Citing “a lot of rot” in chiropractic medicine, a federal judge sentenced a onetime Minnesota practitioner to two-plus years in prison for defrauding a leading health insurer out of more than $330,000.
Steven Wiseth, 36, of Thief River Falls, was sentenced Tuesday in federal court in Minneapolis to 2¼ years after pleading guilty to wire fraud in connection with orchestrating an elaborate scheme to defraud health insurers by submitting claims for scores of services he never provided.
Along with prison time, U.S. District Judge Patrick Schiltz ordered Wiseth to pay back to insurers $337,195.11 and serve a year of supervised release.
Blue Cross and Blue Shield of Minnesota, which said it detected the fraud in 2014, is due the most in restitution: $335,572.69. Three other insurers account for the balance.
“Mr. Wiseth is unfortunately the latest in a long list of chiropractors who have appeared in federal court because they’ve been stealing from insurance companies,” Schiltz said at sentencing. “There seems to be a lot of rot in that profession, and deterrence seems to be much needed.”
One of the largest cases in Minnesota recently involving fraud among chiropractors was filed in 2016, when federal prosecutors charged several practitioners and 15 others in connection with fraud schemes that allegedly bilked insurers out of more than $20 million over the past five years. Two chiropractors were convicted in 2018 and sent to prison.
Schiltz went on to point out that Wiseth’s fraud was a “part of his routine business practice.”
“Based on the federal prosecutions and [state] Department of Commerce investigations and challenges to chiropractors’ licenses over the last several years, there were practices employed by many chiropractic offices that violated state law, anyway,” Wold said.
He also said he hopes his client’s case will encourage “good chiropractors to make sure they keep their practices in conformity with the state law.”
Wold said that his client, who lost his chiropractic license in Minnesota over this case, took responsibility for his actions and acknowledged that “he went too far with some of his billing.”
In a statement, Minnesota Chiropractic Association President Dustin Emblom said that while they support the prison sentence, Schiltz’s statement regarding “a lot of rot” is a “broad and inaccurate characterization of the chiropractic profession,” as well as “disparaging and unwarranted.”
“Insurance fraud is a matter the MCA takes seriously. In fact, the MCA continues to work proactively to prevent these serious matters through its continuing education programs and adherence by our members to the high ethical standards expected of all health care providers,” Emblom said.
For roughly two years until April 2015, Wiseth, who owned Health Quest Family Chiropractic, plotted to defraud insurers by “submitting and causing the submission of false and fraudulent claims for chiropractic services.”
He held many promotional events where he gave away food and drink, prizes and gift certificates to get current and prospective patients to visit Health Quest. After those events, he billed insurers saying he had provided chiropractic services to many of the people who had merely visited the events, using their personal and insurance information without permission.
For example, on Feb. 13, 2014, Wiseth held a “ValenSpine’s Day” event. He submitted bills to insurers claiming to have treated 219 patients just that day, purporting to have provided 641 services.
In many bills, Wiseth dramatically misrepresented services truly provided to patients, prosecutors said. For example, he routinely submitted false bills for treatment with a “wobble chair,” a device for enhancing core strength.
He informed insurers that the services were performed for at least 8 minutes under the direct supervision of a health care professional. In fact, he merely stocked his waiting rooms with wobble chairs where patients sat while waiting for their appointments.
Over the course of two years, Wiseth billed insurers for more than $3.1 million, including for hundreds of treatments that were not provided or were overbilled, and the companies paid him more than $1.1 million.