A chiropractor from New Hyde Park has been charged in a fraudulent health care scheme, according to the U.S. Justice Department.
Melissa Panayiota Kanes, a 50-year-old Manhattan-based chiropractor, allegedly used the identities of three different chiropractors to submit more than $800,000 in fraudulent health care claims between 2014 and 2016, according to a news release from the U.S. attorney’s office for the Southern District of New York.
“As alleged, Melissa Kanes filed numerous fraudulent health insurance claims for her chiropractic services,” Audrey Strauss, the U.S. attorney, said. “Indeed, as further alleged, Kanes filed so many claims that an insurer flagged her for suspicious billing, at which point she tried to circumvent scrutiny by filing claims in the names of other chiropractors without their knowledge. Now Melissa Kanes is in custody and facing federal charges.”
Kanes, who was arrested on March 16, allegedly submitted “a high volume of insurance claims” to an unidentified insurance company. In 2016, that company flagged Kanes for improper billing and slowed or ceased payments to her, according to the news release.
Kanes then reportedly continued to submit claims to the insurance company, but did so under the names and identification numbers of two newly incorporated companies, whose names were not disclosed.
Kanes was charged with one count of health care fraud, which could result in a sentence of up to 10 years in prison upon conviction, and one count of money laundering, which could result in up to 20 years in prison, according to the news release. Kanes also is charged with a count of aggravated identity theft, which carries a mandatory consecutive term of two years in prison.
“This type of activity is detrimental to workers, employers and the entire healthcare system,” Thomas Licetti, regional director for the Department of Labor Employee Benefits Security Administration, said. “EBSA is proud to partner with our fellow federal agencies in protecting hard-earned employee benefits.”
“The crimes with which [Kanes] is charged today are serious ones, which carry the possibility of a lengthy prison sentence,” FBI Assistant Director William F. Sweeney Jr. said. “This case should serve as a warning to others unwilling to make adjustments to their illegal behavior – the federal criminal justice system could be just what the doctor ordered.”
“The offenses charged in this case are particularly troubling because once the fraudulent activities were detected, the defendant allegedly continued the activities using additional concealment methods,” Jonathan D. Larsen, an IRS special agent in charge of the state’s field office, said.
Efforts to reach Kanes’ lawyer were unavailing, as were efforts to reach a representative from the Justice Department for further comment.
