Two Georgia Chiropractors Arraigned For Healthcare Fraud

Andrew L. Sokol and Julie B. Weisberg, licensed chiropractors based in Marietta, Ga., were arraigned on charges they submitted millions of dollars of fraudulent insurance claims to Blue Cross Blue Shield and other private insurers for physical therapy services that were never provided, according to a report in the Atlanta Business Chronicle.

WellnessOne, which was owned by Mr. Sokol and Ms. Weisberg, offered massage, personal training and chiropractic services to patients, which were frequently billed as physical therapy, according to the report.

Mr. Sokol and Ms. Weisberg allegedly targeted employees at MBNA and Bank of America Corp. because the companies' insurance plans generously reimbursed for chiropractic and physical therapy services. To attract patients to the clinic, WellnessOne offered promotions, such as gift cards and raffles, and often waved patients' co-pays and deductibles, according to the report.

From Jan. 2005-Sept. 2007, Mr. Sokol and Ms. Weisberg allegedly employed physicians and licensed physical therapists so they could bill for physical therapy services, although the physicians and therapists never saw the majority of patients. According to the report, several medical providers quit as a result of this practice. Mr. Sokol also allegedly directed services to be billed on different days and under different tax identification numbers to conceal the fraud from insurers.

Mr. Sokol and Ms. Weisberg also allegedly billed gym visits and personal training sessions as physical therapy, pressured medical providers on staff to order unnecessary tests and asked receptionists to ask patients to sit in therapeutic chairs for a few minutes prior to massages so they could bill for so-called therapy.  According to the report, Mr. Sokol and Ms. Weisberg allegedly had receptionists automatically fit patients for two sets of shoe orthotics that were billed to insurers.

As a result of these practices, Mr. Sokol and Ms. Weisberg allegedly submitted more than $11 million in fraudulent insurance claims for physical therapy procedures to Blue Cross Blue Shield and other private insurers, according to the report.

Mr. Sokol was indicted on one count of conspiracy, 53 counts of healthcare fraud, three counts of mail fraud and five counts of money laundering. Ms. Weisberg was indicted on one count of conspiracy, 24 counts of healthcare fraud and three counts of mail fraud.

According to the report, the conspiracy charge carries a maximum sentence of 10 years in prison, the healthcare fraud counts each carry a maximum of 10 years in prison, the mail fraud counts each carry a maximum of 20 years in prison and the money laundering counts each carry a maximum of 10 years in prison. Also, each conspiracy, healthcare fraud and mail fraud count carries a maximum fine of up to $250,000. Each money laundering count carries a maximum fine of up to $250,000 or, in the alternative, a fine of up to twice the amount of criminally derived property involved in the transaction.

Read the Business Chronicle's report about the Georgia physical therapy healthcare fraud scheme.