Long Island Chiropractor Arrested for Multi-Million Dollar Health Care Fraud
Defendant Paid More Than $2 Million for Fraudulent Claims Filed with Insurance Company
An indictment was unsealed today in federal court in Central Islip charging chiropractor Raymond R. Pellegrino with health care fraud. The indictment alleges that Pellegrino billed Anthem Blue Cross Blue Shield over $2 million for health care services that were never performed. Pellegrino was arrested today in Texas, and will be arraigned at a later date in the Eastern District of New York.
Richard P. Donoghue, United States Attorney for the Eastern District of New York, and William F. Sweeney, Jr., Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI), announced the charges.
“Pellegrino abused his position as a licensed medical professional by brazenly stealing millions of dollars in fraudulent billings,” stated United States Attorney Donoghue. “Today’s arrest demonstrates the resolve of this Office and the FBI to hold accountable health care fraudsters who line their pockets at the expense of insurance companies and, ultimately, consumers, who pay the cost of higher premiums.” Mr. Donoghue expressed his grateful appreciation to the New York State Department of Financial Services for its assistance in the case.
“Defrauding our healthcare system, regardless of the amount of money stolen or nature of the crime, eventually harms all of us,” stated FBI Assistant Director-in-Charge Sweeney. “The FBI and our law enforcement partners are aggressively searching out practitioners, suppliers and fraudsters to stop their illegal behavior, and keep the bills we each pay from ballooning out of control.”
As alleged in the indictment and court filings, Pellegrino operated chiropractic offices in West Hempstead and Hicksville, New York. Pellegrino hired medical doctors for part-time work and then billed Anthem Empire Blue Cross Blue Shield under the taxpayer identification numbers of those doctors for osteopathic manipulation and other services purportedly provided to beneficiaries. Between December 2003 and September 2014, Pellegrino was paid over $2 million for fraudulent claims filed with Anthem Blue Cross/Blue Shield, billing for medical services that he knew the doctors had not provided.
The charge in the indictment is an allegation, and the defendant is presumed innocent unless and until proven guilty.
If convicted of health care fraud, Pellegrino faces up to 10 years’ imprisonment.
The government’s case is being handled by the Office’s Long Island Criminal Division. Assistant United States Attorneys Charles P. Kelly and Madeline O’Connor are in charge of the prosecution.
RAYMOND R. PELLEGRINO
E.D.N.Y. Docket No. 18-CR-496 (JFB)