Chiropractor cons senior citizens with self-designed back braces
Blue Cross Blue Shield of Michigan and the Indiana Office of the Attorney General investigated allegations that a chiropractor was prescribing medically unnecessary back braces to senior citizens — back braces that he'd designed himself.
The chiropractor would visit senior citizen complexes to promote his self-designed back brace. Once people were convinced they needed the back brace, he would falsify medical records stating it was medically necessary to show that patients needed the brace. The chiropractor then charged insurance carriers over $1,300 per brace — the brace was actually worth less than $100. Evidence showed that the chiropractor billed more than $1.5 million in fraudulent claims to Medicaid, Medicare, Blue Cross Blue Shield of Michigan and numerous other insurance carriers.
The chiropractor was charged with 34 felony counts of health care fraud and money laundering. Testimony at the trial showed that the chiropractor used under-age children to distribute flyers about his back braces at senior citizen complexes. He would then bring food and beverages to the complexes to entice senior citizens to talk with him about his back brace. They were told that the brace would be covered 100 percent by their insurance carriers. Testimony also showed that many recipients of the braces had no medical necessity, and some were not of sound mind.
A jury found the chiropractor guilty on all charges. He was sentenced to 12 ½ years in federal prison and ordered to pay restitution in the amount of $1,580,581. Of that amount, we'll be reimbursed $44,858.
Members who suspect health care fraud are urged to call our Anti-Fraud Hotline at 1-800-482-3787, or report fraud through our website.