Chiropractor Pleads Guilty in Nearly $1.7 Million Insurance Fraud Scheme

Published: 2011-12-16 15:54:42
Author: Fran Lysiak | Insurance News Net | December 9, 2011

A chiropractor has pleaded guilty to defrauding more than 10 insurance companies out of about $1.7 million, according to David B. Fein , U.S. Attorney for the District of Connecticut.

Marc Kirshner of Stamford pleaded guilty before U.S. District Judge Stefan R. Underhill in Bridgeport to one count of conspiring to commit mail fraud, according to a statement from Fein's office.

Insurance companies included Travelers Insurance Cos., Government Employees Insurance Co. and Progressive Group of Insurance Cos.

From about December 2006 to February 2010, Kirshner conspired with a personal injury attorney and others to defraud the companies by submitting information to the carriers for the settlement of the attorney's accident cases that exaggerated the severity of patient injury and the cost of medical care in order to receive larger settlement payments, Fein's office said.

In pleading guilty, Kirshner also admitted he allowed the attorney to influence the course of patients' medical treatment by acquiescing to the attorney's instructions that patients receive certain treatments and diagnostic tests, despite the questionable medical need for the treatments and tests.

He owned and operated two chiropractor offices in Bridgeport and one in Stamford. The Bridgeport offices, called Health First Medical PC, are no longer operating.

According to Fein's office, Kirshner met with the attorney many times to provide him with cash in return for checks made out to him knowing that the attorney could use the cash for paying individuals to find potential victims of auto accidents for the attorney to represent. During the conspiracy, these cash payments totaled up to $100,000.

Kirshner allowed the attorney to establish what Health First would be paid for services rendered, which allowed the attorney to misrepresent and inflate the size of medical bills tendered to the insurers for payment, Fein's office said.

He also admitted he knew that the attorney was using Francisco Carbone as a treating physician for clients, even though he knew that Carbone had lost his medical license. He never questioned Carbone's role in obtaining for the clients prescriptions for strong pain medications, including Vicodin, and Percocet.

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