Chiro “Mistakes” Medical Treatment for Gym Memberships

Attorney General Tom Corbett announced the arrest of Daniel Dicesaro, operator of DiCesaro Spine and Sport, located in Moon Township—Allegheny County, Pennsylvania for allegedly bilking insurance companies by submitting bills for services that were either not provided, not provided by licensed personnel or were not medically necessary.

According to a press release provided by the Pennsylvania Attorney General, 40-year-old Daniel Dicesaro of 124 Spring Hill Drive, Oakdale, PA is accused of offering sports training services and then coding them as “rehab” to validate the services as medical treatment acceptable to insurance companies.

“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.”

Apparently, DiCesaro’s idea of “rehab” included such things as speed and agility training, high speed treadmill work and weight training which were conducted by unlicensed personal trainers and then billed as medical services.

The investigation uncovered that between 2006 and 2008 insurers paid more that $160,000 for improper billings. Evidence and testimony was presented before a Grand Jury and DiCesaro was charged with one count of Insurance Fraud, one count of Theft by Deception, and one count third-degree felony count of Corrupt Organizations, which carries a maximum penalty of 25 years behind bars and a $25,000 fine.