Case File #3 Chiropractor convicted for submitting fraudulent medical bills to eight victim insurance companies totaling approximately $3 million

A Pennsylvania chiropractor who owned and operated a fitness center fraudulently billed eight insurance companies, including Independence Blue Cross (IBC), for $3 million in health care services that were not rendered.

IBC’s Corporate and Financial Investigations Department (CFID) conducted a lengthy investigation and even used undercover investigators to investigate the chiropractor. CFID found that the chiropractor would routinely bill for services not rendered and for office visits that never occurred.

IBC’s collaboration with federal law enforcement authorities ultimately resulted in federal criminal charges being brought against the chiropractor. The chiropractor plead guilty to health care fraud and mail fraud charges in federal district court and was sentenced to 36 months in federal prison followed by 36 months’ probation. He was also ordered to pay a total of $1,932,000 restitution, of which $979,000 is to be paid to IBC. He also forfeited $432,834 that was found in cash in his home and bank accounts.