Insurance Fraud NEWS
Georgia chiros allegedly bill while on vacation cruise
October 11, 2017, Atlanta, GA
A judge has arraigned two metro Atlanta chiropractors on conspiracy and fraud charges for using their clinic to submit false claims to private insurance providers.
Dr. Allan Spagnardi, 38, and Dr. Stacy Spagnardi, 50, were arraigned Wednesday before United States Magistrate Judge Alan J. Baverman.
The two allegedly operated a chiropractic clinic located in Marietta, Georgia for at least 3 years, and allegedly submitted numerous fraudulent claims to private insurance providers for procedures that never took place.
“These two chiropractors are alleged to have reported fake patient visits in order to enrich themselves through fraudulent insurance claims,” said U.S. Attorney Byung J. “BJay” Pak. “Fraudulent healthcare billing threatens the integrity of our healthcare system and is ultimately paid for by the taxpayers.”
“Healthcare providers need to think twice before trying to illegally maximize their profits at the expense of honest citizens,” said David J. LeValley, Special Agent in Charge of the Atlanta FBI. “Bringing this case to federal court is an example of our determination to protect those citizens and root out waste, fraud and abuse of our healthcare system.”
“Healthcare fraud has become a significant problem in the world today” said James Dorsey, Acting Special Agent in Charge for IRS Criminal Investigation. “The Spagnardis agreed and want of a lavish lifestyle led them to commit healthcare fraud and we will continue to support investigative efforts to deter such actions.”
“I’m thankful for the action by the grand jury and for the work on this case by the U.S. Attorney’s office,” Georgia Insurance Commissioner Ralph Hudgens said. “Alleged actions by the Spagnardis hurt not only Georgia citizens, but citizens across the United States in the form of higher insurance premiums.”
The indictment alleges that after the Spagnardis obtained their patients’ personal identifying information, they continued to bill private insurance providers for services that were never actually rendered.
On some occasions in which the Spagnardis claimed their clinic was treating patients, those patients were not even in the United States when those treatments were supposedly taking place.
In one instance, the Spagnardis allegedly claimed that their clinic had 296 patient visits during a week that they were actually on a Royal Caribbean cruise vacation.
The Spagnardis are alleged to have claimed millions of dollars from private insurance providers. The indictment alleges that Stacy Spagnardi spent much of the fraud proceeds at casinos.
Stacy Spagnardi is also alleged to have frequently made cash withdrawals under $10,000, with the purpose of evading banking reporting requirements. For his part, Allan Spagnardi allegedly used a portion of the fraud proceeds to purchase a BMW motorcycle and a 2015 BMW M4.
This case is being investigated by the Internal Revenue Service Criminal Investigation, Federal Bureau of Investigation, the Georgia Office of Commissioner of Insurance, and the Atlanta Police Department.
Source: 11 Alive