Chiropractor Will Pay Over $200K to Resolve Medicaid Fraud Allegations

by Andrew Murray | September 25th, 2019

On August 15, 2019, Kentucky’s Attorney General announced the $211,000 settlement with the chiropractor who allegedly billed the state’s Medicaid program for services that he did not perform. The Press Release states:

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Dustin Wright, 44, of Parkersburg, West Virginia, agreed to a settlement negotiated by Beshear’s Medicaid Fraud and Abuse Control Unit resolving the allegations. Wright voluntarily placed his Kentucky chiropractic license on inactive status, and is no longer authorized to provide chiropractic services to Kentucky Medicaid patients.

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In December 2016, Beshear’s office launched an investigation after Anthem Inc. provided information regarding Wright’s billing practices from May 2, 2013, to Nov. 13, 2015.

The investigation found that Wright owned and operated a chiropractic clinic in Grayson, Kentucky. In late 2011, Wright moved to West Virginia and opened a chiropractic clinic in Parkersburg. Wright then hired other chiropractors to treat patients at the Grayson clinic in his absence.

These replacement chiropractors were not authorized to treat Kentucky Medicaid patients and one of them was not even licensed to practice chiropractic medicine, which is illegal in the Commonwealth. In addition, unless a chiropractor has entered into a written provider agreement with Kentucky Medicaid, any claims submitted by him or her are not eligible for reimbursement.

The investigation further revealed that, although Wright had not examined or treated any patients at the Grayson clinic during the applicable time period, he submitted claims to Medicaid in which he falsely identified himself as the treating physician.

Data provided by the West Virginia Medicaid Fraud Control Unit revealed that Wright was submitting claims for treating West Virginia Medicaid patients in Parkersburg on the same days he claimed he was treating Kentucky Medicaid patients in Grayson. Parkersburg is more than 150 miles from Grayson and it is physically impossible for Wright to have been treating patients in both places at the same time.

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