AROUND THE WORLD CHIROPRACTIC
Former Chiropractor Sentenced to Nearly Six Years in Federal Prison for Fraudulently Submitting $2.2 Million in Billings to Health Insurers
SANTA ANA, CA - A former Orange County chiropractor was sentenced today to 70 months in federal prison for stealing from health insurers by fraudulently causing the submission of $2.2 million in billings for chiropractic services never provided, medical diagnoses never given, office visits that never occurred, and medical devices that were falsely prescribed.
Susan H. Poon, 57, of Dana Point, was sentenced by United States District Judge David O. Carter, who ordered her to pay $1,379,622 in restitution to her victims.
At the conclusion of a five-day trial in June 2021, a federal jury found Poon guilty of five counts of health care fraud, three counts of making false statements relating to health care matters, and one count of aggravated identity theft.
From January 2015 to April 2018, Poon, whose office was in Rancho Santa Margarita, schemed to defraud health insurance companies by submitting false reimbursement claims for services that were never performed.
Poon also submitted fraudulent prescriptions containing medical diagnoses of individuals that she had never met, including toddlers and children, which led a medical device manufacturer to submit false claims for reimbursement to one health insurer.
The patients that Poon claimed to have met with and treated were dependents - such as the spouses and children - of Costco Wholesale Corp. and United Parcel Service Inc. employees. Poon unlawfully took and used the dependent’s personal identifying information (PII) in her reimbursement requests and prescriptions. Poon obtained the PII by attending health fairs at various UPS warehouses and Costco locations and soliciting such information from employees.
“[Poon’s] scheme consisted of interdependent moving parts,” prosecutors wrote in a sentencing memorandum. “She lied about visits with, diagnoses of, and treatments given to actual people and their children. She sent fraudulent Durable Medical Equipment (DME) prescriptions - predicated on visits with these patients that never happened - to a DME manufacturer. And she fabricated medical documentation containing the personal identifying information of these ‘ghost’ patients to mislead an auditor.”
In total, Poon billed and caused to be billed approximately $2.2 million through her scheme.
Poon’s chiropractic license was revoked in July 2019, according to the California Department of Consumer Affairs.
Source: Department of Justice, U.S. Attorney's Office Central District of California
St. Paul Attorney Charged in Scheme to Rip off Auto Insurers with False Chiropractic Claims
ST. PAUL, MN - A St. Paul personal injury lawyer was part of a scheme to defraud auto insurers by recruiting patients for chiropractic services, according to a conspiracy charge filed Wednesday in U.S. District Court.
Brad Ratgen, 52, was charged with conspiracy to commit health care fraud.
Prosecutors used a charging document called an information, not an indictment, which usually means the defendant has agreed to plead guilty to the charge. Ratgen is due in court for his arraignment Nov. 10.
According to the information, Ratgen conspired with others from at least 2015 through last December to defraud auto insurers under the state’s no-fault insurance law, which requires insurers to pay their clients’ medical bills, whether the crash was their fault or not.
It says he provided legal representation to a person he knew had been illegally recruited to be a chiropractic patient and who threatened a lawsuit against an auto insurance company.
Federal prosecutors in Minnesota have charged at least 20 others for their roles in similar frauds in the last six years.
In December 2016, they announced charges against four chiropractors who reportedly raked in millions of dollars through “nearly identical” but independent conspiracies; 15 patient recruiters, known as “runners,” also were charged at the time.
Ratgen appears to be the second attorney charged in the same kind of scheme.
In November 2020, Minnetonka attorney William Kyle Sutor III was sentenced to 16 months in prison after he admitted to hiring runners who claimed to have been injured in car crashes; he was disbarred last year.
Ratgen, who lives in Hugo and has a law office in St. Paul’s Midway neighborhood, did not return a phone message Wednesday.
Source: twincities.com Pioneer Press
Pass on the information to warn other D. C. s about events that are really happening to chiropractors. If you see an article in your local, regional, or national news about chiropractic or a fellor chiropractor, e-mail or mail it to us at: editorialUfamchiropractor.com or #CO!38, 8530 NW 72nd St., Miami, FL 33166.
