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21 Charged in Minnesota Chiropractic Fraud Conspiracies

December 30, 2016 01:32 PM

Twenty-one people have been charged in connection to multiple chiropractic insurance fraud conspiracies, U.S. Attorney for Minnesota Andy Luger announced Wednesday.

RAW: U.S. Attorney for Minnesota Andy Luger Addresses Chiropractic Insurance Fraud Case

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Luger said the six chiropractors and their associates fraudulently billed “no-fault” insurance policies for more than $20 million and have now been charged with conspiring to commit health care fraud.

“The charges unsealed today represent a serious effort to expose crooked billing abuses that harm consumers,” Luger said.

Luger said the defendants submitted false health care claims under Minnesota’s “no-fault” insurance policies for services that were not necessary or, in some cases, never performed.

Under Minnesota law, drivers have to carry no-fault policies, which include a Personal Injury Protection provision that makes it clear that you can see a doctor if you are injured in an automobile crash. The minimum coverage for medical expenses is $20,000.

To most people, this is a benefit because it means medical bills will be covered in the event of an accident, Luger said. However, this was the key to the false claims because the chiropractors involved decided they wanted to make a living from the no-fault PIP program.

Luger said the chiropractors knew they could be paid $20,000 on behalf of a patient in an accident and worked to collect as much of the $20,000 as they could without raising suspicions.

To keep the scheme going, Luger said the chiropractors used “runners” to find patients who had either been in a car accident or were willing to claim that they had been in an accident.

In exchange, the chiropractors paid the runners an illegal kickback, which was often paid in cash to hide the activity, Luger said.

The runners only received a kickback after the patient had attended a certain number of treatment sessions, so the chiropractor had to bill a lot of money before the runners could be paid. The runners, in turn, paid part of the kickback to the patients. Luger said that the runners sometimes worked with patients to stage phony accidents.

The schemes were uncovered by federal agents who posed as patients.

Luger said that the “most remarkable” part of the case was that the 21 defendants were not part of a single conspiracy; each conspiracy was, in general, independent.

“The way to commit fraud was so obvious that they engaged in almost identical behavior without coordinating with each other,” Luger said during a news conference Wednesday.

FBI Special Agent in Charge Richard Thornton said that every person in Minnesota who owns a car is paying more for car insurance because of this type of fraud.

“Fraud schemes perpetrated by those in the health care sector not only undermine public trust and betray the medical profession but also result in the theft of funds earmarked to cover legitimate health care expenses,” Thornton said.

Luger said more charges are expected to be filed at a later date.
 

Chiropractors

ANGELA A. SCHULZ, 47

Chaska, Minn.

Charges:

·         Conspiracy to commit health care fraud, 1 count

·         Conspiracy to commit mail fraud, 1 count

PRESTON E. FORTHUN, 38

Bloomington, Minn.

Charges:

·         Conspiracy to commit health care fraud, 1 count

·         Conspiracy to commit mail fraud, 1 count

HUY NGOC NGUYEN, 42

Brooklyn Park, Minn.

Charges:

·         Conspiracy to commit health care fraud, 1 count

·         Conspiracy to commit mail fraud, 1 count

ADAM JOHN BURKE, 32

Minneapolis, Minn.

Charges:

·         Conspiracy to commit health care fraud, 1 count

·         Conspiracy to commit mail fraud, 1 count

Runners

ABDISALAN ABDULAHAB HUSSEIN, 48

Minneapolis, Minn.

Charges:

·         Conspiracy to commit health care fraud, 2 counts

·         Conspiracy to commit mail fraud, 2 counts

SAHAL ALI WARSAME, 35

Minneapolis, Minn.

Charges:

·         Conspiracy to commit health care fraud, 2 counts

·         Conspiracy to commit mail fraud, 2 counts

YAHYE MOHAMED HERROW, 45

Minneapolis

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

TEMITAYO IFELOJU OLUSHOLDA DANIEL, 35

Minneapolis

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

MERRON REDI SAMUEL, 36

Saint Paul

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

ABDIRAHIN KHALIF IBRAHIM, 25

Saint Paul

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

DANA ENOCH KIDD, 35

Elk River

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

SAMATAR HASSAN OMAR, 28

Edina

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

ABDINASIR MAYON ABIKAR, 31

Minneapolis, Minn.

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

ALI M ABIKAR, 28

Edina

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

DANA STEPHEN COMEAUX, 57

Brooklyn Center

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

CARLOS PATRICIO LUNA, 48

Minneapolis

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

JEROME TARLVE DOE, 52

Brooklyn Park

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

NAPOLEAN TUTEX DEAH, 32

New Brighton.

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

SAMMANY RATHY SPANGLER, 27

Woodbury

Charges:

  • Conspiracy to commit health care fraud, 1 count
  • Conspiracy to commit mail fraud, 1 count

Credits

Jennie Lissarrague

Copyright 2016 - KSTP-TV, LLC A Hubbard Broadcasting Company

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