In 2018, Steven Wiseth, 35, who had operated Health Quest Family Chiropractic in Thief River Falls, Minnesota, was charged with six counts of wire fraud and two counts of aggravated identity theft that involved submitting false and fraudulent claims to insurance companies. The indictment (shown below) alleged:
- To maximize patient volume at his clinic, Wiseth held promotional events that provided free food and drink, prizes, and gift certificates to induce current and prospective patients to visit Health Quest.
- After the promotional events, he billed insurance companies for chiropractic services to substantial numbers of individuals who had attended the events, including hundreds of services that were not provided.
- In some cases, unknown to the attendees, he used their personal and insurance information to bill their insurance companies for services that were not provided. For example, following a “ValenSpine’s Day” event on February 13, 2014, he submitted bills to insurance companies for approximately 641 services provided to about 219 patients on that day
- He also
misrepresented services that were actually provided. For example, he routinely submitted false bills for treatment with a “wobble chair,” a device intended to develop core strength. He falsely represented to insurers that the treatment had been performed for at least eight minutes under the direct supervision of a healthcare professional when he merely stocked his clinics’ waiting rooms with wobble chairs so that patients would sit in them while waiting for their appointments.- Over the course of the two-year scheme, he billed the insurance companies more than $3.1 million dollars, including bills for hundreds of treatments that were not provided or were overbilled, and the insurance companies paid him and Health Quest more than $1.1 million.
In 2017, after the Minnesota State Board of Chiropractic Examiners became aware of his wrongdoing, Wiseth entered into a consent agreement under which he voluntarily surrendered his chiropractic license for a minimum of three years. Wiseth began practicing in 2012. Graphics posted to his Facebook page assert that (a) everyone should have periodic spinal checkups and adjustments from birth onward, (b) chiropractic was generally safer and more effective than medical care, (c) prescription drugs are generally unsafe and should be avoided, and (d) vaccines are ineffective and dangerous.
UNITED STATES DISTRICT COURT OF MINNESOTA
UNITED STATES OF AMERICA
v. STEVEN RICHARD WISETH,
|
) ) ) ) ) ) ) ) ) ) |
CASE NO. 18-cr-182-PJS/LIB INDICTMENT Â 18 U.S.C. § 1343 |
THE UNITED STATES GRAND JURY CHARGES THAT:
INTRODUCTION
1. Beginning in or around March 2013 and continuing until approximately April 2015, defendant STEVEN RICHARD WISETH, a Doctor of Chiropractic, orchestrated a scheme and artifice to defraud health insurance companies by submitting and causing the submission of false and fraudulent claims for chiropractic services. WISETH billed for services that he never provided, falsely billed for services by misrepresenting the services that were actually provided, and billed for services without the patient’s knowledge or consent. During the course of his scheme to defraud, WISETH billed more than $3 .1 million to insurance companies and was paid in excess of $1.1 million.
GENERAL ALLEGATIONS
At times relevant to this Indictment:
Relevant Entities and Individuals
2. Health Quest Family Chiropractic (“Health Quest”) was a chiropractic clinic located in Thief River Falls, Minnesota.
3. Defendant STEVEN RICHARD WISETH, a resident of Thief River Falls, Minnesota, was a Doctor of Chiropractic, registered with the State of Minnesota, and was the Manager, Registered Agent, and sole owner of Health Quest. WISETH submitted and caused to be submitted to health insurance companies claims for chiropractic services that were false and fraudulent.
The Scheme to Defraud
4. Beginning in or around March 2013 and continuing until approximately April 2015, WISETH orchestrated a scheme and artifice to defraud various health care companies and to obtain money and property from those companies by means of material false and fraudulent pretenses, representations, and promises, by submitting and causing the submission of false and fraudulent claims relating to chiropractic treatments through his clinic, Health Quest.
5. WISETH‘s scheme was dependent on maximizing patient volume at Health Quest, and he held promotional events where he gave away free food and drink, prizes, and gift certificates to induce current and prospective patients to visit Health Quest. After the promotional events, WISETH billed insurance companies for the provision of chiropractic services to substantial numbers of individuals who attended the events, including billing for services that were not provided and misrepresenting services that actually were provided. WISETH used the personal and insurance information of some attendees to bill services to the individuals’ insurance companies, sometimes without their knowledge or consent.
6. On or about March 28, 2013, WISETH held a grand opening event when Health Quest relocated to a new office space. WISETH submitted bills to insurance companies representing that he had treated approximately 178 patients on that day, purporting to have provided approximately 592 services.
7. On or about February 13, 2014, WISETH held a promotional event at Health Quest that he referred to as “ValenSpine’s Day.” WISETH submitted bills to insurance companies representing that he had treated approximately 219 patients on that day, purporting to have provided approximately 641 services.
8. Beyond these promotional events, WISETH also routinely submitted false bills for treatment with a “wobble chair,” which is a device intended to develop core strength and endurance, for patients who were attending scheduled visits. WISETH billed for these treatments using two Current Procedural Terminology (“CPT”) billing codes for “Therapeutic Procedure,” CPT codes 97110 and 97112. Both of these CPT codes are time-based codes broken down into 15-minute increments. By billing a 15-minute increment, WISETH represented to insurance companies that the service was performed for at least 8 minutes of the 15 minute increment and that a health care professional had direct, one-on-one patient contact while the service was rendered. WISETH routinely billed the 97110 and 97112 CPT codes in instances when the patient received the treatment with no direct supervision and when the service was rendered for far less than the eight minute threshold, often not more than a minute or two. During the course of his scheme to defraud, WISETH billed insurance companies over $619,000 for wobble chair treatments alone, and he received payment of $331,420.
9. Over the course of the two-year scheme, WISETH billed the insurance companies more than $3.1 million dollars, including bills for hundreds of treatments that were not provided or were overbilled, and the insurance companies paid WISETH and Health Quest more than $1.1 million.
COUNTS 1-6
(Wire Fraud)
10. The allegations set forth in paragraphs 1 through 9 of this Indictment are realleged as if fully set forth herein.
11. On or around the following dates, in the State and District of Minnesota and elsewhere, the defendant,
STEVEN RICHARD WISETH,
and others known and unknown to the grand jury, having devised and intending to devise the scheme and artifice described above, caused to be transmitted by means of wire communication in interstate commerce the following writings, signs, signals, pictures, and sounds for the purpose of executing and attempting to execute such scheme and artifice:
09/17/2014
| COUNT | APPROX. DATE | WIRE DETAILS |
| 1 | 07/31/2013 | Electronic transmission of claims information for patient J.S. for service date March 28, 2013, from Health Quest to Blue Cross/Blue Shield. |
| 2 | 07/31/2013 | Electronic transmission of claims information for patient L.S. for service date March 28, 2013, from Health Quest to Blue Cross/Blue Shield. |
| 3 | 01/07/2014 | Electronic transmission of claims information for patient A.P. for service date January 2, 2014, from Health Quest to Blue Cross/Blue Shield. |
| 4 | 08/06/2014 | Electronic transmission of claims information for patient M.H. for service date July 21, 2014, from Health Quest to Blue Cross/Blue Shield. |
| 5 | 09/17/2014 | Electronic transmission of claims information for patient E.B. for service date September 9, 2014, from Health Quest to Blue Cross/Blue Shield. |
| 6 | 09/17/2014 | Electronic transmission of claims information for patient A.M. for service date September 10, 2014, from Health Quest to Blue Cross/Blue Shield. |
All in violation of Title 18, United States Code, Sections 1343 and 2.
COUNTS 7-8
(Aggravated Identity Theft)
12. The allegations set forth in paragraphs 1 through 11 of this Indictment are realleged as if fully set forth herein.
13. On or about the dates set forth below, in the State and District of Minnesota and elsewhere, the defendant,
STEVEN RICHARD WISETH,
did knowingly transfer, possess, and use, without lawful authority, a means of identification of another person, to wit: the name and unique identification numbers, which are means of identification within the meaning of Title 18, United States Code, Section 1028(d)(7), of another person, as alleged in each count below, during and in relation to a felony violation enumerated in Title 18, United States Code, Section 1028A(c), specifically, wire fraud:
| COUNT | APPROX. DATE | WIRE DETAILS |
| 7 | 07/31/2013 | Unauthorized use of the name and health insurance number for J.S. during the commission of wire fraud as alleged in Count 1. |
| 8 | 07/31/2013 | Unauthorized use of the name and health insurance number for L.S. during the commission of wire fraud as alleged in Count 2. |
All in violation of Title 18, United States Code, Sections 1028A.
FORFEITURE ALLEGATIONS
14. Counts 1 through 6 of this Indictment are hereby realleged and incorporated as if fully set forth herein by reference, for the purpose of alleging forfeiture pursuant to Title 18, United States Code, Sections 981(a)(l)(C) and 982(a)(7), and Title 28, United States Code, Section 2461 (c).
15. Upon conviction of the offenses alleged in Counts 1 through 6 of this Indictment, the defendant shall forfeit to the United States pursuant to Title 18, United States Code, Section 982(a)(7) and Title 18, United States Code, Section 981(a)(l)(C), in conjunction with Title 28, United States Code, Section 2461(c), all property, real or personal, that constitutes or is derived, directly or indirectly, from gross proceeds traceable to the commission of the offenses charged in Counts 1 through 6, respectively.
16. If any of the above-described forfeitable property is unavailable for forfeiture, the United States intends to seek the forfeiture of substitute property as provided for in Title 21, United States Code, Section 853(p), as incorporated by Title 18, United States Code, Section 982(b)(l) and Title 28, United States Code, Section 2461(c).
A TRUE BILL
| ____________________________ UNITED STATES ATTORNEY |
_________________________ FOREPERSON |
This article was posted on January 22, 2019.
