Chiropractor sentenced in fraud scheme involving six suburban clinics
From Staff Reports December 10, 2012 3:58PM
Updated: January 12, 2013 6:16AM
CHICAGO — A chiropractor who had part ownership in a half dozen suburban clinics — including one in Algonquin — was sentenced Monday to 6 1/2 years in federal prison for defrauding an insurance company out of millions of dollars, the FBI announced.
Bradley Mattson, 51, of Lake Forest, was accused of trying to defraud the company of nearly $5.9 million and causing an actual loss of more than $2 million by submitting false claims for services that were not medically necessary or were not provided to patients.
Mattson pleaded guilty in September to one count of health care fraud, admitting that he engaged in a 10-year scheme to defraud Blue Cross and Blue Shield of Illinois through all six clinics that he owned in combination with two co-defendants.
U.S. District Judge Ronald Guzman also ordered Mattson to pay restitution totaling $2,097,031.
“This scheme required extensive efforts,” Guzman said in passing sentence.
“Frauds like this all across the country are jacking-up the price of insurance,” he said, adding that Mattson showed “no sensitivity to his patients” and “put many of them through unnecessary stress.”
Between 1999 and 2009, Mattson co-owned and operated Algonquin Physical Medicine, Hawthorn Physical Medicine, Woodfield Physical Medicine, Stratford Physical Medicine, Northshore Physical Medicine, and Cumberland Physical Medicine in combination with co-defendants Steven Paul and Neelesh Patel, both chiropractors. According to his guilty plea and court records, Mattson directed that patients receive an initial x-ray and a pre-set schedule of clinic visits for a period of six months, without regard to the medical necessity. In addition, he ordered that the clinics’ staff order MRI exams and neurological diagnostic testing performed by others without regard to necessity, the FBI said.
Overall, Mattson directed billings to Blue Cross Blue Shield totaling $5,891,848 for medically unnecessary tests or physical therapy services that were not provided, and his clinics collected $2,097,031 in reimbursement from the insurance company.
Paul, 41, of Northbrook, is awaiting sentencing after also pleading guilty in September to one count of health care fraud, while the charges against Patel, 37, of Glenview are pending.