’ and said UnumProvident paid more than $5 billion in benefits last year, “hardly the makings of a company intent on systematically denying claims.’’ He said the company disagrees with the ruling but hasn’t decided on its next step.
Hangarter was a chiropractor in Berkeley for 20 years but became unable to treat patients in 1997 because of painful repetitive-stress injuries to her arm and neck, aggravated by an auto accident.
Her insurer paid her $8,150 a month for 1½ years but then stopped, saying a medical examination it commissioned showed she was not disabled. Hangarter, a single mother of two, said she was evicted from her home, lost her car, went on welfare and declared bankruptcy when a later business venture failed.
The doctors who treated Hangarter testified that she was unable to work. Other witnesses testified on her behalf that internal documents revealed an UnumProvident policy of terminating disability claims without regard to their merits. A federal jury ruled in her favor in February 2002 and awarded damages for lost benefits and emotional distress and $5 million in punitive damages.
In its appeal, the company argued that Hangarter was not totally disabled because she performed clerical tasks and managed her office from 1997 to 1999. But the court noted that Hangarter had an occupational disability policy—which provided benefits if she became disabled from her occupation—and said California law defined Hangarter as totally disabled because she was unable to work as a chiropractor.
The jury was also entitled to find that the company conducted a biased investigation and acted in bad faith, justifying punitive damages in the ruling.
- San Francisco Chronicle
Insurance Fraud Rings BUSTED!
CALIFORNIA: Two sisters who owned legal clinics in San Jose were indicted in early July on multiple felony counts for allegedly embezzling funds from their clients’ insurance settlements and for receiving kickbacks from chiropractors for client referrals, among other charges.
The indictments against Ellen Nguyen, and Genny Nguyen are the latest developments in a case that involves what prosecutors are calling one of the longest running and most successful insurance fraud rings in the county.
Also indicted were chiropractors Jonathan Tri Lien, and Lenard Linh Nguyen, who allegedly solicited clients to file personal injury claims against auto insurance companies.
Ellen Nguyen was indicted in October 2003 on charges that she filed numerous fake insurance claims with the help of associates.
The indictments announced this July, which allege that the Nguyen sisters stole more than $120,000 between 2002 and 2003 and received more than $155,000 in kickbacks, stem from information gathered during the original investigation.
If convicted of all charges, Ellen Nguyen faces up to 74 years in prison and Genny Nguyen faces up to 32 years in prison.
No whirlpool, no good!
NORTH CAROLINA: A chiropractor indicted on offenses related to health care fraud was indicted by a federal grand jury in April on 511 counts of health care fraud, one count of conspiracy to commit health care fraud, two counts of obstruction and one count of money laundering. He and his lawyer appeared in court in late June for hearings on several motions.
Steven Ira Cohen was previously indicted in November 2003 on 21 counts of mail fraud and 16 counts of health care fraud. Those charges and the April indictment will be consolidated into one case for trial, but no trial date has been set.
The indictments accuse Cohen of submitting fraudulent claims for services that were not provided, falsely claiming that procedures were administered by medical doctors, and double-billing health care benefit programs between July 1998 and January 2003. The indictments also allege fraudulent claims were filed with multiple insurance companies, including Blue Cross Blue Shield, State Employees Health Plan, Nationwide, Aetna and State Farm.
Cohen conspired with others to “make as much money as possible by submitting materially false and fraudulent claims to the insurance companies and the Standard Corporation,” the April indictment states.
Some of the claims submitted were for patient treatment using a whirlpool, according to the April indictment. The clinic did not have a whirlpool, the indictment states.
According to the court papers, the gross proceeds of the illegal acts were $1.5 million for the 515 charges in the April indictment.
That’s much more than the amount alleged to have been gained from the activities covered in the first indictment. Those 21 counts of mail fraud and 16 counts of health care fraud were based on allegations of falsely billed services involving one family between July and October 1998.
According to the first indictment, the claim forms, submitted to the United States Department of Labor, Office of Worker’s Compensation Program and Blue Cross Blue Shield, claimed payment for services not provided and billed at the higher rate used for medical doctors rather than chiropractors. The indictment lists those gross proceeds as $6,211.
- The Daily Reflector
Written by TAC Staff: Yellow Pages
Tuesday, 08 June 2004 20:39
The Price You Pay for Submitting False Claims:
Worst Case Scenario?
PENNSYLVANIA: In late March, William Matura, DC, pleaded guilty to conspiracy to commit health care fraud and obstruction of a health care investigation, and agreed to $1 million in fines for submitting false patient claims to health insurers.
As part of the plea, he agreed to pay the $1 million within 90 days of his June 23 sentencing.
He and his wife will also forfeit, if necessary, their homes, his 14 Philadelphia commercial properties and investment accounts.
Matura also faces a likely sentence of up to 9 years in prison.
Prosecutors say Matura was the last of four defendants to plead guilty to a scheme which netted about $2 million from eight health insurers between 1997 and 2002.
Filing a False Tax Return Can Be Pricey, Too.
FLORIDA: A Palm Harbor chiropractor pleaded guilty, earlier this year, to filing a false tax return, according to the U.S. Attorney’s Office. Terry Lynn McNight faces up to three years in prison, a $250,000 fine and one year of court supervision for lying about advertising expenses on his clinic’s 1999 federal income tax return. According to a plea agreement filed in Tampa federal court, McNight admitted to claiming more than $80,000 in advertising expenses for his practice when, in fact, he spent almost nothing.
McNight told federal prosecutors he used a Costa Rican group that sells, implements and manages so-called tax reduction strategies to falsify his clinic’s return.
That organization, Anderson’s Ark and Associates, is a multinational, membership-based organization that, according to the U.S. Department of Justice, has assisted thousands of clients in evading income taxes and laundering money. Complaints pending in federal court say the organization obtained approximately $28-million in illegal tax refunds for more than 1,500 clients from 1998 to 2001.
St Petersburg Times Online
Whistle-Blowers Bring in Big Bucks
WASHINGTON: A series of major settlements against health care companies has boosted the government's fraud recovery rate, thanks to whistle-blower provisions in federal law.
According to the latest figures from the Justice Dept., federal enforcement officials recouped $2.1 billion under the False Claims Act in 2003. Of that total, $1.7 billion came from health care companies and practitioners, up from $500 million only four years earlier.
Four of the 10 largest settlements in the history of the act came in 2003, and all involved health care companies. Of the $2.1 billion in False Claims Act recoveries in 2003, $1.48 billion came from suits initiated by whistle-blowers.
The settlements are attributed in large part to False Claims Act amendments by Sen. Charles Grassley (R, Iowa) in 1986 that strengthened the qui tam, or whistle-blower, provisions by offering private citizens who report fraudulent claims a share of the recovered funds.
While federal officials have focused on larger corporate offenders, even the smallest of physician practices can be prosecuted under the False Claims Act.
Michigan Chiropractic Association Sues Blue Cross
MICHIGAN: On March 12, lawyers for the Michigan Chiropractic Association (MCA) took the first legal step to change the discriminatory practices of Blue Cross/Blue Shield (BCBS) by filing a lawsuit in Ingham County Circuit Court.
In the 20-page complaint, the MCA charged that BCBS has interpreted and applied the rules in a way that “prevents subscribers from getting the care that Blue Cross/Blue Shield advertises is available to them.”
Among the issues raised are that Blue Cross is wrongfully attempting to restrict the methods of diagnosis or treatment methods of chiropractors. The complaint also says “that Blue Cross has committed continual breaches of its contract by its improper interpretation of the scope of chiropractic and the services for which reimbursement is allowed, as well as by its failure to provide equitable relief for those provider services for which it does allow reimbursement.”
Dr. Bill Goss, chairman of Michigan Chiropractic Legal Action Committee said, “Blue Cross arbitrarily denies claims that are within the scope of accepted treatment, and they are moving toward a model of care that is based on pain instead of accepted objective findings.”
In the meantime, Goss said, financial support from MCA members continues to be important as legal fees mount. “We also need chiropractors to keep us informed of abuses so we can update the attorneys as the suit continues”
“Walkin’ thru Missouri…”
MISSOURI: On a final, and more positive note, there’s a chiropractor in Rolla, MO, who’s getting some good press in his community for starting up a Walkers Club. Dr. Alan Singer held the first meeting of, what he likes to call, the “Back Acres”, on a Thursday morning in mid-May.
Dr. Singer, a long distance runner who formerly practiced in New York State, started the group walking sessions there, and thought it a “perfect” idea to continue the custom in his new location.
On the walks, Dr. Singer plans to provide information about safe ways to reduce body fat, the proper mechanics of walking, and how to achieve and measure optimum heart rates while walking and doing stretching exercises. TAC
Written by TAC Staff: Yellow Pages
Saturday, 03 April 2004 17:49
Governor Signs Legislation Creating
Nation’s First Public Chiropractic College
FLORIDA: On March 4, 2004, Florida Governor Jeb Bush today signed into law Senate Bill 2002, legislation creating a variety of new health care initiatives including the authorization and funding to establish the nation’s first public chiropractic college at Florida State University. The bill was approved previously by both the Florida Senate and House of Representatives in the opening days of Florida’s annual 60-day legislative session.
You can run, but you can’t hide….
Globe-trotting Chiropractor Faces Tax Charges
FLORIDA: After a 3-year chase across the United States, then to Canada, the West Indies and all the way to Australia, the Internal Revenue Service finally got its man—a former Boca Raton chiropractor and radio show host wanted for tax evasion,
Living in Brisbane, Queensland, Bruce Eric Hedendal was known as Dr. Erik Hedendahl, and he had an office, a website and another radio show promoting holistic and chiropractic care.
Hedendal fled the United States in 2000 after a federal grand jury indicted him on charges of not paying $180,000 in income taxes from 1993 to 1995. The IRS says he tried to hide his income and assets in sham tax-exempt trusts bought from a Royal Palm Beach man who was convicted of tax fraud conspiracy in 2001.
Arraigned in federal court in early February, Hedendal pleaded not guilty to three counts of tax evasion, each carrying a maximum sentence of five years in prison and a fine of $100,000. In addition, with penalties and interest, he now owes the government $742,000. Considered a flight risk, Hedendal is being held without bail.
Palm Beach Post
DC Found Guilty of Rape
OHIO: Chiropractor Darrin Pordash was found guilty of rape and sexual assault in late February for attacks on patients. Jurors determined that Pordash assaulted three women during visits to his office last October and November. He faces the possibility of up to 30 years in prison.
Pordash's lawyer, James Burge, had told the jury of five men and seven women that the sexual contact between Pordash and the women was consensual.
The Plain Dealer.
Undercover Agents Everywhere!
Contrite Cooperative Chiropractor Gets 3 Years for Fraud
NEW JERSEY: A former East Orange chiropractor who pleaded guilty to health care claims fraud and using a runner to drum up business was sentenced to three years in state prison in late January.
Michael Baer was taken into custody after his sentencing in Superior Court in Newark, though the judge said he would recommend that Baer be considered for release under the state’s intensive supervision program as early as possible.
Baer pleaded guilty last June to two counts of an indictment against him and agreed to cooperate with authorities. His agreement included testifying against an associate, Mohsen Mosslehi, another chiropractor charged with health care fraud, but Mosslehi was acquitted at a trial in October. Nonetheless, the judge said he found Baer’s trial testimony credible and, that he apparently had played an important role in the Mosslehi case. Additionally, Baer wrote the judge a letter acknowledging his wrongdoing and expressing contrition.
With his pleas, Baer will have his chiropractic license suspended for a period of time to be determined by the state Board of Chiropractic Examiners.
In admitting his guilt, Baer said he turned in bills for chiropractic services that were never performed in 2000 on a woman who was an undercover investigator with the state Division of Criminal Justice, though he did not know it. State authorities estimate the phony bills amounted to more than $20,000.
During the investigation that began in May 2000, Baer began subletting his office to Mosslehi two days a week, law enforcement officials have said. On days Baer wasn’t using the premises, Mosslehi ran his business out of the same space, authorities said.
According to police, Mosslehi gave a “runner” $500 in the summer of 2000 from himself and Baer. In return, the runner “brought each man a patient that same summer, but the runners also were undercover agents.
FLORIDA: A Port St. Lucie chiropractor could spend up to a year in jail after pleading no contest in late February to four counts of practicing without a license, and two counts of filing false insurance claims.
Gregory Dale Blackman is expected to be sentenced April 26, and the State Attorney’s office has agreed to cap Blackman's punishment at a year in jail, and then, after that, up to 30 years of probation.
Blackman was arrested in December 2002 after a four-month investigation by the St. Lucie County Sheriff's Office. Undercover detectives posing as patients received medical attention on four visits to Blackman from Sept. 23 to Oct. 18, 2002, according to court records.
The investigation began after three insurance companies reported receiving multiple bills totaling $41,915 from Blackman's office. The bills dated back as far as November 2001, when Blackman was suspended from practicing medicine, according court records.
In December 1997, he had agreed to voluntarily withdraw from practicing medicine until he received treatment for drug abuse, specifically of Xanax and hydrocodone, according to a Florida Department of Health report.
But, Blackman, who continued to see patients, failed to finish treatment and his license was suspended on Nov. 6, 2001, according to the report.
His license was revoked on July 25, 2002, when he was described as an “ongoing threat to the public,” according to a state report.
Palm Beach Post
Cruel chiropractor zaps baby daughter with stun gun
JAPAN: A former chiropractic clinic owner, who was arrested in early March for abusing his 3-month-old daughter about a year ago when she did not stop crying, now faces attempted murder charges for using a stun gun on her, investigators said.
The Metropolitan Police Department (MPD) in Japan is seeking to charge the suspect with attempted murder as the stun gun, with an output of 500,000 volts, could cause a heart to stop.
In the specific case for which he was arrested, Tetsuta Iio pushed down heavily on his baby daughter's back and stomach in March last year, causing her injuries that took two weeks to heal, according to investigators.
MPD investigators said they believe that Iio began to abuse the victim under the pretext of chiropractic treatment about two months after she was born, adding that the abuse occurred only when his wife was away from home.
Investigators said that there were traces of burns caused apparently by a stun gun. Iio also allegedly used the stun gun to abuse a rabbit that his family was keeping at their home. He had bought the weapon for self-protection.
Mainichi Daily News
Chiropractor Charged in the Death of Her Husband
WISCONSIN: The Walworth County District Attorney has upgraded the charges against a Park Ridge chiropractor in the death of her husband.
New charges filed in late February against Carol McGough LaPorte include first-degree reckless homicide while armed with a dangerous weapon and aggravated battery while armed with a dangerous weapon.
LaPorte had been charged previously with second-degree reckless homicide in Anthony LaPorte's death.
Anthony LaPorte's death Sept. 28, 2004, in Williams Bay, Wis., was caused by blood loss from a single knife wound to the heart.
The original criminal complaint filed Dec. 8 states that the couple had an argument, and Carol LaPorte was afraid her husband would choke her. She had a bruise on her arm but none on her neck, according to the complaint. She also states in the complaint that she stabbed her husband because she was afraid of what he would do to her.
The couple had not had physical fights before, according to her statements in the complaint.
The first-degree reckless homicide charge carries a sentence of 65 years in prison. The aggravated battery charge carries a fine up to $10,000 and a prison sentence up to 11 years. Both charges carry an additional five-year penalty for the use of a dangerous weapon.
Pioneer Press Online
Quadriplegic sues Quad-City chiropractor
IOWA: A former Davenport man has filed a lawsuit claiming that he went to a chiropractor’s office with a stiff neck and back pain and left a quadriplegic.
Gary D. Davis, 50, has no feeling in his extremities or below his neck and now lives in a nursing home near his family in Kentucky, attorney Andrew Rink said. The lawsuit, filed early in February, claims that Davis went to the Davenport office of chiropractic doctor Bradley Merritt in July for the neck and back problems.
“At the time Davis was lying face down, receiving some sort of treatment, adjustment or manipulation by Dr. Merritt, Davis had the sudden onset of very severe pain and became flaccid and quadriplegic,” the lawsuit claims.
Paramedics called to the scene found Davis sitting by the edge of the table being supported by Merritt, who had not placed Davis in a cervical collar, laid him flat or immobilized him, the lawsuit claims. The lawsuit seeks unspecified damages for past and future physical and mental pain and suffering, disability, disfigurement and medical expenses.
“The allegations are negligence,” Rink said. “Dr. Merritt didn’t do any X-rays ahead of time.”
Davis had been treated once or twice at Merritt’s office about a year prior to the incident.
Dr. Merritt declined comment about the lawsuit, citing legal reasons.
Written by TAC Staff: Yellow Pages
Saturday, 28 February 2004 00:00
Allstate Seeks $3.5M in Fraud Lawsuit
CALIFORNIA: In early January, Allstate Insurance Company and Allstate Indemnity Company began serving summons and complaints upon a Los Angeles County chiropractor and his wife, accusing them of taking part in schemes designed to defraud the companies.
Paul Yan, DC, Winnie Yan and Paul Yan Chiropractic Corporation are accused of reportedly operating a scheme of excessive billing, fraudulent billing and billing for services that were never rendered. The lawsuit alleges that more than 150 false or inflated claims were submitted to Allstate by Yan for patient services including examinations, diagnostic testing and treatment. According to the complaint, filed in Los Angeles Superior Court, most of the patients had been involved in minor car accidents and suffered from minor soft tissue injuries.
Allstate is seeking more than $3.5 million under a California law passed to help combat insurance fraud. Five years ago, Allstate Insurance Company filed the first lawsuit under the 1995 state law designed to augment law enforcement's efforts to prosecute defrauders and in 2001 won an $8.2 million jury award. Allstate has filed a number of similar lawsuits under this statute, emphasizing its zero tolerance for insurance fraud.
No charges have yet been filed against Yan, his wife or the chiropractic firm, according to officials.
DC Acquitted in Tax Evasion Case
FLORIDA: A Florida chiropractor beat the IRS this week when a federal judge in Orlando threw out an income tax evasion case against her.
It was the second time in 11 years that Dr. Lois Somerville defeated a case against her for lack of evidence.
The victory came in early December when a U.S. District Judge issued a judgment of acquittal before the case went to the jury.
In September, Somerville had been charged in a federal indictment with evading taxes from 1990 through 1998. If convicted, she would have faced up to five years in prison and $1.25 million in fines.
Prosecutors with the tax division of the U.S. Department of Justice claimed Somerville concealed her true earnings from the IRS by depositing most of her income into two trusts she created in 1990 “in an effort to keep her personal residence out of the reach of an Internal Revenue Service tax lien,” according to the indictment.
But, there’s more! In 1992, the chiropractor served as her own lawyer when the state District Court of Appeal ruled that state insurance investigators illegally seized her patient, billing and bank records.
The raid followed a nine-month investigation of her practice that produced eight counts of business fraud and one count of organized fraud. State prosecutors dropped the case, saying they could not proceed without the seized records.
And, yet, more! Unrelated charges of grand theft and forgery in a separate case against Somerville were dropped in 1992 when prosecutors said they had witness problems.
Insurers Seek $17 Million from NJ Chiropractors
NEW JERSEY: Allstate New Jersey Insurance Company and Encompass Insurance have filed a multi-million dollar civil complaint, under the New Jersey Insurance Fraud Prevention Act against Scott Greenberg, DC, a Central New Jersey-based chiropractor and Middlesex Diagnostic Associates, a neurological testing company, as well as a medical billing business, Accurate Billing Company, Inc., which he allegedly controls. Other defendants in the suit include Roman Sorin, MD, and Neuro Muscular Medical Group, PA, alleged to be controlled by Sorin, as well as Steven Brownstein, MD, and Brunswick Imaging Corporation, an MRI facility alleged to be controlled by Brownstein. The companies are seeking recovery of more than $17 million they have paid to the various defendants beginning in 1993.
They’re also asking for treble damages, and a declaratory judgment against the practitioners “in order to halt all claims being made by Drs. Greenberg, Brownstein and Sorin and the professional entities controlled by them.” That request was included because the companies are still receiving claims from the defendants.
Greenberg allegedly orchestrated a referral scheme to defraud the carriers. Specifically, he’s accused of illegally self-referring his chiropractic patients to Middlesex, a mobile diagnostic facility in which he was the sole owner, which is illegal under NJ law. Greenberg is also charged with setting up and controlling Accurate Billing Company, which kept 30 percent of Neuro Muscular Group’s monthly gross income. The lawsuit contends that the deal was a kickback from Sorin to Greenberg in exchange for the patient referrals.
Jury Acquits DC of Sex Assault Charges
PENNSYLVANIA: A jury in Delaware County recently acquitted a Dr. Len Finkel of charges that he sexually assaulted a former employee and patient.
The allegations stemmed from a July 15, 2002 ultrasound treatment that Finkel gave to a female patient.
During the trial, Finkel denied deliberately touching the woman's breast and rubbing against her while sexually aroused, as she had accused him of doing.
He acknowledged that he may have “inadvertently” made contact with the patient’s breast while giving her a massage. He said the woman was moving around during the massage and leaned back a few inches.
DC Sentenced for Shooting Dog
ALABAMA: A man accused of fatally shooting a 2-year-old yellow Labrador retriever last Labor Day was sentenced in early December of 2003 to 120 days in jail and fined $1,000.
Patrick James Perschke, DC, was apparently walking his three dogs on the beach when they were approached by the playful Lab, named Shiney, and one of Perschke’s dogs bit him in the ear, whereupon Shiney ran away.
According to witnesses, Perschke then took out a gun and shot the Lab four times, killing him.
In a two-hour non-jury trial, a Municipal Court Judge found Perschke guilty of animal cruelty and reckless endangerment. He was sentenced to 60 days in jail and a $500 fine for each charge, the terms to be served consecutively. A charge of carrying a pistol without a permit was dropped for technical reasons.
Perschke said he will appeal the case.
Beware the Mobile Diagnostic Units
Over the years, chiropractic attorneys from across the country have voiced concern over the practices of diagnostic testing companies. In Ohio, the Justice Department successfully obtained felony plea agreements from several DC’s who used these services. In some cases, the insurers are using state law to pursue action against chiro’s who contract with these mobile service vendors. How these cases will end up is anyone's guess. What is certain, however, is the enormous costs—both financial and emotional—to defend these actions.
Are you going to get caught in a legal quagmire when you use a mobile diagnostic lab company? Before you sign on the bottom line, hire competent legal counsel to advise you.
Keeping Abreast of Things…
IOWA: In late November of 2003, The Iowa Board of Chiropractic Examiners suspended the license of a Fort Dodge chiropractor for 60 days for allegedly improperly touching the breasts of female patients.
Dennis Musselman said he was following legitimate chiropractic procedures, but the board disagreed, saying that he failed to keep proper records to support his actions, and that he failed to ensure the dignity of his patients.
The board placed Musselman on three years’ probation, ordered him to get more education, and ruled that he must have an employee present whenever he treats women.
The board began its investigation after receiving a complaint in 2001 from a patient who also had been Musselman's employee. The woman said the chiropractor had treated her in the past, mainly for lower back pain, board documents say.
Death of Chiropractic Patient in 1996 Ruled Accidental
TORONTO, CANADA: In mid-January, the death of a factory worker who suffered a fatal stroke in 1996 after having her neck manipulated by a chiropractor was ruled as accidental and not due to natural causes.
Lana Lewis, a mother of three, died two weeks after undergoing a procedure known as a high-neck manipulation by Toronto chiropractor Philip Emanuele, who had been treating the 45-year old for migraine headaches.
The coroner's jury finding of accidental death means that “the injury that led to the stroke was as the result of trauma,” said the chief counsel for the coroner’s office.
Tim Danson, the lawyer for the Canadian Chiropractic Association and the Canadian Memorial Chiropractic College, had argued that Lewis died of natural causes brought on by an unhealthy lifestyle.
“It represents a massive miscarriage of justice,” said Danson, who plans to appeal the decision.
Two neurologists who concluded that Lewis died of natural causes were not permitted to testify, he noted.
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