AKRON, OH— A chiropractor was sentenced to 2½ years in federal prison after being convicted of defrauding insurance companies and Medicare of more than $1.8 million.
The chiropractor pleaded guilty to seven counts of health-care fraud as part of a plea bargain. In exchange for his plea, prosecutors dropped 31 more counts of healthcare fraud, nine counts of mail fraud and eight counts of paying illegal kickbacks.
His case was heard in a U.S. District Court.
The chiropractor was accused of supplying patients with medical treatments unnecessary to their health or which were more expensive than required. In some cases, he billed patients for treatments they never received.
“This doctor took advantage of programs designed to provide care and support for the old and the sick,” said U.S. attorney for the Northern District of Ohio. “Our office and the Justice Department are committed to rooting out health-care fraud in all its forms.”
The chiropractor provided custom-molded ankle-foot orthotics, or “boots,” to patients who did not need them and wrote false diagnoses to justify the billing, prosecutors said. He billed Medicare and insurance anywhere from $2,770 to $4,300 for each pair of boots, according to court documents.
He also routinely provided the most expensive back braces without any demonstration of medical necessity or any pursuit of a less costly alternative, billing Medicare and insurance companies from $995 to $1,250 for each brace, according to court documents.
If patients questioned the necessity of this medical equipment, the chiropractor said they were part of a “free package deal” and would be covered by their insurance, according to court documents.
Other questionable billing included supervised physical therapy when the patients were not supervised. He also billed for an hour’s worth of physical therapy when, at most, patients did a half-hour, according to court documents.
Prosecutors said he submitted the bills to Medicare, Anthem Blue Cross and Blue Shield, Medical Mutual of Ohio and the Ohio Bureau of Workers’ Compensation, which reimbursed him more than $812,000.
He was ordered in October to repay the money, U.S. Attorney’s Office spokesman Mike Tobin said.
Source: The Medina Gazette