A Riverside chiropractor was charged by the Riverside County DA’s Office with 47 felony counts related to an insurance fraud and kickback scheme.
Curtis Wayne Montgomery, DOB: 6-1-58, of Riverside, has been charged with three counts of insurance fraud, 28 counts of receiving commission for referring clients, and 16 counts of money laundering.The charged crimes are alleged to have happened from 2011 through 2016.
Montgomery was arrested on May 11, 2018. He posted bail and was released from custody that same day. When he was released on bail, Montgomery was given a court date for arraignment of July 16, 2018.
In March of this year, Riverside County DA’s investigators learned that more than $300,000 in payments had been made from Montgomery to a company called Providence Scheduling, which was designed to field phone calls from injured workers and then funnel those people to doctors and chiropractors throughout California.
The two men who owned and operated Providence Scheduling, Carlos Arguello and Fermin Iglesias, have already entered guilty pleas to federal charges. Arguello and Iglesias required medical providers refer a certain number of patients to outside companies for medical equipment, imaging, and other treatments.
However, the two men owned these outside companies and therefore were able to bill insurance companies for services. If doctors and chiropractors failed to refer enough patients to these outside companies, the two men would stop or slow the number of patients they would refer to the medical providers which then could incentivize the providers financially to refer patients for unnecessary or ineffective treatments.
The case against Montgomery is the result of Operation Backlash, an extensive FBI-led undercover investigation that revealed a widespread workers’ compensation kickback scheme, including attorneys, doctors and medical providers who referred patients for health services in exchange for money. The Operation was first announced in November 2015 when the initial round of federal indictments was handed down.
San Diego chiropractor Steven J. Rigler and San Diego workers’ compensation attorney Sean O’Keefe previously pleaded guilty to federal charges.
Las year, the U.S. Attorney’s Office announced federal indictments against patient recruiters, Fermin Iglesias, Carlos Arguello, Miguel Morales and four corporations. The corporations are Providence Scheduling, Inc., Medex Solutions, Inc., Prime Holdings International, Inc. and Meridian Medical Resources, Inc., doing business as Meridian Rehab Care.
The three federal defendants were accused of recruiting individuals to file workers’ compensation claims resulting from an on-the-job injury. The defendants then directed these patients to specific chiropractors who, in exchange for dozens of new workers’ compensation patients each month, agreed to meet a quota set by the defendants for referrals of the new patients for ancillary goods and services such as MRIs and durable medical equipment from specific providers.
According to the indictment, Providence Scheduling oversaw the scheduling of applicants recruited by defendant Arguello and others, and their assignment to a primary treating physician, which included chiropractors. Defendants Iglesias and Arguello decided which physicians were eligible to receive applicants from defendant Providence Scheduling.
Prosecutors claim the purpose of the conspiracy was to fraudulently obtain money from insurers by submitting claims for ancillary procedures and DME that were secured through a pattern of bribes and kickbacks in the form of an illegal cross-referral scheme in exchange for the referral of patients to particular providers of ancillary procedures.
Near the end of March, 2017, Providence Scheduling entered into a Plea Agreement to plead guilty.