By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
The Department of Justice (DOJ) announced that a Daytona Beach chiropractor pleaded guilty to health care fraud, conspiracy to illegally distribute prescription drugs and money laundering on August 28, 2012. An article in the Daytona Beach News Journal states that he is facing a penalty of 30 years in federal prison.
Click here to read the entire press release from the DOJ.
Chiropractor Submitted Inflated Bills to Medicare.
According to the DOJ, the chiropractor owned a facility that claimed to provide chiropractic and other medical services to patients. The owner would allegedly submit inflated bills to public and private health care beneficiary programs, including Medicare. The beneficiary programs were allegedly charged the higher rates for services provided by medical doctors, instead of the rates appropriate for chiropractors. The chiropractor is also accused of submitting claims for reimbursement for services that were not rendered.
Chiropractor’s Scheme Allegedly Involved Using Medical Doctors’ Names.
As part of the fraud scheme, the DOJ states that the chiropractor submitted fake bills in the names of medical doctors. By doing this, health care beneficiary programs such as Medicare would make payments directly to those doctors. The doctors allegedly accepted those payments and split them with the chiropractor.
Customers Were Illegally Prescribed Drugs.
Some customers at the chiropractor’s facility were allegedly receiving prescriptions for drugs. Since the owner could not prescribe controlled substances, he would use the names of medical doctors who, the DOJ says, were aware that their names were being used illegally on prescriptions the chiropractor gave to patients.
The Chiropractor is Waiting to be Sentenced.
According to the DOJ, this case was investigated by the Federal Bureau of Investigation (FBI), Food and Drug Administration (FDA), Department of Health and Human Services (DHHS), Office of Inspector General (OIG), Florida Department of Financial Services, and the Florida Department of Law Enforcement.
The chiropractor was indicted on 95 charges. He pleaded guilty to health care fraud, conspiracy to distribute controlled substances, and transactional money laundering. According to the Daytona Beach News Journal, he will be sentenced on November 28, 2012.
To read the entire article from the Daytona Beach News Journal, click here.
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.
Sources:
Office of U.S. Attorney. “Former Owner Of Daytona Beach Clinic Pleads Guilty To Fraud, Conspiracy, And Money Laundering.” The United States Attorney’s Office Middle District of Florida. (August 28, 2012). From: http://www.justice.gov/usao/flm/press/2012/aug/20120828_Wagner.html
Longa, Lyda. “Chiropractor Pleads Guilty to Pill Prescriptions, Fraud.” Daytona Beach News Journal. (August 29, 2012). From: http://www.news-journalonline.com/news/local/east-volusia/2012/08/29/chiropractor-pleads-guilty-to-pill-prescriptions-fraud.html
Pavuk, Amy. “Chiropractor Who Illegally Prescribed Drugs Pleads Guilty.” Orlando Sentinel. (August 28, 2012). From: http://articles.orlandosentinel.com/2012-08-28/news/os-chiropractor-joseph-wagner-plea-20120828_1_joseph-wagner-insurance-fraud-chiropractor
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: Health care fraud, Medicare fraud, Medicare audit, defense attorney, quality assurance, criminal charges, Department of Justice, (DOJ), legal defense for chiropractors, legal representation for chiropractors, Federal Bureau of Investigation (FBI), Food and Drug Administration (FDA), Department of Health and Human Services (DHHS), Office of Inspector General (OIG), chiropractor licensing, board of chiropractic medicine