Stamford Man Sentenced to Probation, Community Service in Insurance Fraud Case

Prosecutors say the scheme involved the Stamford man's practice billing insurance companies for medical services that were never provided.

A chiropractor from Stamford was sentenced to probation for his role in an insurance fraud scheme.

U.S. District Judge Stefan R. Underhill handed down the sentence Tuesday in Bridgeport.  

George U. DeCarvalho, 57, of Stamford, was sentenced to three years of probation, during which he must perform 90 hours of community service, accoridng to the U.S. Attorney's office. The case stems from “Operation Running Man,” a 14-month undercover fraud investigation headed by the Federal Bureau of Investigation.  

A second chiropractor, Jennifer Lynne, 41, of Milford, also was sentenced to three years of probation, the first six months of which she must serve in home confinement with electronic monitoring. 
The investigation, which included the use of recordings by an undercover FBI special agent, revealed that Joseph P. Haddad, a Bridgeport-based personal injury attorney, conspired with chiropractorsand others to defraud several insurance companies by exaggerating the auto accident injuries of Haddad’s clients, and the cost of their medical care, to justify larger monetary settlements with the insurance companies. 

As part of the scheme, the co-conspirators fabricated medical records, prescribed unnecessary pain medication, performed unnecessary chiropractic treatment, ordered and billed for diagnostic tests of questionable medical value, and overstated injuries or permanent partial disabilities that were allegedly caused by the accidents.

Between December 2006 and February 2010, Haddad conspired in the scheme with Francisco R. Carbone, who had been licensed to practice medicine until his license was revoked by the State of Connecticut in March 2005, and with Dr. Marc Kirshner, who owned and operated two chiropractor offices in Bridgeport and one in Stamford.

As part of the scheme, Haddad paid “runners” to locate and deliver to him clients for his personal injury practice. Haddad then regularly instructed clients to see Carbone for purported medical treatment, even though Haddad was aware that Carbone had lost his medical license. Carbone provided Haddad’s clients with prescription pain medication, even if the medication was not needed and, in reports, fabricated the clients’ injuries, medical conditions and permanent partial disability ratings. In multiple instances, Carbone did no medical examination at all. Carbone billed the victim insurance carriers in his name or in the name of another physician for services he allegedly rendered, and provided prescriptions, bills, medical reports and final reports to Haddad, who submitted the documents to the victim carriers to support requests for settlement.

DeCarvalho is a licensed chiropractor who owns and operates a chiropractic practice in Bridgeport. DeCarvalho and Carbone shared office space in Bridgeport from approximately January 2004 to November 2005. Before Carbone’s medical license was revoked, DeCarvalho and Carbone provided chiropractic and medical treatment on a number of common patients who were involved in auto-accident litigation. 

After March 2005, DeCarvalho continued to treat certain patients knowing that payments for his services were coming from insurance settlements based, in part, on the purported treatment provided by Carbone.

In addition, in May 2007, DeCarvalho was involved in an auto accident in which the other driver was liable.  DeCarvalho contacted Carbone to fabricate medical records to show that DeCarvalho had suffered certain injuries and had received medical treatment for those injuries allegedly sustained from the accident.  DeCarvalho indicated that Carbone could bill carriers for treatment under DeCarvalho's automobile MedPay insurance. 

In October 2007, Carbone fabricated the medical records and submitted claims to MedPay for reimbursement totaling approximately $6,000. Relying on the false medical bills, DeCarvalho subsequently settled the accident claim for an additional $4,500. On June 29, 2012, DeCarvalho pleaded guilty to one count of conspiracy to commit health care fraud. 

This matter has been investigated by the Federal Bureau of Investigation, with the assistance of the National Insurance Crime Bureau, the Metropolitan Property and Casualty Insurance’s Special Investigation Unit and the Travelers Insurance Company.The case is being prosecuted by Assistant U.S. Attorneys Christopher W. Schmeisser and David J. Sheldon.


More »
Got a question? Something on your mind? Talk to your community, directly.
Note Article
Just a short thought to get the word out quickly about anything in your neighborhood.
Share something with your neighbors.What's on your mind?What's on your mind?Make an announcement, speak your mind, or sell somethingPost something
See more »