Northbrook chiropractor sentenced to 20 months for health care fraud

A Northbrook chiropractor was sentenced to 20 months in federal prison Tuesday for billing an insurance carrier for medically unnecessary or nonexistent services, according to the U.S. Attorney’s Office.

Steven Paul, 46, of Northbrook, previously pleaded guilty to one count of health care fraud. Judge Ronald A. Guzman cited Paul’s “extraordinary cooperation” during the investigation as he imposted the lowest possible prison sentence for the charge, according to a U.S. Attorney’s Office news release.

Paul and co-defendant Bradley Mattson, a chiropractor, stated in plea agreements that they required patients to receive an initial x-ray and a pre-set schedule of clinic visits for a period of six months “without regard to the medical necessity of the visits,” according to the release.

Paul stated that from 1999 to 2008 he directed $3.65 million in bills to Blue Cross Blue Shield for medically unnecessary tests or physical therapy services that were not provided, and his clinics received $1.33 million in fraudulent reimbursements from the insurance company, prosecutors said.

Paul and Mattson owned six chiropractic clinics in the north suburbs including Hawthorn Physical Medicine, Woodfield Physical Medicine, Stratford Physical Medicine, Algonquin Physical Medicine, Northshore Physical Medicine and Cumberland Physical Medicine, according to the news release.

An undercover FBI agent visited the Hawthorn clinic for treatment for a back strain, and Mattson diagnosed the agent with a pinched nerve and ordered a pre-set treatment plan that began with daily visits for two weeks, according to the report.

Mattson made the diagnosis despite an opinion from the clinic’s medical doctor and physical therapist that the agent had a pulled muscle and not a pinched nerve, it said.

Mattson, of Lake Forest, pleaded guilty to health care fraud and was sentenced to six and a half years in prison in 2012, according to the release.

akukulka@chicagotribune.com

Twitter @AKukulka11

Source : http://www.chicagotribune.com/suburbs/northbrook/news/ct-nbs-chiropractor-sentenced-insurance-fraud-tl-1214-story.html

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