Physical therapy clinic uses casino for scam
An office manager for a physical therapist in Central Michigan found an innovative way to drum up business for her employer. The office manager frequented a casino to gamble. While she was there, she'd hand out coupons good for free 30-minute massages at the clinic she managed.
When the recipients of these coupons arrived for their “free” massages, the clinic would take their health insurance information. Then, they would bill the insurance companies for physical therapy services that weren't given.
As a result of this practice, Blue Cross Blue Shield of Michigan payments to the struggling facility increased almost 400 percent. We discovered an error rate of 93 percent when we did an audit.
The office manager had been in an intimate relationship with the physical therapist. When the two parted ways, she told her new love interest of her involvement in the scheme. The love interest, who was a patient of the clinic, contacted us.
The case has been forwarded to federal authorities for prosecutorial review.
Members who suspect health care fraud should call our Anti-Fraud Hotline at 1-800-482-3787, or report fraud through our website.