California Board of Chiropractic Examiners Chiropractor License Insurance Fraud Discipline

California Board of Chiropractic Examiners Chiropractor Defense Attorney

The California Board of Chiropractic Examiners, known as the BCE, vigorously investigates and disciplines Chiropractors accused of participating in Insurance Fraud. California law enforcement agencies heavily prosecute Chiropractors engaging in Insurance Fraud. Chiropractors in California participate in several common types of Insurance Fraud, including:

• Auto Insurance Fraud
• Claim Mills
• Medi-Cal Fraud
• Medicare Fraud
• Medical Mills
• Personal Injury Insurance Fraud
• Workers Compensation Insurance Fraud

Insurance Fraud committed by Chiropractors remains a top enforcement priority for the California Board of Chiropractic Examiners and other law enforcement agencies. False and fraudulent billing for services allegedly rendered, as well as kickback schemes, are an investigative priority for law enforcement. The California Board of Chiropractic Examiners also targets Chiropractors at Claim Mills and Medical Mills. Common methods of Insurance Fraud committed by Chiropractors include, but are not limited to:

• Billing insurance companies for services not rendered
• Capping (Paying for Client Referrals)
• Excessive Treatments
• False Medical Claims
• Gross Negligence in the Practice of Chiropractic Medicine
• Kickbacks to Attorneys, Doctors and insurers
• Overbilling insurance companies for services rendered

Consequences of Insurance Fraud for Chiropractors can include Chiropractor License revocation by the California Board of Chiropractic Examiners and even criminal charges. California Chiropractors facing allegations related to Insurance Fraud should contact an experienced California Board of Chiropractic Examiners License Defense Attorney for representation.

California Board of Chiropractic Examiners Insurance Fraud Investigation Defense Lawyer

The majority of California Board of Chiropractic Examiners Insurance Fraud Investigations begin with the filing of a consumer Complaint. However, California Board of Chiropractic Examiners Insurance Investigations also occur through sting operations and criminal investigations. The California Board of Chiropractic Examiners utilizes non sworn civilian investigators to conduct non criminal investigations. The California Department of Consumer Affairs employs sworn Peace Officer Investigators to conduct criminal investigations against Chiropractors engaged in Insurance Fraud. The California Department of Insurance works closely with the California Department of Consumer Affairs to combat Chiropractor assisted Insurance Fraud. Administrative Law Due Process Rights differ substantially from the Due Process Rights accorded in criminal law.

It is important to have an attorney that understands issues faced by Chiropractors facing disciplinary action for allegations related to Insurance Fraud. At the conclusion of a California Board of Chiropractic Examiners investigation, the Board has several options. The Board can choose to close the Complaint. The Board can choose to issue a Citation. The Board can also choose to refer the matter to the California Attorney General’s Office. The Attorney General’s Office will determine whether cause exists to file a formal disciplinary Accusation. In Insurance Fraud cases involving criminal conduct, the Board may refer the case to the District Attorney’s Office for criminal prosecution.

If you are a Chiropractor facing a California Board of Chiropractic Examiners Investigation arising from Insurance Fraud allegations, contact a California Chiropractor License Defense Attorney for representation.

California Chiropractor License Insurance Fraud Accusation Defense Attorney

A formal Accusation served on a California Chiropractor serves as notice to a Chiropractor that the California Board of Chiropractic Examiners intends to revoke the Chiropractor License. Allegations of Insurance Fraud committed by Chiropractors almost always results in the filing of a disciplinary Accusation.

An Accusation is a serious matter that can result in the suspension or revocation of a Chiropractor License in California. In many cases, it is possible for Chiropractors to reach a Stipulated Agreement with the Attorney General’s Office and California Board of Chiropractic Examiners. A Stipulated Agreement is a formal term for a settlement agreement. If a Stipulated Agreement cannot be reached, the parties will proceed to a formal Hearing before the California Office of Administrative Hearings (OAH).

Disciplinary Accusations involving Insurance Fraud can result in revocation of a Chiropractor License by the California Board of Chiropractic Examiners. Chiropractors facing a California Board of Chiropractic Examiners Accusation should contact an experienced California Chiropractor License Defense Attorney for representation.

California Chiropractor License Hearing For Insurance Fraud

The California Office of Administrative Hearings, also known as OAH, maintains several Court Hearing locations. These Court locations are in Los Angeles, Oakland, Sacramento and San Diego. In some instances, Hearings may be held offsite in Bakersfield, Fresno, Orange County, Riverside, San Bernardino, San Francisco, San Jose or Ventura. The Administrative Law Hearing is a formal Hearing before an Administrative Law Judge.

The Administrative Law Judge, or ALJ, will issue a written Proposed Decision approximately 30 days after the Hearing. The California Board of Chiropractic Examiners can adopt, modify or reject the ALJ’s Proposed Decision. The California Board of Chiropractic Examiners’ action is called the Final Decision and Order. There are two main rights of Appeal of a Final Decision and Order. California Government Code § 11521 allows a Chiropractor to file a Petition for Reconsideration prior to the effective date of the Final Decision and Order. Pursuant to California Code of Civil Procedure § 1094.5, the Chiropractor can also file a Petition for Writ of Mandamus in Superior Court. A Writ must be filed within 30 days of the effective date of the Final Decision and Order.

California Chiropractors facing a California Board of Chiropractic Examiners Administrative Law Hearing need effective representation from a California Chiropractor License Defense Lawyer.

California Chiropractor Insurance Fraud and Criminal Charges

The California Board of Chiropractic Examiners can discipline Chiropractors for misconduct that rises to the level of criminal activity, but violates an Administrative Law regulation. The California Board of Chiropractic Examiners disciplinary process is separate from the Criminal Law process. The California Board of Chiropractic Examiners can discipline Chiropractors for certain criminal convictions. California Board of Chiropractic Examiners Chiropractor discipline occurs for criminal convictions that are substantially related to the duties, functions and qualifications of a Chiropractor. All criminal violations of Healthcare Fraud, Insurance Fraud and Workers Compensation Insurance Fraud are substantially related to the duties, functions and qualifications of a Chiropractor.

The California Board of Chiropractic Examiners and other law enforcement agencies often conduct criminal investigations against Chiropractors for the types of violations described above. In serious criminal cases against Chiropractors pending in Criminal Court, the California Board of Chiropractic Examiners and the California Attorney General’s Office may seek a California Penal Code § 23 Order against the Chiropractor. A California Penal Code § 23 Order seeks to suspend a Chiropractor License in Criminal Court. Chiropractors facing criminal charges and Chiropractors who are convicted of criminal offenses need an experienced California Chiropractor License Defense Attorney for representation in disciplinary proceedings before the California Board of Chiropractic Examiners.