Allegheny County Chiropractor Arrested for Stealing $140,000 from Insurance Companies by Submitting Fraudulent Bills

HARRISBURG, Pa., Sept. 13 -- The Pennsylvania Attorney General's Office issued the following news release:

Agents from the Attorney General's Insurance Fraud section today arrested an Allegheny County chiropractor for allegedly bilking insurance companies out of more than $140,000 by submitting bills for services that were either not provided, not provided by licensed personnel or were not medically necessary.

Attorney General Tom Corbett said that Daniel DiCesaro, 40, 124 Spring Hill Drive, Oakdale, operated DiCesaro Spine and Sport in Moon Township, Allegheny County.

Corbett said that high school athletes allegedly began going to DiCesaro Spine and Sport to train, hoping to gain more speed or more strength.

"Many of the clients at DiCesaro Spine and Sport were allegedly there to receive athletic training, such as speed and agility training, high speed treadmill work and weight training," Corbett said. "Not treatment to correct medical problems."

According to the grand jury investigation, many of the clients rarely saw a chiropractor, but instead had training sessions conducted by personal trainers - yet insurance companies were billed for medical services.

According to the investigation, there were at least 37 student athletes whose insurance was improperly billed.

However, according to the grand jury, DiCesaro instructed that the billing forms submitted to insurance companies should be marked for an office visit, gait training, mechanical traction and therapeutic procedure.

Corbett explained that those procedures would be covered by insurance if used as rehab from an injury, but these services billed to the insurer would not have been paid had the insurer known services were not performed, were performed by unlicensed personnel or were not medically necessary.

According to the investigation, the insurers paid out more than $160,000 for improper billings from DiCesaro Spine and Sport from 2006 into 2008. More than $140,000 was paid for services billed as office visits, gait training, therapeutic procedure and mechanical traction.

"Insurance fraud is not a victimless crime. When people cheat the system, it leads to increased insurance premiums for everyone," Corbett said. "Almost every Pennsylvanian is feeling the burden of rising insurance costs, and our agents take these allegations very seriously."

Evidence and testimony regarding the case was presented to a statewide investigating grand jury, which recommended the criminal charges being filed today.

DiCesaro is charged with one count of insurance fraud and one count of theft by deception. Both charges are third-degree felonies and carry a maximum penalty of seven years in prison and a $15,000 fine each. He is also charged with one count of corrupt organizations, which is a first-degree felony carrying a maximum penalty of 20 years in prison and a $25,000 fine.

DiCesaro was preliminarily arraigned before Allegheny County Magisterial District Judge Mary P. Murray. The case will be prosecuted in Allegheny County by Senior Deputy Attorney General Dennis Kistler of the Attorney General's Insurance Fraud Section.

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