Florida chiropractors must follow federal and state healthcare laws. Healthcare regulations ensure patient safety. Since chiropractors are licensed healthcare professionals, they are legally bound to adhere to all requirements. In Florida, chiropractors must pass the National Board of Chiropractic Exams and meet continuing educational requirements. Florida Statutes (Chapter 460) detail the “Regulation of Professions and Occupations Chiropractic Medicine.” Florida’s strict legal and ethical standards protect patients’ health and safety.
Chiropractor Fraud Examples
Healthcare fraud remains a serious issue. Fraud occurs when a chiropractor engages in dishonest or illegal activities. Examples may include:
- Unnecessary treatment- Any unnecessary procedure used to increase revenue is illegal.
- False diagnosis- Billing for a fake diagnosis is illegal.
- False billing- Billing for services never performed is an example of fraud.
- Kickbacks- Receiving money from another person for a patient referral is against the law.
- Fake auto injury claims- Auto insurance claims when tow truck drivers contact a chiropractic clinic and refer patients to that clinic is considered insurance and healthcare fraud. Many times kickbacks are part of this scheme.
- Clinics not owned by chiropractors- Fake clinics not owned by a chiropractor are part of a healthcare fraud scheme. Chiropractors must be very careful when setting up their business. In other words, contact an experienced attorney before you buy, or open a practice. Florida Laws are very strict on Chiropractor business ownership.
- Improper treatment- Any treatment that harms a patient may be grounds for a lawsuit.
- Fraudulent insurance claims- Using one person’s insurance information to cover another person’s medical bills.
Florida’s Healthcare Fraud Statutes
Key statutes include:
- Florida Statute 817.234- This statute involves insurance fraud. Basically, it is illegal to file a false insurance claim.
- Florida Statute 817.505- This is also known as “The Patient Brokering Act.” This Act prohibits any receipt of money or gifts for patient referrals.
- Florida Statute 456.054- Florida’s Anti-kickback statute is similar to the Patient Brokering Act. Once again, chiropractors may not receive kickbacks for referrals.
- Florida Statute 812.014- Chiropractors must not engage in fraudulent billing practices.
- Florida Statute 460.4167- Defines business relationships for chiropractors.
Federal Healthcare Fraud Statutes
Medical professionals must follow federal laws as well as state laws. Some federal laws regarding healthcare fraud include:
- The Anti-Kickback Statute (42 U.S.C.: 1320a-7b(b) – This federal law is similar to Florida Law except that the Federal Law applies to federal programs. Medicare and Medicaid fall under this statute.
- The False Claims Act (31 U.S.C.:3729-3733) – This act covers any false claims submitted to the government for reimbursement. Once again, this law applies to government insurance programs.
- Stark Law (42 U.S.C.: 1395nn) – Chiropractors, or any healthcare provider may not refer a patient to an entity where they have a financial relationship. For example, if the chiropractor owns another type of healthcare clinic, they may not refer a patient to that clinic.
- Healthcare Fraud Statute (18 U.S.C.: 1347) – This statute prohibits knowingly committing fraud.
Healthcare Fraud Penalties for Chiropractors
Penalties are severe at a state and federal level. In fact, violating statutes may include civil and criminal charges. At a civil level, fines may be tens of thousands of dollars PER OFFENSE, (or claim). At a criminal level, you may face felony charges at a first, second, or third degree level. Federal felony degrees depend on the amount of money involved in the fraud. As a result, you must hire an experienced attorney if you are charged with any healthcare related fraud. Even a first fraud offense may be a felony, particularly if it involves government insurance programs. Your attorney will assist you in understanding the case and preparing a defense. Additionally, you may be sentenced to prison, lose your license, or lose your ability to charge for any future government insurance program.
It’s important to note that healthcare fraud remains a serious offense in Florida. Courts have handed down lengthy sentences to medical professionals found guilty in fraud cases. For example, violation of the False Claims Act may result in 5 years in prison for EACH false claim. Federal charges may range from five-20 years in prison, even more if a death occurred. Therefore, it remains vital to contact an experienced healthcare attorney if you are charged with healthcare fraud.