Chiropractic fraud nets man fine and prison time

The consulting business served chiropractors throughout the country.
COLUMBUS -- The ringleader of a national chiropractic operation that fraudulently billed insurance companies and government agencies nearly $1,000,000 has been sentenced to five years in prison.
A joint investigation by the Ohio Department of Insurance and several federal agencies has led to a plea agreement for health care fraud and the maximum five-year prison sentence for Markel D. Boulis.
"This was a brazen attempt by Mr. Boulis and his cohorts to circumvent the law to defraud insurance companies and the government," said Ann Womer Benjamin, director of the Ohio insurance department.
Boulis was fined $250,000 and must make $820,099.24 in restitution.
According to information from the insurance department, Boulis owned Practice Solutions Inc., a chiropractic "practice management" consulting business, and National Insurance Auditors LLC, both originally licensed in Pennsylvania, which provided services in Ohio and throughout the country. From 1999 to 2003 Boulis' businesses helped chiropractors -- approximately 20 in Ohio and 200 nationwide -- submit bogus insurance claims for unnecessary or fictitious chiropractic services, the department said.
Aimed to increase revenue
Practice Solutions was marketed as the sponsor of "practice building" seminars focusing on methods to increase revenues for attendees. Through the seminars, chiropractors where then encouraged to contact Boulis' National Insurance Auditors, to utilize "experts" who could review chiropractic patient files and identify "lost income" resulting from services that had not been "properly reimbursed" by insurers due to "incorrect coding" or a "failure" to bill for the services.
However, in the Boulis case virtually all of the back-billed claims were fraudulent because they did not represent new or additional services provided to patients, officials said.
Department officials said anyone who suspects insurance fraud should contact the insurance department's fraud hot line at (800) 686-1527.