Boca Raton Medical Billing Company Members Indicted in Ohio Fraud

Seven people and a Florida medical billing company were indicted on December 17, 2014 for their roles in a multi-million dollar health care fraud conspiracy involving a controversial form of chiropractic manipulation, according to a news release by the U.S. Attorney’s Office for the Northern District of Ohio.

Members of the fraud scheme indicted are:

• Physicians Surgical Group (PSG) of Boca Raton, Fla.
• Christopher Liva, 36, of Boca Raton
• Edward Liva, 64, father of Christopher Liva, based in Boca Raton
• Carolyn Via, 51, of Boca Raton
• Mark Fritz, age not provided, of Coral Springs
• Three other medical professionals from Northeast Ohio

The Livas and Via owned PSG and were also part owners of Shaker Heights Surgical Center (SHSC), located in Ohio.  Fritz was chief financial officer at PSG.

The U.S. Attorney for the Northern District of Ohio alleged that, from 2007-2010, the defendants deceived various private insurance companies, bilking them out of millions of dollars on behalf of patients who underwent manipulations under anesthesia, a risky treatment that is normally reserved for those who have not responded to more conservative chiropractic treatment.  The procedure is classified as surgery by the American Medical Association, according to the indictment.

In order to defraud the insurance companies, the defendants disregarded actual diagnoses, created fake diagnoses, submitted false billing claims, and represented that the procedures were performed by medical doctors, when in fact they were performed by chiropractors.

Additionally, the indicted parties marketed SHSC and the experimental manipulation procedure to chiropractors in Ohio. Chiropractors were paid a flat fee of $4,000 for each patient they referred to SHSC, and the clinic waived patients’ co-pays and deductibles.  The clinic then typically submitted three types of claims to the insurance companies—for professional fees, facility fees, and fees for anesthesia services.

The Livas, Fritz, PSG, and the three Ohio medical professionals are charged with one count each of conspiracy, wire fraud, health care fraud, and money laundering.  The Livas and Via each face an additional count of money laundering.

Prosecutors are also seeking to seize property derived from the criminal conspiracy, including two properties in Boca Raton, money, a watch, and 4.18-karat diamond stud earrings.