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, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.