March 28, 2017

DOJ: Chicago Chiropractor Billed over $10 Million for Nonexistent Services

By the C|C Whistleblower Lawyer Team

Seeking to crackdown on fraud within the chiropractic field, the Department of Justice recently announced the indictment of Chicago-based chiropractor Henry Posada on 18 counts of health care fraud. The government alleges that from 2008 to 2016, Posada fraudulently billed over $10 million in chiropractic services to both Medicare and private insurers. According to the indictment, Posada was not even in Illinois on some of the dates that he claimed to have provided chiropractic services to patients.

The health care fraud charges carry a maximum sentence of up to 10 years in prison. Posada pleaded not guilty in federal court last week. The government is also seeking forfeiture of $5.1 million in payments made to Posada and his clinic, Spine Clinics of America S.C., as well as $850,000 in cashier checks, a 2013 Lexus LX 570 automobile, and a property in Watseka, Illinois.

Posada’s indictment follows a series of recent government reports and investigations into fraud within the chiropractic field. According to an October 2016 report by the Department of Health and Human Services’ Office of Inspector General (OIG), more than 80% of all Medicare payments for chiropractic services in 2013 went towards medically unnecessary procedures. As a result, the government spent nearly $359 million on unnecessary care. Similarly, a 2005 OIG report concluded that the government had made $285 million in improper payments for chiropractic services in 2001, 67% of all Medicare payments to chiropractors that year.

These troubling findings have led the government to take a harder look at individual chiropractor practices. For example, four recent OIG reviews of individual practices revealed $2.3 million in payments for services that were medically unnecessary, incorrectly coded, or lacking adequate documentation. DOJ’s decision to charge Posada criminally may signal a new stage in the government’s efforts to root out corruption amongst chiropractors.

To learn more about fraud within the chiropractic field, click here.

To learn more about the False Claims Act and explore resources for would-be whistleblowers, visit http://constantinecannon.com/whistleblower.

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