Skeptic News: Chiropractor convicted of insurance fraud

From: Newsmagazinenetwork

Dr. Anthony Calandro, a Chesterfield resident, and owner of the Chiropractic Accident Centre of Crestwood was convicted Nov. 8 of billing insurance companies for X-rays never taken and for appointments that the patients had canceled or missed. His billing assistant Sherry Rueter previously pled guilty to related charges.

According to testimony presented at trial, during 2010 and 2011, two undercover investigations revealed that Dr. Calandro and Ms. Rueter billed multiple insurance companies for services that were never rendered. From 2006 to 2011, they submitted numerous reimbursement claims that falsely stated that the Chiropractic Centre had taken more X-rays than were actually taken. In most instances, only one or two X-rays were taken during a patient’s visit, but many more X-ray views were billed. Since health insurance companies would not reimburse Chiropractic Centre if a claim indicated the patient had missed an appointment and had not received a billable service, they falsely indicated that a billable service had been provided to patients. Using false codes, they submitted thousands of false claims for missed appointments.

Calandro and Chiropractic Accident Centre of Crestwood PC were convicted of one felony count of health care fraud. Dr. Calandro was also convicted of three counts of making false statements related to health care services; the corporation was convicted of four counts of making false statements. The four-day trial was held before United States District Judge E. Richard Webber. Sentencing for Dr. Calandro is scheduled for Feb. 7, 2013.

Co-defendant Sherry Rueter, St. Louis, Missouri, pled guilty in October to four felony counts of making false statements related to health care services and is scheduled for sentencing Jan. 24, 2013.

Each count of health care fraud carries a maximum penalty of 10 years in prison and/or fines up to $250,000; each count of making false statements carries a maximum of five years in prison and/or fines up to $250,000. The corporation faces maximum fines up to $500,000 per count.

The pair were caught out by the Federal Bureau of Investigation. Assistant United States Attorneys Dorothy McMurtry and Dianna Collins prosecuted the case for the U.S. Attorney’s Office.

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