A Medina chiropractor was sentenced to 30 months in prison for overbilling Medicare and insurance companies more than $1.8 million for medical equipment and treatment that were not medically necessary, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio.
Dr. John N. Heary, 39, previously pleaded guilty to seven counts of health care fraud.
“This doctor took advantage of programs designed to provide care and support for the old and the sick,” Dettelbach said. “Our office and the Justice Department are committed to rooting out health care fraud in all its forms.”
“Most medical professionals endeavor to provide quality health care services and submit proper claims for payment to the Medicare program” said Lamont Pugh III, Special Agent in Charge of the U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “This doctor chose to exploit Medicare and other insurers for illegal personal gain and paid the price for his criminal acts. The OIG will continue to work with our law enforcement partners to combat fraud in the health care system and protect vital taxpayer dollars.”
Heary did business under his name and two corporate entities. HealthSource of Medina was the operating name of Heary’s chiropractic practice until October 2009. Medina Health & Wellness Center, Inc. was the corporate name under which Heary sold durable medical equipment, according to court documents.
Both entities were located at 433 West Liberty Street, Medina, Ohio, 44256, according to court documents.
Heary provided custom-molded ankle-foot orthotics, or “boots”, to patients who did not need them and wrote false diagnoses to justify the billing. He billed Medicare and insurance anywhere from $2,770 to $4,300 for each pair of boots, according to court documents.
He also routinely provided the most expensive back braces without any demonstration of medical necessity or any pursuit of a less costly alternative. He billed Medicare and insurance anywhere from $995 to $1,250 for each back brace, according to court documents.
When patients questioned the necessity of this medical equipment, Heary told them tha they were part of a “free package deal” and would be covered by their insurance, according to court documents.
Hearly also billed for supervised physical therapy often when the patients were not supervised. He also billed for an hour’s worth of physical therapy when, at most, patients did a half hour, according to court documents.
Heary submitted more than $1.8 million in fraudulent claims to Medicare, Anthem Blue Cross and Blue Shield, Medical Mutual of Ohio and the Ohio Bureau of Worker’s Compensation, according to court documents.
The insurance programs reimbursed Heary for more than $812,000. He will repay that amount in restitution, according to court documents.
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