Central Pa. chiropractors accused of $150,000 insurance scam
Two Central Pennsylvania chiropractors have been arrested for allegedly orchestrating a scheme to defraud health insurance companies of about $150,000.
Joshua M. Rosinski, 37, of Mechanicsburg, and Joseph P. Brady Jr., 44, of Chambersburg, were arrested following an investigation by the Insurance Fraud Section of the Pennsylvania Office of Attorney General’s office.
Their alleged Harrisburg-area scheme resulted in the fraudulent billing of three insurance companies — Highmark Blue Shield, Capital Blue Cross and Erie Insurance.
The charges were announced by Pennsylvania Attorney General Bruce R. Beemer.
According to a presentment issued by the grand jury, Rosinski and Brady over a four-year period caused fraudulent claims to be submitted to insurance companies for treatments they alleged they provided to each other and each other’s family members. The grand jury’s investigation revealed these treatments never occurred. Rather, they were part of a ploy that led to increased monthly bonuses for both men.
“The evidence and testimony presented to the grand jury clearly showed the defendants manipulated the system for their own gain,” Beemer said. “This is an especially egregious case that impacts insurance companies and threatens a system that depends on medical providers to follow the law.”
According to the grand jury, Rosinski provided chiropractic services to patients at Herman Chiropractic Center of Harrisburg. Meanwhile, Brady provided chiropractic services to patients at Herman Chiropractic Center of Chambersburg.
Their alleged scheme resulted in the fraudulent billing of three insurance companies — Highmark Blue Shield, Capital Blue Cross and Erie Insurance — for chiropractic services that were never rendered. The grand jury found that many of the dates that the doctors purportedly provided chiropractic services coincided with dates when either the patient or chiropractor was out of town, in the hospital or otherwise indisposed.
In one case, claims were submitted for Rosinski’s purported treatment of Brady’s wife in Harrisburg on Oct. 13 and 15, 2010. In reality, Brady’s wife had been admitted to the hospital, where she gave birth to a child on Oct. 13. Hospital records showed no indication that the woman left the hospital to be treated at Rosinski’s practice, which was roughly 60 miles away.
The grand jury also learned that Carnival Cruise records confirmed that Rosinski, his wife and children boarded a Carnival Cruise ship for a weeklong cruise in May 2013. Two insurance companies were billed for services that Brady claimed to have provided to Rosinski, his wife and child in Chambersburg, when in fact the dates of treatment coincided with the dates the family spent on the cruise ship.
The grand jury presentment contains many other examples of “absentee” claims, where travel records confirmed that claims submitted for treatments purportedly provided by the two chiropractors were false.
The grand jury also heard testimony that staff at Rosinski’s office was expected to add the Bradys’ names to the Harrisburg office patient sign-in sheet, even though no services were rendered to them at that location. The grand jury learned of a similar alleged course of conduct at Brady’s Chambersburg office, where staff was expected to add the Rosinskis’ names to the patient sign-in sheet, despite no services being rendered to those individuals in Chambersburg.
Rosinski, of the 200 block of Brook Meadow Drive, Mechanicsburg, Cumberland County, and Brady, of the first block of Romance Lane, Chambersburg, Franklin County, are both charged with three counts each of insurance fraud and one count each of corrupt organizations, theft by deception and criminal conspiracy to commit theft by deception.
Rosinski and Brady both appeared Monday for preliminary arraignments. Bail was set at $150,000 unsecured for each defendant. Preliminary hearings are scheduled for Jan. 18.