By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
A former Daytona Beach chiropractor will spend more than 15 years in federal prison for an alleged health care fraud scheme and illegally prescribing pills, according to the Federal Bureau of Investigation (FBI), Jacksonville Division. He was also ordered to pay more than $2 million in restitution to his victims. The former chiropractor was sentenced on November 29, 2012, by a United States District Judge who called his fraud scheme “sophisticated.”
Click here to read the press release from the FBI.
I previously wrote about this scheme in August 2012, when the former chiropractor was found guilty. To read that blog, click here.
Former Chiropractor Worked with Other Doctors to Complete Scheme.
According to the Daytona Beach News Journal, the former chiropractor is thought to have worked with five other doctors in a scheme. The group allegedly split the money they collected from sending inflated bills to insurance companies, including Medicare.
Criminal’s Prescriptions Allegedly Caused a Dozen Patients to Overdose.
FBI investigators also accused the former chiropractor of writing prescriptions for controlled substances. Since the man could not prescribe controlled substances, he would use the names of medical doctors who most likely knew their names were being used illegally. It’s believed that there were about a dozen patients who overdosed on controlled substances prescribed by the former chiropractor, according to the Daytona Beach News Journal.
Click here to read the entire Daytona Beach News Journal article.
Consequences of Voluntarily Relinquishing a Professional License.
Back in December of 2011, the former chiropractor voluntarily relinquished his license. We almost always counsel our clients to refrain from voluntarily relinquishing their licenses. A voluntary relinquishment of a license in the face of a pending investigation is treated, for all practical purposes, the same as a disciplinary revocation.
The consequences will usually include:
1. Mandatory report to the National Practitioner Data Base (NPDB) (Note: Healthcare Integrity and Protection Data Bank or HIPDB recently folded into NPDB) which remains there for 50 years.
2. Any other states or jurisdictions in which the client has a license will also initiate action against him or her in that jurisdiction. (Note: I have had two clients who had licenses in seven other states).
3. Action to revoke, suspend or take other action against the clinical privileges and medical staff membership of those licensed health professionals who may have such in a hospital, ambulatory surgical center, skilled nursing facility, or staff model HMO or clinic.
4. The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) will take action to exclude the provider from the Medicare Program. If this occurs (and most of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the HHS OIG.
5. If the above occurs, the provider is also automatically "debarred" or prohibited from participating in any capacity in any federal contracting and is placed on the U.S. General Services Administration's (GSA's) debarment list.
6. The U.S. Drug Enforcement Administration (DEA) will act to revoke the
professional's DEA registration if he or she has one.
7. The board certified health professional's certifying organization will act to revoke his or her certification.
For more reasons why a health care provider should not relinquish a professional license, click here.
Guilty in Court of Law.
Remember, all person are presumed innocent until convicted in a court of law. In this case, the chiropractor has been convicted in a court of law.
Contact Health Law Attorneys Experienced in Handling Medicare Audits.
Medicare fraud is a serious crime and is vigorously investigated by the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), state Medicaid Fraud Control Units (MFCUs) and other law enforcement agencies participate. Don't wait until it's too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today.
The Health Law Firm’s attorneys routinely represent physicians, nurses, chiropractors, medical groups, clinics, pharmacies, home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Do you think this sentence is too steep? Do you think the doctors the former chiropractor worked with will receive the same sentence? Please leave any thoughtful comments below.
Pavuk, Amy. “Chiropractor gets 15 Years Prison for Illegally Writing Prescriptions and Healthcare Fraud.” Orlando Sentinel. (November 28, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-chiropractor-painkillers-sentence-20121128,0,60766.story
Federal Bureau of Investigation. “Former Daytona Beach Chiropractor Sentenced to More Than 15 Years in Federal Prison.” FBI. (November 29, 2012). From: http://www.fbi.gov/jacksonville/press-releases/2012/former-daytona-beach-clinic-owner-sentenced-to-more-than-15-years-in-federal-prison
Longa, Lyda. “Judge Sentences Chiropractor Joseph Wagner to 15-Year Term.” Daytona Beach News Journal. (November 28, 2012). From: http://www.news-journalonline.com/article/20121128/NEWS/311289998/1025?p=2&tc=pg
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.
Tag Words: Medicare, Medicare fraud, Medicare audit, Chiropractor, healthcare fraud, prescription, painkillers, defense attorney, defense lawyer, quality assurance, criminal charges, Department of Justice, (DOJ), legal defense for chiropractors, legal representation for chiropractors, Federal Bureau of Investigation (FBI), chiropractor licensing, board of chiropractic medicine, license relinquishment, Office of Inspector General (OIG) of the Department of Health and Human Services (HHS), U.S. Drug Enforcement Administration (DEA)
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