the ^ break- Fraud Fighters Score Record-Breaking Year WASHINGTON, DC: The Department of Justic. raked in SI.6 billion in civil fraud payments over past fiscal year, makiim 2001 the second record- ing year in a row. And the health care industry remains the DOJ's number one target: At more than SI.2 billion in settlements and judgments, the FY 2001 health care fraud tally makes up about three-quarters of the government's total haul. Whistleblowcrs continue to fuel the government's anti-fraud campaign. Almost 75 percent of the DOJ's recoveries in FY 2001 stemmed from cases filed by qui tarn relators, according to figures released this month. And whistleblowers were richly rewarded for their efforts, collecting more than S210 million over the fiscal year. Physician Compliance Wire To whit: From the "Let's Make a Deal" Department TEXAS: An Arlington chiropractor that helped authorities crack a Metroplex billing scam was sentenced to five years in federal prison in early November and ordered to pay S2.7 million in restitution. The 36-year-old doctor pleaded guilty to reduced charges of mail fraud in July in a scheme that collected $3.2 million in five years from insurance companies through fraudulent bills from clinics set up at local fitness clubs. Prosecutors said he cooperated fully in the federal investigation, and, as a result, more indictments are expected in the next three months against a half-dozen additional North Texas physicians, chiropractors and their business managers. Authorities said the DC provided software and database files and explained to federal and state investigators the inner work- ings of the scam that sought to bilk insurers of S5.7 million. To reward the chiropractor for his cooperation, prosecutors asked for leniency from U.S. District Judge John McBryde. After listening to testimony from an IRS investigator and a Justice Department auditor about the extent of the DCs cooperation, McBrvde sentenced him to three years fewer than the maximum he could have received under federal sentencing guidelines. Fort Worth Star-Telegram NEW JERSEY: A chiropractor who bilked two dozen insurance companies out of S500.000 to feed his drug habit faced a possible five-year prison term when he went to court in early October, but was sentenced to only 364 days in the County Jail. The doctor, who overbilled for 300 patients in during 1996 and 1997, got his first break last March, when he pleaded guilty to a count that normally carries a maximum 10-year term, but was promised a sentence in the three- to five-year range. The DC was remorseful, and agreed to pay restitution, said state Superior Court Judge Ralph DeLuccia, explaining the lesser term. The judge added that the chiropractor saved the state months of investigation by pleading guilty before an indict- ment. He also pointed out that the doctor helped the state Attorney General's Office se-■ire a plea in another insurance fraud case. Record Passiac County Supreme Court Ruling Cites 1st Amendment Rights FLORIDA: A Florida state law designed to restrict the way chiropractors can market their services to accident victims is unconstitutional, the state Supreme Court ruled last month. The law had been used to indict two DCs in 1998 for using police accident reports to solicit business, according to the Florida Times-Union. But the high court justices found that this action violated the chiropractors' free speech rights under the First Amendment. The state Attorney General's office says it still wants to find a way to prevent a practice prosecutors call "ambulance chasing." Legislators have been refining the law in order to make it more specific, but attorneys warn that these restrictions will continue to face challenges if the rules limit free speech. Chiro Wire NJ Running Out of Control with New Law NEW JERSEY: The injuries he treated were real, but that wasn't enough to keep a New Jersey DC out of trouble for allegedly using a "runner" to direct accident victims to him for treatment. Prosecutors charged the chiropractor with paying someone to solicit patients for him, the Bergen County Record reports. Even though the prosecutors admit they have no evidence that the accidents were "staged." the practice of using a runner can lead to fraud, they insist. The charge could lead to a prison term of up to five years, according to the paper. Chiro Wire In a separate case, a New Jersey DC was actually indicted on fraud charges for allegedly paying a runner to deliver patients to him, patients who were undercover cops, and then billing for treatments he never gave them! Late Breaking News! VIRGINIA: Leaders of the House and Senate Veterans Affairs Committees reached agreement December 10 on the details of a proposed chiropractic benefit they intend to incorporate into the Department of Veterans Affairs (DVA) health care system. After the final agreement was reached, the U.S. House of Representatives quickly moved to incorporate the agreed-to legislative provisions into a new bill (H.R.3447) that was voted on and approved by the full House of Representatives the next evening. The proposal now awaits action by the U.S. Senate. which must formally pass an identical bill before the proposal can be signed into law by President Bush. It is expected, but not guaranteed, that the U.S. Senate will take that necessary step prior to the adjournment of this session of Congress, which is expected in the near future.
