1791 Oregon DCs Exonerated on Billing Fraud Charges
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Dynamic Chiropractic – January 1, 1994, Vol. 12, Issue 01

Oregon DCs Exonerated on Billing Fraud Charges

By Editorial Staff
PORTLAND, Oregon -- Chiropractors Miles Anderson and Steve DeShaw were cleared of all civil liability for billing practices by the Oregon Court of Appeals on Nov. 17, 1993.

Attorney Daniel Gatti called the victory a "complete vindication"; his remarks were quoted on the front page of the Statesman Journal.

Background

Nine Oregon DCs were sued by the State Accident Insurance Fund Corp. (SAIF) in March of 1992 for racketeering and fraud, alleging a dual rate billing structure wherein the SAIF was charged more for workers' compensation services than comparable services to the general public. Six of the DCs chose to settle the lawsuit with terms proposed by the SAIF.

Drs. Anderson, DeShaw, and Larry Glubka chose to fight the litigation, and each underwent separate trials by jury in the Marion County Circuit Court. All three trials were presided over by Judge Robert McConville.

The SAIF sought revocation of the DCs' licenses, forfeiture of all business and personal property, and three times the amount of actual damages, punitive damages of $750,000, plus cost of investigation and attorneys' fees.

The Verdicts

In all three cases, Judge McConville ruled that the SAIF failed to present any evidence of a false representation or of an intent to defraud, refusing to allow those claims go to the jury. The jury in each case did find in favor of the SAIF under the claim for money had and received": $9,000 in Dr. Anderson's case; $7,415 in DeShaw's case; $134 in Glubka's case.

Appeals

The Anderson and DeShaw verdicts were immediately appealed, while the small claim in the Glubka case did not justify an appeal. The defendants claimed that the Department of Insurance (DIF) had sole jurisdiction of disputes between an insurer and medical providers in the workers' comp. system, i.e., that the SAIF had no right to bring the case to a jury.

SAIF cross-appealed, contending the claims for racketeering and fraud, that were dismissed in the circuit court trial, should have been decided by the jury.

In a unanimous opinion, the Court of Appeals held the DIF had exclusive jurisdiction over such workers' compensation claims, unless DIF was shown to be inadequate. The Court of Appeals rejected the SAIF's cross-appeal, saying the SAIF had no constitutional right to a jury trial, that civil penalties were the jurisdiction of the DIF.

The judgments against Drs. Anderson and DeShaw were reversed and the claim for money was dismissed.

The defendants' law firm stated that the DIF had already ruled that the billing practices of the chiropractors were legal and appropriate, and "did not constitute any wrongdoing on the part of these or any other doctors."

"There's never a vindication that allows you to build back the reputation I've built over 20 years in a small community," Dr. DeShaw was quoted as saying in the Satesman Journal.

Drs. DeShaw and Anderson have malicious prosecution lawsuits pending against the SAIF.

The attorneys for the chiropractors called the decision by the Court of Appeals a "victory for all chiropractors and their patients throughout Oregon..."

Editor's note: Arguing the case for the chiropractors in the Oregon Court of Appeals was Anthony Allen. With him on the opening brief was Gatti, Gatti, Maier & Associates; with him on the reply brief was Gatti, Gatti, Maier, Jackson & LeDoux.


Dynamic Chiropractic editorial staff members research, investigate and write articles for the publication on an ongoing basis. To contact the Editorial Department or submit an article of your own for consideration, email .


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