Australian Chiropractor Suspended for Two Years for Misconduct

AUSTRALIA, A chiropractor  who gave an Essendon player hyperbaric treatment has been suspended for two years after he was found guilty of misconduct.
According to findings by VCAT (Victorian Civil and Administrative Tribunal), South Yarra chiropractor Dr Malcolm Hooper also charged a “vulnerable” cerebral palsy patient $50,000 for unproven treatments.
Dr Hooper who claims hyperbaric chambers can be used to “upregulate peptide use”, was accused of using questionable and expensive oxygen therapies on 30 different conditions including cerebral palsy, cancer, multiple sclerosis, infertility and autism.
He was found guilty of six different counts of misconduct and his registration was cancelled. He will not be able to reapply for his certificate for two years, unless he successfully appeals the decision.
The Chiropractic Board of Australia will also hold Dr Hooper to an undertaking that he will not use hyperbaric chamber treatment on patients with 10 conditions, including adult cerebral palsy.
The VCAT panel ruled that due to Dr Hooper’s “zealotry and unfaulting belief” in the healing powers of oxygen therapy only a lengthy period of cancellation would protect the public.
VCAT and the Australian Chiropractic Board will also hold Dr Hooper to an undertaking that he will provide patients with medical research that discredits the effectiveness of oxygen therapy on 20 conditions.
In his judgment, presiding member Robert Davis said at no point did Dr Hooper acknowledge he was wrong.
“It is almost impossible to envisage that Dr Hooper would concede that his method of carrying out the treatment had faults in any way,” he said.
“Dr Hooper deserves a severe sanction and it is only after a lengthy period with a severe sanction that he may realise the error of his ways.
“In our view, nothing less than cancellation is sufficient to drive that message home to Dr Hooper.
“The public cannot be protected with anything less than cancellation.”
The Chiropractic Board of Australia who lodged the case said the decision showed the length the board would go to protect the public.

“The VCAT decision sends a clear message: the Board will not tolerate chiropractors who provide treatment that puts the public at risk and is not in their patients’ best interests,” said chairman Dr Phillip Donato.

Source: Herald Sun

Windermere Chiropractor Sentenced to Federal Prison in Fraud Scheme

CAPE CORAL, FL— A  Windermere chiropractor was sentenced to five years in federal prison on Wednesday for his role in a health care fraud scheme, prosecutors said.
Dr. Stephen M. Lovell, 55, was convicted of conspiracy to commit health care fraud after a two week trial in February. His sentence also included a financial judgment of $1.695 million.
Federal prosecutors alleged Lovell and other licensed health care practitioners posed as the owners of Xtreme Care Rehabilitation Center Inc. in Cape Coral. By claiming the business was owned exclusively by licensed practitioners, the actual owners avoided additional regulatory scrutiny.
The clinic also engaged in staged accidents, including submitting false insurance claims, prosecutors said. Insurance payouts from the bogus accidents were then laundered through corporations created by the conspirators, according to the federal government.
Two men identified as among the actual owners of the clinic pleaded guilty earlier this year and were also sentenced to federal prison.

Source:  Orlando Sentinel

Clackamas Chiropractor Cleared of False Charges

CLACKAMAS, OR An administrative law judge decided a Clackamas chiropractor didn’t commit fraud, pinch a client’s butt or commit other improper acts but was the target of lies by a disgruntled former employee.
The Oregon Board of Chiropractic Examiners recently released it’s final order which clears Kim Jameson’s name. Jameson had filed a lwasuit to force the board to release the judge’s order. The board hasn’t done that, but the final order heavily quotes the judge, who exonerated Jameson of all the accusations except one record keeping violation. For that, she was ordered to 12 hours continuing education.
In the new document, the Oregon Board of Chiropractic Examiners admits its lead witness, Caroline Rackley, committed perjury and that six of their other seven witnesses testified based on Rackley’s statements.
The judge said “Rackley likely provided this information in an effort to cover up her own wrongdoing and to shift suspicion and blame onto Dr. Jameson. In short, without information provided, directly or indirectly, by Rackley, the Board has little or no substantive evidence against Dr. Jameson.”
The board’s order alludes to accusations that Rackley borrowed money from the chiropractor’s clients and took petty cash.
In her lawsuit, Jameson said she lost business because of the false accusations. Some insurance companies won’t pay for services by a doctor who is being investigated, she wrote. Some clients heard about the accusations and stopped going to her.
“I’m grateful that my name has finally been cleared,” Jameson said in an email. “That’s what I’ve wanted for the past two years.”
Jameson intends to sue the board and its investigator for damages, her attorney said.

Source: Oregon Live

$750k for Lack of Documentation?

A Patient’s Personal Tragedy Becomes a Practice Tragedy

malpracticecasesummaryMr. Smith, 50 years old, presented as a new patient in January 2009. He checked “no” to all questions on the health history form but complained of headache and nausea. Dr. Jones performed an upper cervical adjustment on Mr. Smith’s first visit and prescribed Mr. Smith an 8 week care plan.

On Mr. Smith’s third visit, Dr. Jones’ staff noted that Mr. Smith did not look well and appeared lethargic. Mr. Smith still complained of headache and nausea and vomited in the office. Dr. Jones told Mr. Smith that he cannot treat Mr. Smith and that Mr. Smith should go to the emergency room. However, Mr. Smith refused and stated that he probably just came down with the flu and begged Dr. Jones to adjust him. Dr. Jones reluctantly performed an upper cervical adjustment on this visit. Dr. Jones did not document that he advised Mr. Smith to go to the emergency room.

The next day, Mr. Smith’s spouse called Dr. Jones to report that Mr. Smith had vomited again. Dr. Jones advised Mrs. Smith to take Mr. Smith to the emergency room immediately. Again, Dr. Jones did not document his conversation with Mrs. Smith. Mrs. Smith did not take Mr. Smith to the hospital as she thought Mr. Smith merely came down with the flu.

Dr. Jones treated Mr. Smith a total of five times. However, in February 2009, Mr. Smith passed away. Autopsy of Mr. Smith revealed the cause of death was due to blunt trauma to the head.

The Estate of Mr. Smith subsequently filed an action against Dr. Jones alleging failure to properly review and inquire about Mr. Smith’s health history and failure to refer to a physician which ultimately caused Mr. Smith’s untimely death. The Estate of Mr. Smith sought $750,000 in compensatory damages, future earnings, and loss of companionship.

At trial, the Estate of Mr. Smith argued that had Dr. Jones properly reviewed and inquired about Mr. Smith’s health history, Dr. Jones would have discovered that Mr. Smith fell and hit his head on the cement while playing basketball in the last week of December 2008. The Estate of Mr. Smith further argued that Dr. Jones should not have treated Mr. Smith and should have referred Mr. Smith to a physician.

The jury found in favor of the Estate of Mr. Smith and awarded $750,000.

Learning Points
What could Dr. Jones have done differently to prevent such a lawsuit? As an initial matter, Dr. Jones should have held an interactive discussion with Mr. Smith regarding his health history form. At trial, Dr. Jones admitted that he never reviewed Mr. Smith’s health history form with him. Had Dr. Jones held an interactive discussion with Mr. Smith, Dr. Jones would have asked key simple questions including “what has changed recently that may contribute to Mr. Smith’s headache and nausea?” and “when did Mr. Smith’s headache and nausea start?”

Furthermore, at trial, Dr. Jones argued that he in fact referred Mr. Smith and Mrs. Smith to the emergency room but they refused to listen. Although Dr. Jones believed that he complied with applicable standard of care when he referred Mr. and Mrs. Smith to the emergency room, Dr. Jones did not have any documentation to support his defense. Had Dr. Jones appreciated the importance of thorough and appropriate documentation and understood that a complete patient record serves as more than just treatment notes, Dr. Jones most likely would have achieved a more favorable outcome.

Beyond the case of Dr. Jones, every practitioner should consider employing the following practices to prevent a similar fate:
  • Hold an interactive discussion with the patient regarding the health history form, document the discussion, and note any clarifications you made to the patient’s responses;
  • Have the patient review, sign, and date the heath history form at every visit;
  • Pursue unanswered questions;
  • Ask the patient if he/she had seen other health care professionals since the last visit and why;
  • Inquire about any medication regimen that has been started, discontinued, or changed (prescribed or over-the-counter);
  • Ask about noticeable changes in the patient;
  • Take vital and diagnostic signs at every visit if there is an acute situation warranting it;
  • Compare current to historical findings;
  • Consider not treating or refer to another Health Care provider when positive changes are not achieved;
  • Pay attention to other indicators (i.e. level of consciousness; skin; eyes; inability to feel and move; as well as patient comments);
  • Record should reflect all that transpired between practitioner and patient including documentation of missed appointments, telephone messages, patient non-compliance;
  • Always document referral to a physician, emergency room, or specialist by completing a referral form, giving the patient a copy and keeping a complete referral form in the patient’s file;
  • In the event of patient non-compliance, consider withdrawing from professional attendance in writing and sending the withdrawal letter via certified mail with return receipt and keeping a copy of the letter and receipt signed by the patient in the patient’s file.
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Letter from Logan President Emphasizes Need for Cooperation Following No Confidence Vote

CHESTERFIELD, MO On June 16, 2013, the Logan College of Chiropractic Alumni Association Board of Directors passed a vote of no confidence in the Logan University Board of Trustees and their General Counsel.  The vote of no confidence included language that states that the Logan College of Chiropractic Alumni Association Board continues to support the faculty, staff, students, and the new Logan President.  The Logan Alumni Board has been concerned about the financial and human resource management of the College for several years.  The Logan Alumni Board has had repeated failed attempts to meet jointly with the Board of Trustees, most recently at this year’s Homecoming. Furthermore, the Alumni Board sent a letter of questions to the Board of Trustees and received a letter back that did not address the concerns at all. 
Logan Alumni Association President Christopher N. Shoff, DC, states “We hope that the Board of Trustees recognizes and listens to the concerns of the independent voice of the Alumni Association and works with us for the betterment of Logan College of Chiropractic.  We have continued confidence in the faculty, staff, students, and new President of Logan College but are concerned with the past direction of the Board of Trustees and their future direction of the College.  I look forward to working with the Board of Trustees to address the concerns and wishes of the Alumni Association Board of Directors.”
Further action was taken by the Alumni Board demanding an independent accounting firm perform a transparent, forensic audit of the school’s financials over the past five years.

Source: Logan College Alumni Association

Animal Chiropractor Daniel Kamen Prompts State Crackdown

BUFFALO GROVE, IL, June 19, 2013  In 1995 chiropractor Daniel Kamen conducted his first of four hundred animal chiropractic technique seminars that was not just for licensed chiropractors and veterinarians, but also for regular horse and dog owners.  Each seminar quickly sold out. Kamen, an animal chiropractic pioneer and author of three bestselling books on animal chiropractic technique, The Well Adjusted Dog, The Well Adjusted Horse, and The Well Adjusted Cat, was swiftly served with cease and desist letters from several states claiming he violated their veterinary laws by teaching non-professionals to manipulate Spot, Seabiscuit, and Fluffy.
“Soon after I conducted my first few seminars I heard from a lot of states warning me to stay out.  Minnesota, Oklahoma, Arkansas, Georgia, Washington, Ohio, Louisiana, and Nevada all sent me cease and desist letters. Nevada! They allow gambling and prostitution but they’ll lock you up for cracking a horse’s tuchus.”

Nevada even threatened Kamen with legal action if he didn’t remove seminar announcements from his website,
“It’s all about money,” Kamen said.  “Dog owners won’t spend five grand for hip dysplasia surgery when a simple, almost free chiropractic technique can help prevent its onset.”
Aside from the hip dysplasia technique, dog owners paid close attention when Kamen demonstrated the bladder control move.  “It just takes four minutes a day,” Kamen said.  “And no more soiled carpets.”
By far, the most popular chiropractic technique among Thoroughbred trainers and barrel racers is the “Pre-Race Adjusting Sequence,” which, according to Kamen, “increases efficiency and can shave fractions off the time.”
Practitioners from as far away as Hong Kong, Australia, South Africa, and England flew in to learn these techniques. “My seminars attracted people from all over the world,” said Kamen, 57, who is mostly retired and now conducts only one seminar a year.  “A Saudi prince once flew his personal chiropractor to my Philadelphia seminar so he could adjust his prized Arabians.”
State laws regulating the practice of animal chiropractic haven’t changed much in 18 years.  Even though there is a national veterinary chiropractic association certifying licensed practitioners, there are still less than two hundred full time professional animal chiropractors nationwide.  Additionally, most veterinary boards have shut out licensed human chiropractors who are also certified in animal chiropractic.  It’s no wonder horse and dog owners who want their animals adjusted have to fend for themselves.

“That’s why my seminars thrived,” Kamen said. “Horse and dog owners were just as fed up with the system as I was and were forced to learn how to adjust their own animals who suffered from neck, back, and leg pain. Their frustration in searching for a trained professional fueled my business. The states who made it illegal for licensed chiropractors to adjust animals were really doing me a favor. They created a lay market for me for which I am eternally grateful.  My only problem now is finding the appropriate thank you card at Walgreens.”

Bryan Chiropractic Clinic Owner Convicted in $3 Million Automobile Insurance Fraud

HOUSTON, TX—The owner of a now defunct chiropractic clinic in Bryan has pleaded guilty to engaging in a conspiracy to defraud various automobile insurance companies of more than $3 million, United States Attorney Kenneth Magidson announced today.
Marion Young, 42, co-owner of Private Chiropractic Care, admitted he participated in a two-year conspiracy to defraud numerous auto insurance companies by recruiting alleged auto accident victims to be represented by a Bryan area law firm. He further admitted he operated Private Chiropractic Care clinic as a front to allow fraudulent chiropractic bills to be created for treatments that were never performed and then used as support for fraudulent settlement demand letters sent to auto insurance companies. During the course of the conspiracy, Young received checks and cash from the firm totaling approximately $112,000.
Once represented by the firm, clients were sent to Private Chiropractic to be evaluated by chiropractor and co-defendant Chase Lindsey, 34. Lindsey pleaded guilty earlier this year, admitting he entered into an agreement with the office manager of that same law firm. Lindsey agreed to provide medical evaluations of and recommend treatment for those patients in exchange for $2,000 in cash per month, which totaled approximately $58,000 during the course of the conspiracy. Lindsey routinely prescribed medically unnecessary treatment which was provided, if at all, by unlicensed, untrained, and unqualified individuals and never supervised the treatments allegedly administered by these unqualified individuals. Lindsey always prescribed the same six treatments, but the patients usually received only two—ice/heat packs and electric stimulation. Lindsey prescribed the treatments be done three to four times per week for five to six weeks, but the patients usually went once a week for three to four weeks.
Young knew the patients were not receiving most of the treatments prescribed and that they were not going for treatments on many of the days reflected on the Private Chiropractic Care bills. Young knew the false Private Chiropractic Care billing was prepared at the law firm and that the fraudulent bills were used as support for settlement demand letters sent to auto insurance companies. The fraudulent demand letters caused the insurance companies to issue settlement checks, which were spilt between Young and others.
The scheme to defraud the automobile insurance companies resulted in the submission of more than $3 million in false billing claims. The insurance companies paid at least $1.2 million in false claims during 2007-2009.
U.S. District Judge Kenneth Hoyt, who accepted the guilty plea, has set sentencing for September 16, 2013, at which time Young faces up to 20 years in prison and a possible $250,000 fine. As part of his plea agreement, Young also agreed to forfeit the $112,000 he received and to pay restitution of $1.2 million to the insurance companies victimized by the scheme. Young was allowed to remain free on bond pending his sentencing.
Three remaining defendants charged in relation to this case are scheduled for trial on September 24, 2013. They are presumed innocent unless convicted through due process of law.
The criminal charges are the result of a joint investigation by agents of the FBI and the National Insurance Crime Bureau. Assistant United States Attorney Al Balboni is prosecuting the case.
Source: FBI

Chiropractor Gets Prison Selling Boots for 4k

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

Blue Cross Must Pay $4M for Dropping Patient-Advocate Doc

A doctor who claimed health insurer  retaliated against him for being a strong patient advocate, has won a $3.8 million verdict against the insurer.
Jeffrey Nordella, a family-practice and urgent care doctor, used to be a preferred provider on the Anthem Blue Cross network, a unit of insurance giant WellPoint Inc. During that time, Nordella challenged the insurer’s decisions to deny his patients claims for coverage. He often protested Anthem’s denial of coverage because it wasn’t “medically necessary” and he even met with top Anthem officials in 2001.
When he applied to be a provider again in 2010, the insurer rejected his application.
Nordella sued Anthem, arguing that the reason he was not allowed in the network was in retaliation for sticking up for his patients.
Anthem claimed it did not need any more family practitioners because it already had 137 primary-care doctors in its network within 10 miles of Nordella, who was medical director of an urgent-care clinic and family medicine in southern California.

But at trial the insurance company could only name seven doctors, according to Nordella’s attorney, Theresa Barta. Barta argued that in order to lower costs and boost its profits, Anthem intentionally cuts doctors from its network to make it harder for patients to get care.
The jury found that Anthem denied the doctor’s right to a “fair procedure” with “malice, oppression or fraud,” and originally awarded Nordella $4.49 million. However, the jurors found he was 15 percent to blame for his loss of income and which cut down the award to $3.8 million.
The second phase of the trial began on Apr. 12. Barta argued that the jury should punish Anthem based on a portion of its profits of $525 million in 2010. If the jury agrees, Nordella’s award could be increased. 


Chiropractor Sued for Damaging Breast Implant

SYDNEY, AUSTRALIA  A judge in Sydney, Australia, awarded a woman $51,137 in damages after her chiropractor dislodged one of her breast implants while he adjusted her back in 2008.
Amanda Jurkovic, 33, claimed the damaged implant destroyed her sex life and led to the breakdown of her marriage, the Daily Telegraph reports.
Judge Michael Finnane ruled chiropractor Paul Hubbard was negligent because he failed to ask her if she had prior surgery or medical problems before “compressing her breasts” against the treatment table, the newspaper reported.
Jurkovic, a beautician from Winmalee, said her deformed breast caused her to be too embarrassed to have sex with her husband and led to their separation.
“She is a young, fit looking and attractive woman to whom her appearance is very important. She is entitled, in my opinion, to substantial compensation,” Finnane said.

Source: Toroto Sun