Cracking the Ethics Code

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Cropped shot of a medical professional filling out paperwork

A Rhode Island chiropractor has been sentenced for executing a scheme to defraud a healthcare benefits program and failing to pay taxes on the income he received from his business. (Hiding money from the government doesn’t tend to go well.)

Eugene Kramer, 51, was the sole owner of New England Spine and Disk Center in Providence. Kramer admitted that he fraudulently submitted claims for days when a patient did not attend treatment and for treatment not provided. (Kramer tried to get paid for sitting around and doing nothing.)

Kramer also admitted that he falsified documentation to support a patient’s nonexistent personal injury claim. According to court documents, an individual cooperating with the FBI visited Kramer’s office on 15 occasions for treatment, claiming he had been in a car accident. This person was provided with little to no treatment and was never given a diagnosis.

These sessions were a part of Kramer’s efforts to further his patient’s illegitimate personal injury claim. He provided falsified medical notes and invoices documenting this patient’s chiropractic treatment to an attorney from January 1, 2018 to December 31, 2018. (As we know, no treatment occurred during their sessions.)

These falsified documents were then provided to an automobile insurance company in order to secure unnecessary payments from insurance. (I think this may go against the chiropractor’s code of ethics.)  Kramer also admitted that for tax years 2015, 2016, and 2017, he failed to report a portion of his personal income, resulting in a tax bill from the IRS totaling $66,914.

Kramer previously pleaded guilty to one count each of healthcare fraud and filing a false tax return. He was sentenced to three years of probation with the first six months to be served in home confinement. He must also perform 900 hours of community service and pay a $25,000 fine.

Today’s Fraud of the Day comes from a Department of Justice press release, “Chiropractor Sentenced in Health Care Fraud, Tax Evasion Scheme,” dated February 11, 2021.

PROVIDENCE – A Providence chiropractor who admitted to creating and executing a scheme to defraud a health care benefits program and who failed to pay taxes on some of the income he received from his business was sentenced on Wednesday to three years probation, to include the first six months in home confinement; to perform 900 hours of community service while on probation; and to pay a $25,000 fine.

Eugene Kramer, 51, sole owner of New England Spine and Disk Center, previously admitted to the court that he fraudulently billed for days a patient did not attend treatment, for treatment not provided, and that he falsified medical notes and documentation to support a nonexistent personal injury claim.

 

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.