Central Florida Chiropractor Convicted in False Claims Scheme

Tuesday, March 12, 2013

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Central Florida chiropractor was convicted of conspiracy to commit health care fraud by a federal jury on March 1, 2013. Since 2009, the chiropractor fraudulently claimed to own a rehabilitation center in Cape Coral, Florida. According to the Department of Justice (DOJ), in March 2012, the chiropractor and several co-conspirators were formally charged with conspiracy to commit health care fraud, conspiracy to commit mail fraud and conspiracy to commit money laundering.

To read the press release from the DOJ on the charges, click here.


Rehabilitation Clinic Operating Illegally.

According to the Orlando Sentinel, the rehabilitation center was operating as an unlicensed health care clinic. The State of Florida licensing requirements were circumvented by the group because they claimed the licensed chiropractor as the owner for the clinic. As a result of the falsified ownership of the clinic, the facility was able to avoid regulatory scrutiny.

Click here to read the entire article from the Orlando Sentinel.

Clinic Submitted False Claims for Staged Vehicle Accidents.

The chiropractor and the co-conspirators are also accused of recruiting people to be involved in staged vehicle accidents. The individuals would go to the rehabilitation center for “treatment” in exchange for payment. The false claims were then submitted to insurance companies.

The chiropractor faces up to 20 years in prison. His sentencing is in June. Be sure to check our website for updates on this blog.


Chiropractors Are Not Allowed to Work for Clinics Owned by Non-Chiropractors in Florida, with Limited Exceptions.

The facts described in this case seem to be illegal, from the fraudulent ownership of the clinic by the chiropractor, to submitting false claims to insurance companies. However, if the clinic had been owned by one of the co-conspirators, it most likely still would have been illegal for the chiropractor to be employed at the Florida rehabilitation facility. There are many chiropractic physicians and other medical business owners who are unaware of the prohibition provided in Florida law against a chiropractor providing services for a business owned by non-chiropractors. By non-chiropractor, this means anyone who does not have a current, active Florida chiropractic physician’s license. To learn more on this law and the exceptions to it, click here to read a blog I previously wrote.

Contact Health Law Attorneys Experienced in False Claims Act Cases.

The Health Law Firm represents physicians, nurses, medical practices, pharmacists, chiropractors and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving government health programs (Medicare, Medicaid, TRICARE). The Health Law Firm also represents health providers in False Claims Act cases.
 
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Comments?

Are you familiar with these kinds of stories? Are these fraud schemes worth it for licensed health care professionals? Please leave any thoughtful comments below.


Sources:

Pavuk, Amy. “Windermere Chiropractor Convicted in Fraud Case.” Orlando Sentinel. (March 1, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-windermere-chiropractor-guilty-fraud-20130301,0,7566259.story

Department of Justice. “Chiropractic Clinics Charged with Fraudulent Insurance Scheme.” Department of Justice. (March 22, 2012). From: http://www.justice.gov/usao/flm/press/2012/mar/20120322__PIP.html


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.


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3/12/2013

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