State Crime Reports

Former Suburban Chiropractor and His Wife Sentenced to Federal Prison for $1 Million Health Insurance Fraud Scheme

CHICAGO—(ENEWSPF)—September 3, 2014. A former suburban chiropractor and his wife, who was a fitness instructor and personal trainer, were sentenced to federal prison terms for engaging in a $1 million health insurance fraud scheme that continued for a year after they were indicted in 2011. WENDY CARR, 43, was sentenced today to 28 months in prison, a week after her husband, ANDREW CARR, 45, both of Lake in the Hills, was sentenced to eight years in prison.

Andrew Carr worked as a chiropractor at Premier Health in Palatine, Community Physical Medicine and Rehabilitation in Mundelein, Allied Health in Mundelein, Edgewater Rehabilitation and Wellness Center in Lake in the Hills, and Fusion Health and Fitness in Lakemoor.

“They pretended to be the victim patients’ friends, convinced the victim patients to take their fitness classes, and convinced the victim patients to get treatment from [Andrew Carr] when the classes caused physical pain or injury,” Assistant U.S. Attorney Shoba Pillay argued at sentencing.

Between 2005 and June 2011, Andrew Carr submitted health insurance claim forms for at least 376 patients to six different private health care insurers, knowing that more than $4.2 million worth of claims were for services that were not provided, and as a result, he fraudulently obtained payments totaling approximately $865,697.

Between January 2009, when Wendy Carr joined the scheme, and June 2011, she processed the insurance claims, knowing that nearly $1.6 million worth of claims were for services that were not provided, and, as a result, the couple fraudulently obtained payments during that time totaling approximately $328,964.

After the couple were indicted in June 2011, they submitted an additional 596 fraudulent claims totaling more than $475,000 for 51 additional patients over another year and, as a result, fraudulently obtained an additional $164,168. Each pleaded guilty to health care fraud earlier this year.

Andrew Carr was ordered to pay restitution totaling $1,029,865, and Wendy Carr was ordered to pay $493,132 in restitution by U.S. District Judge Robert M. Dow, Jr., who imposed the sentences in Federal Court. The restitution was ordered to be paid to the victim insurance companies ― Aetna, Inc., Allied Insurance, Blue Cross Blue Shield of Illinois, CIGNA, Professional Benefit Administrators, Inc., and United Healthcare, some of which provided coverage through union health and welfare funds they administered in the Chicago area.

Andrew Carr, who was sentenced on Aug. 25, has been in federal custody for approximately two years. Wendy Carr, was sentenced today and was ordered to begin serving her 28-month sentence on June 25, 2015, to be followed by six months of home detention.

The sentences were announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois, and Robert J. Holley, Special Agent-in-Charge of the Chicago Office of the Federal Bureau of investigation; James Vanderberg, Special Agent-in-Charge of the U.S. Department of Labor Office of Inspector General in Chicago; and Donna J. Seermon, Acting Regional Director in Chicago of the U.S. Department of Labor’s Employee Benefits Security Administration.