Chiropractor billed Medicaid for services he did not provide
FRANKFORT, Ky. (Aug. 15, 2019) – Attorney General Andy Beshear announced today a West Virginia chiropractor will pay $211,000 to resolve allegations that he submitted fraudulent claims to Kentucky’s Medicaid program for chiropractic services he did not personally render.
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.
“My office holds accountable those who place profits ahead of our Kentucky families,” Beshear said. “This chiropractor is no longer practicing in our state and is paying up for defrauding our Medicaid program.”
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.
The settlement money will be returned to the state Medicaid program.
Since taking office, Beshear’s office has been committed to holding accountable those who seek to defraud the state Medicaid program.
In May, Beshear and the Medicaid Fraud and Abuse Control Unit announced a former eastern Kentucky doctor pleaded guilty to eight counts related to the illegal operation of a Suboxone clinic in Lawrence County. Beshear said the former doctor will pay restitution and has agreed not to seek reinstatement of his Kentucky Medical License.
To date, civil settlements and criminal restitution efforts by Beshear’s office have resulted in more than $97.6 million in obligations to the state and federal Medicaid programs, Medicare, Tricare, commercial payers and other entitie
To report allegations of Medicaid provider fraud contact the attorney general’s tip line at 877-228-7384.