Louisville Chiropractic Scheme in $5m Fraudulent Insurance Case

Louisville, Ky. — U.S. District Judge Rebecca G. Jennings has sentenced defendants of a healthcare fraud scheme that billed insurance companies for services never performed to years in federal prison. Sergio Betancourt was sentenced on Wednesday to 37 months imprisonment for healthcare fraud, money laundering and crimes committed while on pre-trial release.

The sentence will be followed by 2 years supervised release, and $1,153,770.34 in restitution. According to the evidence before the Court, beginning no later than on or about June 12, 2012, and continuing through on or about November 1, 2014, Claudia Lopez, Ledinson Chavez, Oskel Lezcano, Ariel Borrego-Hernandez, Sergio Betancourt and Yuriesky Diaz Rodriguez recruited unsuspecting chiropractors for employment in Louisville area chiropractic clinics in order to obtain and use the chiropractors’ names and National Provider Identifiers (NPI) to fraudulently bill insurance companies.

Each chiropractor provided his/her NPI number to Lopez and Lezcano in order to credential the clinics with various insurance companies. Thereafter, the group of defendants recruited employees from Jeffboat and other local employers to seek chiropractic services from the clinics. However, unbeknownst to the chiropractors, the clinics billed approximately $5,000,000 for methocarbamol injections (a muscle relaxant), using the patients’ names, dates of birth, insurance/policy numbers, addresses, and patient IDs/Social Security Numbers for injections. Most of the patients from Jeffboat were paid to go to the clinics by the defendants and were told the injections were being billed, according to testimony during trial.

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