Sep 30, 2010 9:48 PM by Alison Haynes
LAFAYETTE, La. - A licensed chiropractor and former owner of Scott Oaks Chiropractic
Clinic located in Scott, La., was sentenced today to three years in prison, for submitting fraudulent
claims to health insurers for services that were never performed, United States Attorney Stephanie A.
Finley announced. Richard Montalbano, 64, of Lafayette, La., was also sentenced to three years
supervised release, and was ordered to pay a fine of $115,228.24. The sentence was imposed by
United States District Judge Rebecca F. Doherty.
Evidence revealed that Dr. Montalbano submitted fraudulent claims to Blue Cross Blue Shield
of Louisiana (BCBSLA) for healthcare services that patients never received. The defendant was
required to use certain billing codes provided by the American Medical Association on the health
insurance claim forms, and the defendant was aware of which code was associated with a specific type
of treatment. Dr. Montalbano was also aware of the different rates of pay for different codes. Dr.
Montalbano was the sole chiropractor and owner of Scott Oaks Chiropractic Clinic at the time of the
charged conduct. The investigation revealed that over a two-year period, Montalbano submitted false
claims causing thousands of dollars in overpayment by BCBSLA. The defendant has agreed to forfeit
his license and agreed to pay restitution to BCBSLA in the amount of $22,051.24. Additionally, Dr.
Montalbano was ordered to pay a fine of $115,228.24, which includes the cost of his incarceration and
United States Attorney Finley stated: "Dr. Montalbano was a healthcare provider who cheated
Blue Cross Blue Shield out of thousands of dollars. He sought to enrich himself at the expense of
patients who pay Blue Cross premiums. The U. S. Attorney's office will continue to investigate and
prosecute this kind of fraud which contributes to the escalating healthcare costs of all citizens."
Vice President of Communications, Blue Cross and Blue Shield of Louisiana, John Maginnis
stated: "This is another great example of how private payers like Blue Cross and Blue Shield of
Louisiana and the government can work together to fight healthcare fraud. Blue Cross works hard
every day to detect and deter healthcare fraud, and this case typifies the results that can be achieved
when private and public agencies work together. Fraud like this hurts the healthcare system for all of
us, this is why Blue Cross works hard to fight back for its customers. We appreciate all the efforts of
the United States Attorney's office, federal court system and the FBI.
This case was investigated by the Federal Bureau of Investigation, Blue Cross Blue Shield of
Louisiana and was prosecuted by Assistant United States Attorney Myers P. Namie.
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