A Chicago chiropractor is facing federal fraud charges after billing a private insurer for nonexistent services. The defendant is alleged to have owned and operated Movement Health and Rehab, also known as Motu Chiropractic. According to federal authorities, he submitted false claims to Blue Cross Blue Shield of Illinois for health care services that the defendant knew he never rendered. In some cases, allegedly fraudulent claims were rendered on dates when the patient or their chiropractor was not in Illinois. Other claims involved chiropractic services that were provided to the defendant and his family members even when the defendant knew that those services were not provided. Blue Cross Blue Shield denies claims that are provided to family members. So, the defendant knew that the claim would be denied.
When Blue Cross Blue Shield audited the defendant’s claims, he submitted false patient information to them. As a result of the fraudulent claims, the defendant made $430,000 in ill-gotten proceeds, according to the indictment. The defendant is now facing 14 counts of healthcare fraud. Each individual count is punishable by up to 10 years in federal prison. Below, we will discuss the crime of healthcare fraud.
Those Accused of Healthcare Fraud Often Face Federal Charges
The crime of healthcare fraud is committed when a defendant makes false claims to an insurance company. It is a type of insurance fraud. It can be found in 18 U.S. Code § 1347. Essentially, any individual who makes a false claim to an insurance company for reimbursement can be charged with healthcare fraud. The majority of these lawsuits involve public insurers like Medicare or Medicaid. But they can be filed by the federal government in cases where a private insurer is the victim as well. In the case mentioned above, Blue Cross Blue Shield was the victim of the fraudulent claims, and they disbursed $450,000 for services that never occurred. In an attempt to cover up the crime, the defendant provided the insurance company with false information. However, the information provided was easily debunked. In some cases, the patients were not even in the State of Illinois when the defendant said they received medical services.
The defendant faces 14 counts of healthcare fraud. The maximum sentence for that would be 140 years behind bars. He is unlikely to face that long of a prison sentence. In many cases, the crime is prosecuted based on how much money the defendant stole from the insurance company. You cannot accidentally commit health care fraud, so the prosecution must establish that you knew you were committing health care fraud at the time the fraud occurred. Other areas that can drive up your sentence are the sophistication of the scheme and the number of victims that were involved.
Talk to a Chicago Criminal Defense Attorney Today
David Freidberg represents the interests of those facing federal fraud charges in Illinois. Call our office today at (312) 560-7100, and we can begin preparing your defense immediately.