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8 Orange County chiropractors accused of illegal kickbacks

Three office administrators and an attorney also are charged after a sting uncovers schemes to defraud insurance companies through illegal patient referrals and overbilling.

February 05, 2009|Tony Barboza

Eight chiropractors, three office administrators and an attorney were arrested and charged in Orange County this week after an undercover operation allegedly caught them in schemes to defraud insurance companies through illegal patient referrals, kickbacks and overbilling for procedures that were never done, authorities said Wednesday.

Orange County district attorney's investigators set up a fake law office and posed as law office administrators seeking referrals and patients claiming to be suffering from car accident injuries. It is illegal for professionals who file insurance claims -- doctors, chiropractors and attorneys included -- to exchange money for patient referrals.

Starting in August 2007, investigators sent nearly 250 letters to medical professionals already suspected of fraud. The letter proposed an illegal fee-splitting scheme in which providers would pay up to 30% of a patient's billing in exchange for the referral.

Seven people -- six chiropractors and an office administrator -- allegedly responded positively to the proposal, agreeing to pay kickbacks, authorities said.

Five additional suspects -- two chiropractors, an attorney and two office administrators -- were snared through walk-in stings in which undercover investigators allegedly were able to get them to agree to an overbilling or fee-splitting scheme within 30 minutes of meeting.

Some of the suspects allegedly went on to overcharge insurance companies for more treatments than they gave, prosecutors said.

In the most egregious instance, authorities said, it took only one 30-minute meeting in July 2005 with an investigator posing as a law office administrator for Anaheim chiropractor Florin Catinas, 35, to allegedly agree to pay 30% of his insurance company billings for every patient that the investigator referred to him.

Catinas is accused of later overbilling the insurance company $3,658 for 27 visits for treatment when the undercover patient had gone only to seven.

The attorney, David Gonzalez, 45, of Placentia, is accused of coaching an undercover investigator posing as a patient to lie to an insurance company to exaggerate the extent of his injuries and the number of his medical visits. He later allegedly split the insurance payment among himself, Catinas and an investigator posing as a patient.

When investigators went back two years later, they allegedly found Catinas and Gonzalez engaging in the same scheme.

"It is shocking how easily so many of these professionals are willing to engage in fraud," Orange County Dist. Atty. Tony Rackauckas said at a news conference in Santa Ana. "We obviously cannot catch every crooked chiropractor or amoral attorney who has had their hand in the cookie jar, but we hope to send a message that they will be risking their licenses and freedom if they engage in these types of fraudulent conduct."

So as not to raise suspicion and maintain the illusion that they were real customers paying with insurance, investigators went to as many as 16 treatments with the chiropractors, and the district attorney's office paid $26,000 for the fake claims. Authorities had to wait months for the inflated insurance payments.

All of those arrested have posted bail, and most are scheduled to appear in court next month. Catinas pleaded not guilty Wednesday to seven counts of fraud, theft, unlawful referrals and false claims.

If convicted, the defendants face maximum prison sentences of three years to eight years and eight months.

Authorities believe they uncovered fraud that would have resulted in insurance companies being cheated out of hundreds of thousands of dollars.

"This kind of fraud is really pretty widespread," Rackauckas said. "We need people out there to know that they're going to be investigated."

California Department of Insurance Commissioner Steve Poizner said insurance fraud is rampant statewide, costing about $15 billion and netting 2,000 arrests each year.

"Insurance fraud is not a victimless crime," he said, noting that the inflated costs are passed on to consumers.

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tony.barboza@latimes.com

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(BEGIN TEXT OF INFOBOX)

Charged with illegal kickbacks and overbilling

Keith Tran Callaway, 41, of Huntington Beach; chiropractor at Newport Spinal Rehabilitation in Fountain Valley

Florin Catinas, 35, of Anaheim; chiropractor who rented an office at Schwartz Chiropractic in Anaheim

David Gonzalez, 45, of Placentia; attorney in Santa Ana

Tam Van Nguyen, 34, of Westminster; chiropractor at Century Chiropractic in Garden Grove

Mark Allen Tichelaar, 50, of Anaheim; chiropractor at Advanced Care Sports Rehabilitation in Anaheim

Ky Hoang Tran, 67, of Fullerton; chiropractic administrator at Newport Spinal Rehabilitation in Fountain Valley

Lisa Marie Tran, 48, of Midway City; law office administrator at Westminster L&M Legal Services/Law Offices of Walter Martinez

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Charged with illegal kickbacks

Dung Tuan Le, 56, of Westminster; chiropractor at Dr. Le's Chiropractic Clinic in Garden Grove

Rosalyn Mai, 50, of Westminster; office administrator at Dr. Le's Chiropractic Clinic in Garden Grove

Layn Ford Miller, 44, of Westminster; chiropractor at the Head, Neck and Back Pain Relief Center in Fountain Valley

Michael Benjamin Saloman, 42, of Paramount; chiropractor at Advanced Chiropractic Medical in Santa Ana

Quan Hoang Tran, 35, of Huntington Beach; chiropractor at California Pain Center in Fountain Valley

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Source: Times staff reports

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