Grand jury indicts two Jefferson County Chiropractors and eight others for fraud scheme

From the U.S. Attorney’s Office, Eastern District of Missouri:

ST. LOUIS, MO – Dr. Thomas Hobbs and Dr. Vivian Carbone-Hobbs of Jefferson County were indicted with two members of their office staff, a former union representative of Anheuser-Busch In Bev, and five patients with conspiring to fraudulently obtain disability benefits from the Social Security Administration and disability insurance payments from providers of long-term and short-term disability insurance. The indictment charges Dr. Hobbs, Dr. Carbone-Hobbs, Clarissa Pogue, Christina Barrera, James Ralston, Elizabeth Guetersloh, Glenda Johnson, Sheila Huffman, Shannon Nenninger, and Gary Walesky with various violations including: conspiracy to defraud; health care fraud; and, theft of government funds. 

According to the indictment, the defendants exaggerated the patients’ medical conditions and ability to care for themselves in order to qualify for the government disability benefits and the private insurance disability payments. The chiropractors also required their patients to undergo excessive medical treatments and diagnostic evaluations beyond what was medically necessary to pad their medical records. Beginning as early as 2011, AB In-Bev employees sought the chiropractors’ assistance because it permitted them to fraudulently obtain Social Security disability insurance benefit payments, a long-term disability insurance payment of $100,000.00 from Prudential Insurance Companies, and long-term and short-term disability benefits through Met-Life. In exchange, his patients paid him as much as $3,000.00 for each of the types of disability payments they were seeking in addition to insurance payments he collected from Blue Cross Blue Shield and United Health Care and payment for unreimbursed services from the patients.

The losses resulting from the false and fraudulent statements to the Social Security Administration and the private insurance disability providers exceeded $12,000,000.

Conspiracy to defraud carries a maximum penalty of five years imprisonment for each count and a fine of $250,000 or both.  The health care fraud violations and the theft of government fund violations carry a maximum penalty of 10 years imprisonment for each count and a fine of $250,000 or both. Restitution to the victims is also mandatory.

In a separate indictment, the federal grand jury also charged Dr. Thomas Hobbs with being a convicted felon in possession of a firearm. That violation carries a maximum penalty of 10 years imprisonment and a fine of $250,000 or both.

Charges set forth in the indictment are merely accusations and do not constitute proof of guilt.  Every defendant is presumed to be innocent unless and until proven guilty. 

The cases were investigated by the Social Security Administration – Office of Inspector General and the Federal Bureau of Investigation.  Dorothy McMurtry and Tracy Berry are handling the cases for the U.S. Attorney’s Office.

Because the Social Security Administration provides benefits through the Disability Insurance Benefit Program to more than 8.4 million individuals a year at a monthly rate of more than $10.4 million, the Social Security Administration accepts reports of those suspected of committing fraud against the program through the Social Security Administration (SSA) Office of Inspector General Hotline at: 1-800-269-0271 or http://oig.ssa.gov/report-fraud-waste-or-abuse/fraud-waste-and-abuse.

ST. LOUIS, MO – Dr. Thomas Hobbs and Dr. Vivian Carbone-Hobbs of Jefferson County were indicted with two members of their office staff, a former union representative of Anheuser-Busch In Bev, and five patients with conspiring to fraudulently obtain disability benefits from the Social Security Administration and disability insurance payments from providers of long-term and short-term disability insurance. The indictment charges Dr. Hobbs, Dr. Carbone-Hobbs, Clarissa Pogue, Christina Barrera, James Ralston, Elizabeth Guetersloh, Glenda Johnson, Sheila Huffman, Shannon Nenninger, and Gary Walesky with various violations including: conspiracy to defraud; health care fraud; and, theft of government funds. 

According to the indictment, the defendants exaggerated the patients’ medical conditions and ability to care for themselves in order to qualify for the government disability benefits and the private insurance disability payments. The chiropractors also required their patients to undergo excessive medical treatments and diagnostic evaluations beyond what was medically necessary to pad their medical records. Beginning as early as 2011, AB In-Bev employees sought the chiropractors’ assistance because it permitted them to fraudulently obtain Social Security disability insurance benefit payments, a long-term disability insurance payment of $100,000.00 from Prudential Insurance Companies, and long-term and short-term disability benefits through Met-Life. In exchange, his patients paid him as much as $3,000.00 for each of the types of disability payments they were seeking in addition to insurance payments he collected from Blue Cross Blue Shield and United Health Care and payment for unreimbursed services from the patients.

The losses resulting from the false and fraudulent statements to the Social Security Administration and the private insurance disability providers exceeded $12,000,000.

Conspiracy to defraud carries a maximum penalty of five years imprisonment for each count and a fine of $250,000 or both.  The health care fraud violations and the theft of government fund violations carry a maximum penalty of 10 years imprisonment for each count and a fine of $250,000 or both. Restitution to the victims is also mandatory.

In a separate indictment, the federal grand jury also charged Dr. Thomas Hobbs with being a convicted felon in possession of a firearm. That violation carries a maximum penalty of 10 years imprisonment and a fine of $250,000 or both.

Charges set forth in the indictment are merely accusations and do not constitute proof of guilt.  Every defendant is presumed to be innocent unless and until proven guilty. 

The cases were investigated by the Social Security Administration – Office of Inspector General and the Federal Bureau of Investigation.  Dorothy McMurtry and Tracy Berry are handling the cases for the U.S. Attorney’s Office.

Because the Social Security Administration provides benefits through the Disability Insurance Benefit Program to more than 8.4 million individuals a year at a monthly rate of more than $10.4 million, the Social Security Administration accepts reports of those suspected of committing fraud against the program through the Social Security Administration (SSA) Office of Inspector General Hotline at: 1-800-269-0271 or http://oig.ssa.gov/report-fraud-waste-or-abuse/fraud-waste-and-abuse.