Suburban clinic owners accused of defrauding insurers

The owners of six suburban chiropractic clinics face charges they defrauded health insurance companies over a decade beginning in 1999, according to federal court records.

An indictment filed in federal court Wednesday charges Bradley Mattson, Steven Paul and Neelesh Patel with health care fraud and alleges they submitted phony claims for chiropractic, medical and physical therapy services.

Court documents indicate the defendants jointly owned and operated Stratford Physical Medicine in Bloomingdale, Algonquin Physical Medicine in Lake in the Hills, Woodfield Physical Medicine in Schaumburg and Hawthorn Physical Medicine in Vernon Hills. Mattson and Paul also jointly owned and operated North Shore Physical Medicine in Niles and Cumberland Physical Medicine in Norridge, according to the court documents.

Authorities said that Mattson, Paul and Patel submitted phony claims to Blue Cross Blue Shield of Illinois, Aetna and Humana for services — including X-rays, MRI, neurological testing and physical therapy — that patients did not need or that Mattson, Paul and Patel did not provide.

The indictment claims the defendants billed more than $18 million to Blue Cross, but does not indicate what percentage, if any, was for legitimate medical tests or treatment.

A conviction for health care fraud could carry a sentence of 10 years, or more if the fraud results in serious injury or death.

The defendants marketed their clinics through their company, ARC Health, at malls and employee health fairs targeted toward people insured by the health care benefit programs, authorities say. They reportedly instructed ARC Health employees to offer potential patients coupons for free X-rays or a discounted office visit, services that they later billed to the patients' insurers.

The indictment claims the defendants instructed the clinics' chiropractors to diagnose medical problems, regardless of a patient's actual condition, that would cause the patient to return for physical therapy and other medical services.

According to the indictment, Mattson received kickbacks from a company that provided MRI exams in exchange for sending patients to that facility.

Employees contacted by phone at the Vernon Hills and Norridge facilities said the defendants are no longer associated with those practices.

Phone lines for the Bloomingdale, Lake in the Hills and Schaumburg facilities were either disconnected or not in service. The phone number listed for the Niles facility apparently belongs to an unrelated medical practice.