
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: FRIDAY, July 27, 1990                   TAG: 9007270355
SECTION: VIRGINIA                    PAGE: B2   EDITION: BEDFORD/FRANKLIN 
SOURCE: MONICA DAVEY STAFF WRITER
DATELINE: BEDFORD                                LENGTH: Medium

CLINIC CO-OWNER ADMITS SCHEME

The co-owner of a Bedford County chiropractic clinic pleaded guilty Thursday to conspiring to commit grand larceny, a charge that stemmed from an investigation of Medicaid and Medicare fraud at the clinic.

Deborah K. Heaton entered her plea as part of a plea agreement.

Two other charges against Heaton will be dropped and Heaton must cooperate with authorities in their continuing investigation into her estranged husband and another doctor, according to the plea agreement.

Circuit Judge William Sweeney gave Heaton a five-year suspended sentence and ordered her to serve 90 days in the Bedford County Jail.

She also was ordered to pay $15,475 restitution. That, her attorney told the judge, would involve selling just about everything she owns and starting over.

Authorities allege that officials at Chiropractic Center of Virginia in Forest set up a complex scheme to defraud Medicaid and Medicare since the center opened in 1981.

Holding up three hefty notebooks, Assistant Commonwealth's Attorney Philip Baker told the judge, "This is just the tip of the iceberg."

Boxes upon boxes of medical records made up the case that Baker said had befuddled more than one investigator over several years of study. "This is very much of a paper chase."

Baker said state and local authorities estimate the amount of money involved in the insurance scam at $200,000.

The chiropractic clinic was combined with a medical clinic - though the two listed separate mailing addresses, Baker explained. Clinic officials would employ a medical doctor to work there and "use him" to defraud Medicare and Medicaid, which strictly limit reimbursements for chiropractic work.

Baker outlined several methods that the Forest clinic allegedly used to defraud Medicaid and Medicare:

The clinic billed Medicaid or Medicare for services that were never performed. Records would list 18 treatments at the clinic, while a patient would only remember having six, he said.

The clinic billed for doctor's services when a medical doctor was not even on the premises or had gone on vacation.

The clinic billed Medicaid and Medicare for payments that had not been authorized.

But Deborah Heaton was not "running the show" when it came to fraud at the clinic, Baker told Sweeney.

Her husband, chiropractor Paul Heaton, and William Harris, a medical doctor, also have been charged in connection with the case. Paul Heaton had a hearing scheduled Monday.

by CNB