A Tale of 2 Chiropractors Faced with a Moral Decision About PIP Fraud
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Name: DrTirpak
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Experienced Chiroprctor and Internet lover, Amy Tirpak, DC, started CE Cruncher with the support of the Advertising Agency that she co-owns.
by: DrTirpak posted: November 08, 2012
This is a tale of 2 chiropractors practicing in Florida and
the consequences of their actions. Both Chiropractors were approached with
similar scenarios: A non-doctor asked them to register a chiropractic clinic in
their name with the intention of circumventing Florida law to treat personal
injury patients. A clinic can obtain a certification of exemption if it is
owned by a physician, some facilities have had an illegal “straw” physician registered
as the owner to circumvent the rigorous certification process.
Chiropractor Dr. Lisa Adams agreed to put her name on
corporate documents of Ovy Rehabilitation Medical Center Inc in West Palm Beach
Florida and Chiropractic Office of South Florida LLC in Palm Springs Florida.
Dr. Adams’s ownership was in name only. She received a paycheck from the
corporations, but had no control of the finances or business dealings.
According to court documents Dr. Adams a 1998 Life
University graduate, stated she was not aware of the staged accidents that were
the source of her patients initially.
The scheme perpetuated by the true owners involved paying individuals to
stage accidents, then report to the clinics with a list of symptoms that they
were coached to provide. Various accusation were made in court documents
including: having patients sign bills for numerous dates of service when
treatment was not rendered, upcoding exams and billing for more services than
provided.
A
joint task force from the State of Florida, the FBI and the IRS arrested 10
other individuals including the clinic owners from Palm Beach County along with
Dr. Adams in June. This week in Federal Court Chiropractic Physician Jennifer
Adams pled guilty to one count
of conspiracy to commit mail fraud.
Dr. Adams did profess in the court records that she was aware of the fraud, but not at first. As a result she may be required to pay restitution of up to $250,000 to the court and 1.9 million to the 10 insurance companies that she defrauded. 1.9 million is the amount billed under her name after she was aware of the fraud.
Dr. Jennifer Adams will be sentenced in the future in federal court. She faces a maximum term of 20 years in prison, to be followed by a term of supervised release of not more than three years.
The second Chiropractor’s name in this story has not been
release so let’s call him Dr. B Dr. B contacted authorities right after he was
approached with the same situation in Sarasota Florida. For months he aided the Florida Department of Financial
Services’ Division of Insurance Fraud by applying for a clinic exemption for
Garden Relief Center, LLC on the behalf of Nerber A. Iglesias.
The
clinic submitted almost $40,000 in fraudulent insurance claims to 6 separate insurance
companies. Also while working under the direction of law enforcement Dr. B was
approached by Michael Borkowski, owner of a local collision repair shop, to
provide patients for a fee. Both men were arrested last week and charged with
personal injury protection fraud.
What is the moral of the story? Know the laws in the state where
you practice, it is your responsibility. If someone approaches you with a
business proposal make sure it is legal, don’t hesitate to contact an attorney.
Most states require chiropractor to report illegal activity, so do it.
As a physician you have an ethical and legal obligation for the services/care that you provide. Dr. B is left looking for a new job and Dr. Jennifer Adams is looking at prison. Not just prison, but restitution for possibly millions of dollars for funds that she never controlled.