Chiropractor Sentenced to 27 Months in Federal Prison for Role in Insurance Fraud Scheme
Deirdre M. Daly, United States Attorney for the District of Connecticut, and Patricia M. Ferrick, Special Agent in Charge of the New Haven Division of the Federal Bureau of Investigation, announced that MARC KIRSHNER, 49, of Stamford, was sentenced today by U.S. District Judge Stefan R. Underhill in Bridgeport to 27 months of imprisonment, followed by three years of supervised release, for his role in an extensive insurance fraud scheme.
This matter stems from “Operation Running Man,” a 14-month undercover fraud investigation headed by the Federal Bureau of Investigation.
According to court documents and statements made in court, KIRSHNER owned and operated Health First Medical PC (“Health First”), a now-defunct chiropractic practice that had two offices in Bridgeport and one in Stamford. From approximately December 2006 to February 2010, KIRSHNER conspired with attorney Joseph Haddad and others to defraud several insurance companies by exaggerating the auto accident injuries of Haddad’s clients to justify a larger monetary settlement with the insurance companies. As part of this scheme, the co-conspirators fabricated medical records, prescribed unnecessary pain medication, performed unnecessary chiropractic treatment, ordered and billed for diagnostic tests of questionable medical value, and overstated injuries or permanent partial disabilities that were allegedly caused by the accidents.
KIRSHNER met with Haddad numerous times to provide him with cash in exchange for checks made out to KIRSHNER, knowing that Haddad could use the cash for, among other things, paying individuals to find potential victims of auto accidents for Haddad to represent. During the course of the conspiracy, these cash payments totaled as much as $100,000. KIRSHNER also allowed Haddad to establish what Health First would be paid for services rendered, which allowed Haddad to misrepresent and inflate the size of medical bills tendered to the victim insurance carriers for payment.
KIRSHNER and Health First established a protocol to treat patients in Haddad’s cases for six months, regardless of medical need, and would not resolve treatment of patients unless instructed to do so by Haddad. After the six-month period, each patient would receive a permanent partial disability rating, regardless of the permanence of the medical condition. If a patient had received a permanency rating for a prior accident, the protocol was to give a higher or different disability rating for the present accident.
KIRSHNER also knew that Haddad was using Francisco Carbone as a treating physician for clients even though Carbone had lost his medical license. KIRSHNER never challenged Haddad’s continued use of Carbone, or questioned Carbone’s role in the obtaining for clients prescriptions for unduly strong pain medication, including hydrocodone, Vicodin, and Percocet.
KIRSHNER also owned a diagnostic testing company, Midas Medical LLC, and instructed his employees to conduct Nerve Conduction Velocity (NCV) Tests whenever a patient’s symptoms could potentially implicate testing, even though he knew the test results would not change the course of treatment. KIRSHNER arranged for Carbone to order the tests, believing that, if ordered by a doctor, the tests would be given greater weight by the victim insurance companies and increase the likelihood of higher settlement payments. KIRSHNER’s office would submit a bill to Haddad in the amount of approximately $2000 for each NCV test that was performed, which would eventually be paid out of settlement proceeds.
In addition, KIRSHNER, Haddad and Carbone engaged in a scheme to defraud the State of Connecticut. By law, the state is entitled to 50 percent of the proceeds of a personal injury case if the individual who receives a settlement has been on public assistance, or has outstanding child support obligations. Haddad provided fraudulent settlement statements to the state that inflated the payments to him, KIRSHNER and Carbone, and reduced the net payout to the client.
KIRSHNER and Carbone, at Haddad’s request, regularly kicked back a portion of their medical fees to Haddad’s clients.
More than 10 insurance carriers lost a total of approximately $1.7 million as a result of this fraud scheme.
Today, KIRSHNER was ordered to pay $1,692,798 in restitution to the victim insurance carriers.
KIRSHNER was sentenced below the recommended sentencing guidelines range for cooperating during the investigation.
On December 7, 2011, KIRSHNER pleaded guilty to one count of conspiring to commit mail fraud to defraud insurance carriers. He was ordered to report to prison on October 8, 2014.
Haddad, Carbone, three other chiropractors, and a licensed doctor of osteopathic medicine pleaded guilty to charges stemming from this scheme. On July 10, 2014, Haddad was sentenced to 51 months of imprisonment and, on July 18, 2014, Carbone was sentenced to 24 months of imprisonment.
This matter was investigated by the Federal Bureau of Investigation, with the assistance of the National Insurance Crime Bureau, the Metropolitan Property and Casualty Insurance’s Special Investigation Unit and the Travelers Insurance Company.
The case is being prosecuted by Assistant U.S. Attorneys Christopher W. Schmeisser and David J. Sheldon.