Defendants In Louisville Area Chiropractic Scheme Sentenced To Federal Prison
Fraudulently Billed Insurance Companies approximately $5 Million for Services Never Performed
LOUISVILLE, Ky. – U.S. District Judge Rebecca G. Jennings has sentenced defendants of a health care fraud scheme that billed insurance companies for services never performed to years in federal prison, announced United States Attorney Russell M. Coleman.
“This sentence sends a message that theft in the Western District of Kentucky – health care related or otherwise – results in real time in federal prison,” stated U.S. Attorney Russell Coleman
On Wednesday, the Court sentenced Ledinson Chavez to 74 months in prison for health care fraud, money laundering, and aggravated identity theft. The sentence is followed by 2 years supervised release, and $1,016,393.23 in restitution. There is no parole in the federal system.
Sergio Betancourt was sentenced on Wednesday to 37 months imprisonment for health care fraud, money laundering and crimes committed while on pre-trial release. The sentence will be followed by 2 years supervised release, and $1,153,770.34 in restitution.
According to the evidence before the Court, beginning no later than on or about June 12, 2012, and continuing through on or about November 1, 2014, Claudia Lopez, Ledinson Chavez, Oskel Lezcano, Ariel Borrego-Hernandez, Sergio Betancourt and Yuriesky Diaz Rodriguez recruited unsuspecting chiropractors for employment in Louisville area chiropractic clinics in order to obtain and use the chiropractors’ names and National Provider Identifiers (NPI) to fraudulently bill insurance companies. Each chiropractor provided his/her NPI number to Lopez and Lezcano in order to credential the clinics with various insurance companies.
Thereafter, the group of defendants recruited employees from Jeffboat and other local employers to seek chiropractic services from the clinics. However, unbeknownst to the chiropractors, the clinics billed approximately $5,000,000 for methocarbamol injections (a muscle relaxant), using the patients’ names, dates of birth, insurance/policy numbers, addresses, and patient IDs/Social Security Numbers for injections. Most of the patients from Jeffboat were paid to go to the clinics by the defendants and were told the injections were being billed, according to testimony during trial.
Borrego-Hernandez, Lopez, Betancourt, Chavez and allegedly Lezcano operated and controlled multiple chiropractic clinics in the Louisville area including: Xpress Diagnostics Center, Inc.; Prudential Chiropractic Medical Center, PLLC; Klondike Chiropractic Medical Center, LLC; Be Well Chiropractic Center, Corp.; and Chiropractic and Medical Center, LLC, even though the clinics were placed in various chiropractors’ names.
According to additional court documents on or about March 14, 2017, and March 17, 2017, while on pre-trial release, Borrego and Lopez conspired to traffic in marijuana – which caused about 109 pounds of marijuana to be transported from Colorado to Kentucky.
Lopez was sentenced in September to 61 months imprisonment, followed by 3 years of supervised release and ordered to pay $232,617.96 in restitution, as well as forfeit an Audi Q-7 and $53,775 in proceeds.
Ariel Borrego-Hernandez was sentenced in October to 54 months in prison, followed by 3 years supervised release and ordered Borrego-Hernandez to pay $89,161.81 in restitution, and over $53,000 in forfeited cash.
Yuriesky Diaz Rodriguez was sentenced in December to 18 months of probation and ordered to pay $104,624.70 in restitution.
Assistant United States Attorneys Joseph Ansari, Lettricea Jefferson-Webb and Christopher Tieke prosecuted the case and were assisted by Bob Masterson as health care fraud investigator and Mary Kennedy as paralegal. The case was investigated by the Federal Bureau of Investigation, the United States Postal Inspection Service, the Internal Revenue Service Criminal Investigation, the Louisville Metro Police Department, and the National Insurance Crime Bureau.