Ohio Chiropractor Pleads Guilty to Work Comp Fraud; Must Repay $300K

August 29, 2014

A Nelsonville (Athens County) chiropractor has been ordered to pay more than $300,000 in restitution to the Ohio Bureau of Workers’ Compensation.

Michael L. Brown pleaded guilty Aug. 22 in Franklin County Court of Common Pleas to one count of workers’ compensation fraud, a fourth-degree felony.

“We suspected there was a problem after multiple individuals contacted BWC to report Mr. Brown’s fraud schemes,” said BWC Administrator/CEO Steve Buehrer. “Medical providers have an extremely important job of evaluating the condition of injured workers and determining whether they are able to return to work. We place our trust in them, and unfortunately, it appears Mr. Brown was not focused on providing the best care for his patients.”

BWC’s Special Investigations Department received allegations that Brown was billing for services not rendered, billing patient claims for dates of service when the patients were not at the office, and billing for treatment at times when his office — located at 1257 E. Canal St., Nelsonville — was closed.

Multiple interviews confirmed both the allegations and that Brown controlled billing for the office. In June 2010, numerous pieces of evidence that substantiated the allegations were seized from Brown’s office. Records showed that patients were not at his office on days that Brown billed their claims for treatment; documents showed that multiple patient claims were billed on dates the office was closed; evidence was also discovered that Brown fabricated the amount of treatment patients received in order to receive a higher payment for services.

Brown was ordered to pay $394,021.03 in restitution, which includes approximately $60,000 in investigative costs. He was sentenced to five years of probation. If he fails to comply with the terms of his probation, Brown could be sentenced to serve nine months in jail. Brown voluntarily decertified himself as a BWC health care provider.

The case was prosecuted by the Ohio Attorney General’s office.

Source: Ohio BWC