'False and fraudulent' radiology reports cost chiropractor $7 million
A California judge has ordered a chiropractor to pay more than $7 million for attempting to defraud the Allstate Insurance Company via fraudulent radiology reports.
Los Angeles Superior Court Judge Ernest Hiroshige found that Daniel H. Dahan and Progressive Diagnostic Imaging Inc. of Long Beach, violated the California Frauds Prevention Act in 487 claims presented to Allstate, according to an announcement. The claims included radiology reports that falsified medical records and, Hiroshige held, had "no diagnostic, clinical or medical value whatsoever." The judge also found that health insurance claim forms and billing statements accompanying the radiology reports were "false and fraudulent."
Allstate alleged that Dahan used report-writing software to analyze and form medical opinions and diagnoses on X-rays solicited from chiropractors. He then tasked untrained and unlicensed individuals prepare fraudulent radiology reports, authenticating them by cutting and pasting the signatures of board certified radiologists without their knowledge or permission. Afterward, the reports were presented to Allstate in support of claims.
In addition to that verdict, the judge issued an order prohibiting Dahan from owning, operating or working for a business engaged in the practice of medicine. The judge ordered that Dahan pay Allstate $4,870,000 in civil penalties, more than $900,000 in assessments, and roughly $1.22 million in attorney's fees, costs and investigative expenses, according to DOTmed News.
Insurance fraud is not a victimless crime," Phil Telgenhoff, Allstate California field vice president, said, according to the announcement. "Fraud drives up the cost we all pay for insurance and stealing millions of dollars from insurers cannot and will not be tolerated in California or anywhere across the country."
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