CHIROPRACTOR PLEADS GUILTY
TO CONSPIRING TO COMMIT HEALTH CARE FRAUD
David B. Fein, United States Attorney for the District of Connecticut, today announced that GEORGE U. DeCARVALHO, 55, of Stamford, waived his right to indictment and pleaded guilty on Friday, June 29, before United States District Judge Stefan R. Underhill in Bridgeport to one count of conspiracy to commit health care fraud.
This matter stems from “Operation Running Man,” a 14-month undercover fraud investigation headed by the Federal Bureau of Investigation. The investigation included the use of recordings of an undercover special agent meeting with an attorney, various doctors and chiropractors in relation to auto-accident personal injury litigation. To date, six persons have pleaded guilty, including four chiropractors, a licensed doctor of osteopathic medicine, and a formerly licensed physician.
According to court documents and statements made in court, DeCARVALHO is a licensed chiropractor who owns and operates a chiropractic practice in Bridgeport. From approximately May 2007 to January 2009, DeCARVALHO conspired with Francisco Carbone and others to commit health care fraud. Carbone previously had been licensed to practice medicine, working as a sole practitioner in Bridgeport. In March 2005, Carbone’s license to practice medicine was revoked by the State of Connecticut.
DeCARVALHO and Carbone shared office space in Bridgeport from approximately January 2004 to November 2005. Before Carbone’s medical license was revoked, DeCARVALHO and Carbone provided chiropractic and medical treatment on a number of common patients who were involved in auto-accident litigation. After March 2005, DeCARVALHO continued to treat certain patients knowing that payments for his services were coming from insurance settlements based, in part, on the purported treatment provided by Carbone.
In addition, in May 2007, DeCARVALHO was involved in an auto accident in which the other driver was liable. DeCARVALHO contacted Carbone to fabricate medical records to show that DeCARVALHO had suffered certain injuries and had received medical treatment for those injuries allegedly sustained from the accident. DeCARVALHO indicated that Carbone could bill carriers for treatment under DeCARVALHO’s automobile MedPay insurance. In October 2007, Carbone fabricated the medical records and submitted claims to MedPay for reimbursement totaling approximately $6,000. Relying on the false medical bills, DeCARVALHO subsequently settled the accident claim for an additional $4,500.
Judge Underhill has scheduled sentencing for September 21, 2012, at which time DeCARVALHO faces a maximum term of imprisonment of five years and a fine of up to $250,000.
On July 19, 2011, Carbone pleaded guilty to one count of conspiring to commit mail fraud to defraud insurance carriers, one count of conspiring to commit mail fraud to defraud the State of Connecticut, one count of making a false statement relating to health care matters, and one count of conspiring to distribute controlled substances outside the scope of the usual course of professional practice. He awaits sentencing.
This case is being investigated by the Federal Bureau of Investigation, with the assistance of the National Insurance Crime Bureau and Metropolitan Property and Casualty Insurance’s Special Investigation Unit. The case is being prosecuted by Assistant United States Attorneys Christopher W. Schmeisser and Susan Wines.
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