Brothers sentenced in insurance fraud case
Compliance Monitor, June 14, 2006
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Two brothers were sentenced last week on charges of healthcare fraud for allegedly making some $2 million in false claims to Blue Cross, according to the Community Dispatch in Atlanta.
Eric Topel, 34, of Allen, TX, and Christopher Topel, 44, of Wichita, KS, each received a two years and ten months prison sentence, followed by a three year supervised release and 350 hours of community service.
The Topels fraudulently billed Blue Cross for a back pain procedure called Veterbral Axial Decompression, which they performed on multiple patients, according to the Dispatch. This is considered an experimental procedure by the insurer and consequently not eligible for coverage.
The Topels, however misrepresented the procedures they performed to obtain coverage by using a different billing code. Employees were also told not to mention the name of the procedure when speaking with Blue Cross representatives.
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