Feds, SD Chiropractor Association Reach Settlement

SIOUX FALLS, SD The U.S. Department of Justice says it has reached a settlement with a chiropractor association in South Dakota over fixed prices. The department’s Antitrust Division filed a civil lawsuit against Chiropractic Associates Ltd. of South Dakota. The association comprises approximately 80 percent of all practicing chiropractors in the state. 
The Department of Justice says the association negotiated at least seven contracts with insurers that set prices for chiropractic services, which caused consumers to pay higher fees.
The proposed settlement will prevent the association from establishing prices or terms and from negotiating with insurers on behalf of competing chiropractors. It must still be approved by the court.

Source: Rapid City Journal

Two Years Later Chiropractor Charged With Groping Patient

Seattle, WA: A Federal Way chiropractor alleged to have sexually assaulted three patients now faces a criminal charge in one purported groping.
More than two years after the first woman went to authorities, King County prosecutors have a chiropractor with indecent liberties, a felony sex offense.
The chiropractor has been charged with groping one patient in September 2010. At least three other former patients have filed complaints against him with the state Department of Health; two of those complaints have been detailed publicly.

The charges against the chiropractor filed earlier this month stem from a complaint by a 51-year-old woman alleged to have been groped b at his office.
The woman initially went to police and Department of Health authorities shortly after the September 2010 incident. Her complaint was at first rejected by a state disciplinary board, a board that reversed itself after two other women came forward with complaints.
Writing the court, a Federal Way detective said the initial complainant met with Summers at the chiropractor’s office. The D.C. is alleged to have reached up the woman’s shirt and fondled her breasts during the visit.

Concerned by the chiropractor’s behavior, the woman filed a complaint with the Department of Health later that day. She contacted police a week later.
Department of Health investigators reviewed the woman’s complaint and in January 2011 submitted their findings to the Chiropractic Quality Assurance Commission, an oversight board comprised primarily of licensed chiropractors.

The board found the evidence presented by investigators did not support a finding and did not take any action against the chiropractor, a Department of Health spokeswoman said Tuesday. The Chiropractor was allowed to continue his practice until November, when the board suspended his license after receiving additional information from the woman and two other purported victims.
The allegations now made against Summers through the state process are more severe than those currently offered by King County prosecutors.

In addition to the first woman’s claims, Department of Health investigators detailed two other former patients’ complaints in their report to the chiropractic board. A fourth patient has also complained to the Department of Health about Summers.

According to documents filed by the state, one of the more recent patients claimed Summers touched her crotch and offered himself as a sexual teaching tool. A third woman claimed Summers touched her inappropriately after offering to massage her internally.
The complaints against Summers were not made public until November, two years after the woman’s initial complaint that Summers had groped her. Summers’ medical license has been suspended by the chiropractic board.

Summers was charged Friday with indecent liberties. He has not been jailed in the case.

Source:  SeattlePI.com

D.C. Burglarizing Tucson Area

Tucson, AZ – A string of businesses burglaries throughout the Tucson area in a 3-month period. There’s been well over 60 cases in the Tucson area. Pima County Sheriff’s Burglary detectives say they may have a break in the case but they need your help.
Detectives are looking for Charles Spear a former chiropractor no longer in practice. Detective Hans Goritz says he wears a black surgical mask due to a facial deformity and he may be living out of his Ford Explorer. “We have forensic evidence that ties him specifically to one break in at the chiropractic office on Oracle Road.”
A string of burglaries followed. News 4 Tucson obtained surveillance video of another suspect investigators are hoping you can help identify. Det. Goritz describes the video, “You actually see the rock getting thrown through the window a white male subject wearing dark clothing coming in crawl in thru the window. He hops over the counter.” He’s seen rifling through drawers of an east side dental office grabbing what he can. He hops back over the counter and leaves. All this in 65 seconds.
Detectives say he stole $4.00 and change. “In this particular case, the damage is far exceeding what he gained out of it.”
Last month, there was a special operation to try and catch the burglars in the act. The target area, North Oracle Road from River to Magee.
The Sheriff’s Department is determined to find the burglars wreaking havoc on businesses, not knowing if the suspects could be dangerous. Detective Jesus Banuelo says, “You prepare as if they are the most dangerous person especially at night.” He says the motivation for the burglaries “is typically drug related. It always comes back to somebody trying to get quick money to get their quick fix.”

Source: KVOA News

Largest Ever Automobile Fraud Ring Accept Guilt

Washington, DC – Preet Bharara, the United States Attorney for the Southern District of New York, announced that five defendants have pled guilty for their roles in a systematic scheme to defraud private insurance companies of more than $400 million under New York’s no-fault automobile insurance law.
The case is the largest single no-fault automobile insurance fraud scheme ever charged. Andrey Anikeyev, an owner and controller of various acupuncture clinics, pled guilty before U.S. District Judge J. Paul Oetken to conspiracy to commit mail fraud and health care fraud. Dmitry Slobodyansky, who owned and controlled chiropractic clinics, also pled guilty before Judge Oetken to conspiracy to commit mail fraud and health care fraud. Sergey Gabinsky, a medical doctor, pled guilty before Judge Oetken earlier in Febuary, and Pavel Poznansky, an acupuncturist, and Constantine Voytenko, a chiropractor, pled guilty before Judge Oetken in December 2012. All five were arrested in February 2012 with 31 other defendants, some of whom were also charged with racketeering and money laundering. The 36 defendants include 10 doctors and three attorneys.
Manhattan U.S. Attorney Preet Bharara said, “These five defendants piled up fraud to the tune of $400 million in a scheme to exploit New York’s no-fault auto insurance laws. We remain committed to ensuring that all their alleged co-conspirators, including the corrupt medical and legal professionals charged with using their professional licenses and training to facilitate this brazen fraud, see justice.”
According to the indictment, superseding informations, and other publicly filed information in the case:
Under New York State law, every vehicle registered in New York State is required to have no-fault automobile insurance, which enables the driver and passengers of a registered and insured vehicle to obtain benefits of up to $50,000 per person for injuries sustained in an automobile accident, regardless of fault (the “No-Fault Law”). 
In order to mislead New York authorities and private insurers, some of the defendants in this case who were the true owners of these medical clinics (“No-Fault Clinic Controllers”) paid licensed medical practitioners, including doctors, to use the practitioners’ licenses to incorporate the professional corporations through which the medical clinics billed the private insurers for the bogus medical treatments. Gabinsky was one such doctor who admitted in open court to prescribing unnecessary medical treatments and to allowing co-conspirators to use his medical license to unlawfully open medical clinics in order to defraud insurance companies. Poznansky and Voytenko were medical practitioners who billed insurance companies for treatments to patients that were unnecessary.
The No-Fault Clinic Controllers also instructed the clinic doctors to prescribe excessive and unwarranted referrals for various “modality treatments” for nearly every patient they saw. The treatments included physical therapy, acupuncture, and chiropractic treatments—as much as five times per week for each—and treatments for psychology, neurology, orthopedics, and audiology. Clinic doctors also prescribed unnecessary MRIs, X-rays, orthopedics, and medical supplies. The No-Fault Clinic Controllers received thousands of dollars in kickbacks for patient referrals from the owners of the modality clinics (“modality controllers”). Anikeyev and Slobodyansky were two such Modality Controllers who admitted to billing insurance companies for treatments that patients did not need.

Source: Imperial Valley News


Boca Raton Chiropractor Sentenced in Staged Accident Scheme

Boca Raton, FL- A Boca Raton chiropractor connected with a staged accident fraud scheme has been sentenced to more than four years in prison and ordered to pay nearly $2 million in restitution to insurance companies, the U.S. Attorney’s Office said on Friday.
Jennifer Adams, 39, pleaded guilty in November to a charge of conspiring with others to commit mail fraud in the scheme. She was linked to an accident-staging ring at clinics in West Palm Beach and Palm Springs.
 Adams, who agreed to give up her medical licenses, has also practiced in Fort Lauderdale.
According to court documents, drivers and their friends and family members were recruited to participate in the staged accidents. The recruiters coached the participants on how to stage the crashes, speak with police officers and claim injuries.

After they obtained police reports for the bogus accidents, the participants would then file false insurance claims alleging that they, along with their passengers, had been injured, the U.S. Attorney’s Office said.
The participants would then go to chiropractic clinics, Ovy Rehabilitation Medical Center Inc., in West Palm Beach, and Chiropractic Office of South Florida LLC in Palm Springs, and sign blank paperwork indicating they had received treatment.

However, some had received little to no treatment at all, authorities said.
According to the U.S. Attorney’s Office, Adams lent her name on corporate paperwork for both clinics to allow them to bill the insurance companies for the claims. Although she was listed as the owner, co-conspirators ran the clinics and controlled the bank account.
Court records show that Adams initially believed the clinics were legitimate but remained affiliated with them after learning about the fraud.
The fake claims were submitted to 10 insurance companies that made a total of $1.9 million in payments.
Adams’ 54-month prison sentence will be followed by three years of supervised release.

Source:  Sun Sentinel

Hennepin County Jury Returns Excess Verdict Against American Family Insured

EAGAN, MN, January 26, 2013 After being told to “get over it” by an American Family adjuster, a 22-year old woman, after nearly drowning in a car crash, was awarded almost $284,000 by a Hennepin County jury. On Wednesday, January 16, 2013, after a 2 day trial, a Hennepin County (Minnesota) jury returned an excess verdict in favor of a 22-year old passenger who was injured in a collision in late March 2010.
The 22-year old was a passenger in a vehicle driven by Champale Carter on March 28, 2010. The young women were traveling to Willmar to visit friends. On the way there, after dark, the driver went through a t-intersection and into a holding pond. The car hit the water, the front windshield broke and water began rushing in. The young women escaped the vehicle. When they jumped from the car into the water, they realized that the cold water was over her heads. The two young women swam to shore.
The passenger suffered injuries to her neck and back in the collision. More devastating, however, was the emotional injuries she sustained. Following the collision, the 22-year old passenger experienced nightmares 2 to 3 nights per week. She received medical care from a chiropractor, neurologist and a psychologist.
The passenger’s attorney, Thomas Bennerotte of the Eagan based law firm of Bennerotte & Associates, PA, pursued the driver’s insurance carrier, American Family, in an effort to attempt resolution of the case. American Family offered a small sum of money for what they deemed soft tissue injuries. With respect to the emotional aspects of the passenger’s case, the American Family adjuster suggested Mr. Bennerotte tell his client to “get over it.” After the verdict, Mr. Bennerotte said his client and him both remembered that May 2011 conversation with the American Family adjuster like it was yesterday. Bennerotte said, “I did not react to the insensitive comment like I would have liked to. I simply told the adjuster that the comment was foolish but that I would not get mad. I did ‘promise’ him, however, that my client and I would get even.” A lawsuit was commenced in response to the low-ball offer.

“Get even” is exactly what Bennerotte and his client did. The driver did not admit fault or offer an apology. “We asked the jury to do what the negligent driver did not – make things right.” The Hennepin County jury returned a verdict in favor of the passenger for almost $284,000, which included over $220,000 for past and future pain, suffering, embarrassment and emotional distress. The verdict is well over the American Family insured’s $100,000 policy limit. When asked about the verdict, Bennerotte smiled and said, “As it turns out, American Family will be the ones getting over it.”
While the result was not Bennerotte’s largest, he commented that, “it was one of the most satisfying.”


Federal Judge Dismisses Lawsuit to Block Florida PIP Reform

TALLAHASSEE, FL, The R Street Institute, a free-market think tank headquartered in Washington, D.C., has issued a press release praising the order by Judge Richard Lazzara of the U.S. District Court for the Middle District of Florida dismissing a lawsuit by chiropractors, acupuncturists, and massage therapists that sought to block implementation of reforms passed last year to Florida’s personal injury protection auto insurance system. 
In his decision, Lazzara found no basis for the plaintiffs’ claims that, because the law constrains PIP coverage for chiropractors and proscribes it altogether for massage therapists and acupuncturists, they were denied due process and equal protection under the Fifth and 14th Amendments to the U.S. Constitution. 
“What plaintiffs fail to grasp is that although they do have a state-created property interest in their professional licenses, that interest is only subject to procedural due process protection and not substantive due process protection,” Lazzara wrote, adding that the practitioners’ procedural due process rights are covered by the legislative process that passed the law. 
Lazzara added that the statutory restrictions in the PIP reform law do not appear to impinge on the plaintiffs’ liberties to follow their chosen professions. In a press release, R Street Florida Director Christian R. Cámara called the decision a victory for Florida consumers. 
“Governor Scott and the Florida Legislature heard the calls from Florida consumers about their runaway auto insurance costs and took action to cut out the fraud and unscrupulous claims that were driving up rates,” Cámara said in the release. 

“The federal court did the right thing in upholding those cost-saving, pro-consumer reforms by throwing out this lawsuit. It is unfortunate that opponents of reform who couldn’t get their way in the Capitol last year insist on using the courts to legislate on their behalf.”
Lazzara’s decision allowed the plaintiffs to proceed with a separate suit in Florida state court, which he said was in a better position to judge unique claims made under Florida constitutional law. That suit was filed Jan. 9 in Tallahassee in the 2nd Judicial Circuit Court of Florida.

Source: Sunshine State News

Lawsuit Attacks Colorado D.C. Ability to Administer Drugs

Colorado Springs, CO, The Colorado Medical Society filed a lawsuit Monday to halt a rule that would allow chiropractors to administer drugs.
The rule was created by the Chiropractic Board of Examiners and would authorize practitioners to administer drugs topically, orally, by inhalation and injection, after completing 24 hours of study and a certification exam. The board certifies doctors of chiropractic and changed the rule in November. Without action, it will go into effect Jan. 14.
Colorado Attorney General John Suthers said the changes “exceed the legislative scope of the authority” granted to the board of examiners. And records at the AG’s office show most chiropractors oppose the rule.
“The enactment of the rule exceeds the authority of chiropractors as defined in the Chiropractors Practice Act and intrudes on the practice of medicine by professionals licensed under the Medical Practice Act,” said Susan Koontz, general counsel and senior director of government relations for the Colorado Medical Society.
“Authorizing chiropractors to administer drugs and perform injections threatens irreparable injury to the public welfare and the safety of the patients the members of the Colorado Medical Society serve to protect,” said John Conklin of Martin Conklin, counsel for CMS.
Also opposing the new rule in the lawsuit: Colorado Society of Osteopathic Medicine, Weld County Medical Society, an attorney for several state medical societies, including Creek Valley Medical Society, Aurora-Adams County Medical Society, Denver Medical Society, Mesa County Medical Society, Colorado Radiological Society, Colorado Chapter of American College of Emergency Physicians, Colorado Orthopaedic Society, Colorado Society of Anesthesiologists, Boulder County Medical Society and Larimer County Medical Society.

Source:  Colorado Springs Business Journal

Chiropractor to Prison for Fraud

ALGONQUIN, IL– A chiropractor who partly owned six clinics, including one in Algonquin, has been sentenced to 6½ years in federal prison for health care fraud.
Bradley Mattson, 51, of Lake Forest pleaded guilty in September, admitting to a 10-year scheme to defraud Blue Cross Blue Shield.
Between 1999 and 2009, Mattson co-owned the clinics, which included Algonquin Physical Medicine.
According to prosecutors, Mattson submitted nearly $5.9 million for medically unnecessary tests or physical therapy services that were not provided. He collected almost $2.1 million in reimbursements, which he was ordered to repay.
U.S. District Judge Ronald Guzman said Mattson showed “no sensitivity to his patients” and “put many of them through unnecessary stress.”
“Frauds like this all across the country are jacking up the prices of insurance,” Guzman said.
In 2008, an undercover FBI agent visited one of the clinics for treatment of a lower back strain. Despite diagnoses by the clinic’s medical doctor and physical therapist that the agent had a pulled muscle, Mattson diagnosed him with a pinched nerve and put him on a treatment plan that began with daily visits for two weeks.
The other owners of the clinics, Steven Paul, 41, and Neelesh Patel, 37, of Glenview, face charges, as well. Paul is awaiting sentencing after pleading guilty to health care fraud. Charges against Patel are pending.

Source:  Northwest Herald

Chiropractor Indicted in Alleged Insurance Fraud Scheme

aroundtheworldHOUSTON, TX—Bryan chiropractor Chase Lindsey, 44, and four other residents are named in a 31-count indictment unsealed Tuesday that charges conspiracy and mail fraud in an alleged scheme to defraud auto insurance companies of more than $3 million, U.S. Attorney Kenneth Magidson said.

The indictment, handed up on Nov. 28, names Lindsey, who’s part owner of Lindsey Chiropractic Care in Bryan; Marion Young, 52; Edward Graham, 46; Brittany Jessie, 23, and Earlie Dickerson, 50, who was office manager of the Bryan office of Sanjoh & Associates Law Firm and part-owner along with Young, Graham and Jessie of several other chiropractic clinics in Bryan.

Dickerson and Jessie appeared Tuesday before a U.S. magistrate in Waco and Lindsey and Young appeared before a federal magistrate in Houston.
Lindsey was freed after posting $75,000 bond and Young was ordered to remain in custody pending a detention hearing Wednesday morning.
Graham is expected to appear Wednesday before the magistrate in Houston.

The indictment alleges that Dickerson used his position at the law firm to recruit victims of traffic accidents as clients and then sent them to the clinics he, Young, Graham and Jessie owned or to Lindsey’s clinic.
The indictment says Lindsey, who served as the chiropractor at all four of the clinics, would recommend medically unnecessary therapeutic treatments for the clients whom Dickerson sent in return for about $2,000 a month, which was usually in paid cash.
Then, the indictment says, Lindsey allowed fraudulent bills under his name from the clinics to be submitted by the law firm to various auto insurance companies, which paid the law firm and its clients more than $1.5 million based on the fraudulent claims.
The alleged scheme ran from February 2007 through December 2009, prosecutors said.

Source: KWTX.com