We have repeatedly discussed the fraud committed by many chiropractors. A recent article provided further information on this lamentable issue. Here are a few excerpts:
Fraud in US chiropractic care is on the rise. A shocking 82 percent of the chiropractic services billed to Medicare is unallowable, according to a recent audit by the Office of Inspector General. The audit found a lack of effective controls allowed an estimated $358.8 million in taxpayer funds to be improperly billed to Medicare.
Chiropractors engage in fraudulent billing practices in a variety of ways. Sometimes they target environments like nursing homes or substance abuse rehabilitation centers, looking for new patients who may – or may not – require their services.
In one case, a St. Louis-based chiropractor bribed police officers to get access to personal information about individuals who had been in car accidents. The chiropractor then contacted the accident victims and claimed to be from an insurance company or the state to arrange appointments at his practice.
In another case, a Houston-based chiropractor and his medical group settled with the federal government for $2.6 million and were also banned from billing federal programs for 10 years due to their involvement with a fraudulent billing scheme.
Lastly, in 2021, a chiropractor was found guilty of federal criminal charges, including five counts of healthcare fraud. The chiropractor was accused of defrauding health insurers by submitting $2.2 million in billings for chiropractic services that were never provided, office visits that never occurred, false diagnoses, and falsely prescribed medical devices.
Although other medical specialties also have bad actors, certain specific reasons can be identified as to why fraudulent billing and abuse have been increasing among chiropractors. These practitioners have fewer lower-cost codes to bill for, which means they need more patients to boost their earnings. For example, a service may only be billed at $25 or $50, but if this is billed to every patient on every visit, it quickly adds up. Because employers often have limited resources, it’s easy for minor charges to go unnoticed.
According to a 2018 report, the inspector general has conducted numerous evaluations and audits of chiropractic services since 2005 and has identified hundreds of millions of dollars in overpayments for services that did not meet Medicare requirements. The report also noted that the OIG’s investigations and legal actions involving chiropractors have demonstrated that chiropractic services are susceptible to healthcare fraud.
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Personally, I am not surprised by such reports. Sure, not all chiropractors committ financial fraud. But arguably ALL chiropractors are dishonest when they tell their patients that their spinal manipulations are effective and safe for a wide range of conditions. To put it bluntly: chiropractic was founded by a crook on a bunch of lies and unethical behavior, therefore, it is hardly surprising that today the profession has a problem with honesty and fraudulent behavior.
9 Responses to Medicare fraud by chiropractors costs taxpayers millions
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And Medicare fraud is $60 billion annually in the entire healthcare industry. Chiros represent 6% of total Medicare fraud. Not a justification, just context.
right!
and as my neighbor is beating his wife, it is ok when I do the same?
Therefore, on a per practitioner basis, the 44,000 practicing chiropractors are responsible for $8750 in fraud each. The per practitioner fraud must be much lower in the other healthcare providers. In short Medicare fraud is rife, and done probably mostly a “little” spread among many.
The main motivation for fraud among chiropractors is too many without real prospects of making a living without lying and exaggerating about the need for chiropractic services – wellness, tuning up the nervous system, disease prevention, etc..
Yes Michael…without question I have yet to meet anyone who visited a chiropractor and was told just “one” adjustment should do the trick.
It’s hard to imagine all the wasted money…not to mention the unnecessary health risks.
Thanks for sharing.
When do you hear a medical doctor suggesting just one dose of antibiotics is sufficient? Do the WHO Guidelines say vigorous exercise is required just once in our life?
My dad had spinal surgery. Then a repeat procedure on the same level. Then a third on the level above. Followed by countless steroid injections. And he is still in pain. Where is the fraud?
I’m on visit 8 with a physiotherapist, with no mention of “being done.” Am I wasting my money or being defrauded?
This idea that “just one” adjustment or any treatment being sufficient is unfounded.
Yeah, tell me about it. I’ve had my wisdom teeth removed a dozen times already. I’ve lost count of my polio vaccinations. And the last course of antibiotics I was prescribed was for seven days! Why not just one tablet?
Am I wasting my money or being defrauded? Perhaps I should ask a chiropractor for the truth: I’m sure most of them are as honest as D D and B J Palmer.
FRAUD:
Our Chiropractor who injured my wife on September 13, 2007 and destroyed her quality of life, committed blatant fraud(s) by forging her name on the “consent form” and also modifying her past medical treatment she received at his hands.
We hired a forensic handwriting expert but given the Chiropractor eventually admitted and confessed to his wrongdoing, the Experts Report findings ultimately were not required in the end.
I am not sure which is worse for the public at large: Medicare Fraud or Criminal Fraud. Perhaps someone can explain the difference.
To me, fraud is fraud regardless who is doing it.
Accountability? The Chiropractor got a three month suspension and had his insurance revoked. What is the penalty for Medicare Fraud?
Hi David,
Based on a recent case:
https://www.tdmr.org/miami-chiropractor-surgeon-sentenced-in-31-million-medicare-fraud-scheme/ penalty for Medicare fraud is fines and jail time.
Hi Talker,
Thanks for sharing this.
It looks like things are much stricter in the United States as far as dealing out punishment for this type of crime than here in Canada.
Still…who says crime doesn’t pay, when they payback is one tenth the amount stollen?
That said, jailbird time accountability should provide perhaps some to question to any ill gotten gains.
Still wondering why my wifes Chiroquacker didn’t end up behind bars.