Observations of a Forensic Chiropractor
Forensics is not only the scientific investigation of crimes. It also includes the application of medical science in civil matters, such as personal injury cases. Forensic chiropractors provide expert opinions about chiropractic diagnosis and treatment. The following story illustrates why we are needed. Several years ago, a chiropractor approached me with his right hand outstretched, a car-salesman smile on his young face. I stood up from the bench in the courthouse hallway to meet his handshake. “How’s it going?” he asked enthusiastically as he pumped my arm. I knew what his question meant; it wasn’t How are you? or How’s your day been? No, he was asking about my chiropractic practice. Those three words were a code for other questions like How many patient visits …
Continue Reading >Sparks Fly at Denenberg Hearing on Chiropractic (1972)
During the 1970s, chiropractors campaigned relentlessly for a law that would force Pennsylvania Blue Shield to pay for chiropractic x-rays. In 1972, while one such bill (H.B. 816) was being considered, Insurance Commissioner Herbert S. Denenberg scheduled a hearing to consider a Blue Shield request to increase its premiums. When I asked him to include discussion of chiropractic’s role in health care, he agreed to do so and invited me to testify. Denenberg, who was sometimes referred to as “the Ralph Nader of Insurance,” had spoken out repeatedly about excessive medical costs and the overuse of x-rays by medical doctors and dentists. About a year before the hearings were held, I suggested that he also look at chiropractic use of x-rays. He invited me to meet …
Continue Reading >Insurance Fraud Involving Chiropractors
General Article Insurance Fraud and Abuse: A Very Serious Problem (link to Quackwatch) California Allstate Suing 21 for Billing Fraud (posted 12/22/99) Three Chiropractors Among 14 Arrested for Staged Accident Scheme (posted 8/23/99) Illinois Allstate Alleges Businessman Operated Unlicensed Chiropractic Clinics (updated 12/28/99) Massachusetts Boston Area Chiropractor and Wife Sentenced in Fraud Case (posted 8/23/99) Nevada Las Vegas Chiropractor Convicted of Mail Fraud (link to another site) New Jersey Manager of North Jersey Chiropractic Center Indicted posted 8/23/99) Two Chiropractors, Five Others Indicted (posted 8/22/99) Twelve Charged in Scheme Involving Faked Accidents (posted 8/22/99) Chiropractor Caught in Undercover Sting (posted 8/23/99) Chiropractor Loses License for Fraud (link to another site) Allstate Sues to Recover Many More Millions (posted 12/30/99) Allstate Seeks to Recover $4.8 Million …
Continue Reading >Allstate Sues to Recover Many More Millions
On October 19, 1999, Allstate Insurance Company filed two suits against 258 individuals suspected of participating in two staged accident rings in Camden and Perth Amboy, New Jersey. A third suit targeted chiropractors, medical doctors, and related medical and business corporations who allegedly created a dummy medical corporation to misrepresent a chiropractic facility as a physician-owned medical center. The scheme is connected to a seminar run by a California chiropractor and advertised on the World Wide Web. The most complex of the three suits was filed in Morris County Superior Court. Allstate accuses Atlantic County chiropractor J. Scott Neuner of setting up a phony medical corporation, Northfield Medical Center, PC, in order to circumvent a New Jersey health-care regulation that limits chiropractors’ scope of practice …
Continue Reading >Allstate Alleges Chicago Businessman Operated Unlicensed Chiropractic Clinics
On August 19, 1999, Allstate Insurance Company filed suit in Cook County Circuit Court against Richard Burton and his corporation, Mandella Business Services, Inc, accusing them of providing medical services without a license through two Chicago-area chiropractic clinics they owned: Oak Park Medical Center a/k/a Oak Park Chiropractic Clinic, and Spellmate Medical Center a/k/a Universal Chiropractic Clinic. Allstate also accuses Burton of permitting unlicensed individuals to provide treatment to the clinics’ patients without the necessary supervision from a licensed health care professional, and of rubber-stamping medical reports with the signatures of licensed chiropractors to mislead Allstate into believing that a licensed professional prepared the reports and provided treatment. The company is seeking $700,000 in statutory and compensatory damages [1]. The suit describes how Burton and …
Continue Reading >Allstate Suing 21 for Insurance Fraud
On August 24, 1998, Allstate Insurance Company served summons and complaints accusing 13 physicians, chiropractors, health care providers and others, of taking part in an elaborate scheme to defraud the company of millions of dollars. Allstate seeks to recover approximately $25 million in statutory damages, attorneys’ fees, and costs from the defendants. The two suits, filed in Los Angeles County and San Bernardino County, detail how the named medical professionals had allegedly engaged in insurance fraud, ranging from “upcoding” to charging for services that were never rendered. Upcoding involves submitting invoices for more expensive services than the injured person actually received, in an attempt to obtain a larger fee from the insurance company. Allstate first suspected that it had been victimized by these individuals and …
Continue Reading >Chiropractor Charged with Faking Disability
On October 2, 1998, New York State Superintendent of Insurance Neil D. Levin announced that Robert A. Strange, 45, of 749 Route 82 in Hopewell Junction, New York, was arrested September 28 and charged with four counts of insurance fraud in the third degree, two counts grand larceny in the third degree, and five counts of insurance fraud in the second degree. Strange, a self-employed chiropractor, allegedly collected $38,000 fraudulently from insurance companies claiming that he was disabled and could not work. However, an Insurance Department investigation revealed that Strange treated numerous patients during the period he claimed he was not working. Insurance fraud in the third degree and grand larceny in the third degree are punishable by up to seven years in prison. Insurance …
Continue Reading >Department of Justice Reports
The Western District of Louisiana obtained a $2.1 million judgment against a Shreveport chiropractor. The Louisiana Department of Health and Hospitals performed an audit of Medicaid reimbursements which revealed 86% of his patients were minors, and often members of the same family. The audit also revealed that billed services were not actually provided or were upcoded. (1997) A chiropractor, with high billing rates, and his wife were convicted of numerous counts of mail fraud involving the padding of bills in the treatment of victims of automobile accidents. Their scheme had two principal components: the making of fraudulent disability findings for potential plaintiffs in auto accidents and in workers’ compensation claims, and performing fraudulently excessive testing and treatment of such individuals, often in order to raise …
Continue Reading >Chiropractor Pleads Guilty in Million-Dollar Case
United States Attorney J. René Josey announced today that John Gregory Osteen, DC, of Greenville, South Carolina, pled guilty on Thursday, February 2, 1998, to one count of mail fraud related to a scheme to defraud insurance companies by performing unnecessary nerve and vascular tests. Osteen pled guilty before the Honorable William B. Traxler, Jr. at the U.S. District Court in Greenville. Osteen was indicted for the mail fraud scheme in November, 1997 by a federal grand jury. The indictment was the result of a health care fraud investigation conducted by the South Carolina Health Care Fraud Task Force, and included the participation of the Federal Bureau of Investigation, the United States Postal Inspector’s Office, the South Carolina Attorney General’s Office, and the Fraud Investigation …
Continue Reading >Three Chiropractors Among 14 Arrested for Staged Accident Scheme
In June 1998, Charles G. LaBella, United States Attorney Southern District of California; William D. Gore, Special Agent in Charge, San Diego Division of the Federal Bureau of Investigation; and Chuck Quackenbush, Insurance Commissioner, California Department of Insurance; announced the culmination of a three-year investigation code-named “Twisted Metal.” Eleven individuals in San Diego and 3 individuals in the Los Angeles area were arrested: Bruce Edward Ankrom, DC, 43, chiropractor Viatcheslav M. Borokhov, 52 , “stuffed passenger” Inna Elana Gofman, 37, attorney Dmitry Goldman, 46, “stuffed passenger” Gavriyel Kaziyev, 50 , “stuffed passenger” Irma Elizabeth Palacios, 53 , paralegal/office administrator Igor Pruchanskiy, 22 , “stuffed passenger” Mikhail Rozenberg, 53 , paralegal/office administrator Paul G. Shvartsburd, 47 , physical therapist Igor Snarsky, 39 , capper/recruiter Marvin Charles …
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