There Was a Crooked Man…

7

Chiropractors are supposed to be master manipulators—of the human spine, that is. But a press release issued by the U.S. Attorney’s Office, District of Columbia, details the scheme of a chiropractor who manipulated the D.C. Medicaid program out of more than $50,000 with fraudulent billings for home care services.

The Maryland man, who operated out of a neck and back pain center in Southeast Washington, was licensed as a chiropractor in the District. But he was not a physician or an advanced practice registered nurse, which are the only medical professionals authorized to issue prescriptions for the home care services that are eligible for Medicaid coverage. (But a medical degree is so expensive!)

This practitioner enlisted the help of personal care aides from eight different home care agencies who initially paid him $75 per patient to write up phony prescriptions and plans of care to support their fraudulent claims for reimbursement from Medicaid. He upped his fee to $150 per diagnosis, some of which did not even include an examination of the patient. The scheme went on for 14 months and resulted in hundreds of invalid ”prescriptions,” usually for chronic severe back pain that required assistance for eight hours a day, seven days a week, for a period of six months. (Until it ‘backfired’)

After pleading guilty to a charge of health care fraud, the man was sentenced to five months in prison and two years of supervised release. In addition, he was ordered to pay $50,260 in restitution to the D.C. Medicaid program. (Let’s hope he learns to walk a straighter path in future.)

Source: Today’s ”Fraud of the Day” is based on, ”Area Chiropractor Sentenced to Prison for Health Care Fraud,” a press release issued by the U.S. Attorney’s Office, District of Columbia, on March 18, 2016.

Lewis J. Levine, 59, a chiropractor who practiced in Southeast Washington, was sentenced to five months of incarceration, to be followed by two years of supervised release for his role in a scheme involving fraudulent claims to the D.C. Medicaid program.

Levine, of Laurel, Md., pled guilty in September 2014 to health care fraud and must pay $50,260 in restitution and an identical amount in a forfeiture money judgment.

Levine signed hundreds of prescriptions and plans of care in exchange for cash payments from D.C. Medicaid beneficiaries and personal care aides, who used the paperwork to justify claims to Medicaid – even though they were not prescribed by a physician as required.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.