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Wednesday, 22 May 2013 18:17

Texan Admits Guilt in $1.2M Chiropractic Insurance Fraud

Marion Young, 42, of Texas, recently pleaded guilty in federal court in Houston to charges that he operated a chiropractor’s office as a front for an auto insurance scam that bilked companies out of $1.2 million.

Authorities say he ran the defunct office in Bryan, TX, to create fraudulent bills for treatments that were never performed. Young also recruited alleged accident victims to be represented by a Bryan-area law firm. The fraudulent billing caused the insurance companies to issue settlement checks, with the proceeds split by Young and at least four other defendants.

Young, co-owner of Private Chiropractic Care, admitted he participated in the two-year conspiracy to defraud numerous auto insurance companies. He further admitted he operated Private Chiropractic Care clinic as a front to allow fraudulent chiropractic bills to be created for treatments which were never performed and then used as support for fraudulent settlement demand letters sent to auto insurance companies.

During the course of the conspiracy, Young received checks and cash from the firm totaling approximately $112,000.

Once represented by the firm, clients were sent to Private Chiropractic to be evaluated by chiropractor and co-defendant Chase Lindsey, 34. Lindsey pleaded guilty earlier this year, admitting he entered into an agreement with the office manager of that same law firm. Lindsey agreed to provide medical evaluations of, and recommend treatment for, those patients in exchange for $2,000 in cash per month, which totaled approximately $58,000 during the course of the conspiracy.

Lindsey routinely prescribed medically unnecessary treatment which was provided, if at all, by unlicensed, untrained and unqualified individuals and never supervised the treatments allegedly administered by these unqualified individuals. Lindsey always prescribed the same six treatments but the patients usually received only two—ice/heat packs and electric stimulation. Lindsey prescribed the treatments be done 3-4 times per week for 5-6 weeks, but the patients usually went once a week for 3-4 weeks.

Young knew the patients were not receiving most of the treatments prescribed and that they were not going for treatments on many of the days reflected on the Private Chiropractic Care bills.

Young also knew the false Private Chiropractic Care billing was prepared at the law firm and that the fraudulent bills were used as support for settlement demand letters sent to auto insurance companies. The fraudulent demand letters caused the insurance companies to issue settlement checks, which were spilt between Young and others.

Young also participated in the scheme to defraud the insurance companies as an accident client of the law firm. Three separate checks, totaling nearly $5,000, were sent and made payable to Young and the law firm to settle an accident claim which was based on fraudulent chiropractic bills produced at the firm. Young never received the treatments reflected on the bills sent to the insurance companies.

The scheme to defraud the automobile insurance companies resulted in the submission of more than $3 million in false billing claims. The insurance companies paid at least $1.2 million in false claims during 2007-2009.
U.S. District Judge Kenneth Hoyt, who accepted the guilty plea, has set sentencing for Sept. 16, 2013, at which time Young faces up to 20 years in prison and a possible $250,000 fine.

As part of his plea agreement, Young also agreed to forfeit the $112,000 he received and to pay restitution of $1.2 million to the insurance companies victimized by the scheme. Young was allowed to remain free on bond pending his sentencing.

Three remaining defendants charged in relation to this case are scheduled for trial on Sept. 24, 2013.

The criminal charges are the result of a joint investigation by agents of the FBI and the National Insurance Crime Bureau. Assistant United States Attorney Al Balboni is prosecuting the case.

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