Long Island Chiropractor Settles Federal Fraud Allegations | USAO-EDNY

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Gary Stein, a licensed chiropractor in Levittown, New York, paid the United States $ 290,197.24 to resolve civil claims he submitted false claims to the department’s Office of Workers’ Compensation Programs (OWCP) United States Labor Organization (DOL) for services it did not provide. provide a federal employee who receives benefits from the Federal Employees Compensation Act (FECA) program.

Jacquelyn M. Kasulis, Acting United States Attorney for the Eastern District of New York, Matthew Modafferi, Special Agent in Charge, US Postal Service, Office of the Inspector General (USPS-OIG), Jonathan Mellone, Special Agent in Charge, Office of the Inspector General of the United States Department of Labor, New York Region (DOL-OIG), and Christopher Godfrey, director of OWCP, announced the settlement.

By billing for medical services that he did not provide to his patient, the defendant defrauded a taxpayer-funded program designed to help federal employees disabled by workplace injuries, Acting U.S. Attorney Kasulis said. This Office and its law enforcement partners are committed to protecting taxpayer-funded programs from fraud and abuse.

Special agents in the Office of the Inspector General of the U.S. Postal Services will vigorously investigate those who commit fraud against federal benefit programs and the U.S. Postal Service, said the special agent in charge of the USPS-OIG , Modafferi. I would like to thank the United States Prosecutor’s Office and the Office of the Inspector General of the United States Department of Labor for their continued support of the mission of our agencies.

Investigating health care fraud offenses against United States Department of Labor programs is an important task of the Office of the Inspector General. We will continue to work diligently with our law enforcement partners to hold accountable those who seek to defraud DOL programs and siphon taxpayer funds for personal gain, DOL Special Agent said. -OIG, Mellone.

The settlement allows OWCP to recover $ 290,197.24 in medical bill payments under federal employee compensation law and return those funds to the US Postal Service, OWCP director Godfrey said. The Office of the Inspector General of the Ministry of Labor, as well as various other offices of the Inspector General, devote significant investigative resources to the detection of possible cases of abuse under the FECA program, and this regulation demonstrates the commitment of DOL and its OIG to help ensure that funds issued under the program are paid appropriately.

Certain federal employees who become disabled as a result of industrial accidents suffered in the course of their official duties are eligible for OWCP benefits. When healthcare providers bill OWCP for services rendered to FECA recipients, they use Current Procedural Terminology (CPT) codes that specify the services that were provided. By doing so, they signify that the services were performed as described and correctly billed in accordance with recognized industry standards. Applicable industry standards prohibit billing for an extended medical appointment when an FECA recipient has in fact received only routine service.

An investigation by the DOL-OIG and the USPS-OIG found that from March 6, 2014 to April 14, 2019, Stein was routinely using CPT codes that incorrectly told the OWCP that he had performed detailed reviews of the patient when in fact he had not. The settlement resolves potential claims that Steins’ alleged conduct violated the false claims law. Claims resolved by the settlement are only allegations.

The US case was handled by Assistant US Attorney Jolie Apicella of the Civil Division of Bureaus with the assistance of Civil Investigator Joseph Giambalvo.

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