STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, vs. CASE NO, 2008-27285 LAWRENCE ERIC SCHECHTMAN, D.C., RESPONDENT, ne ADMINISTRATIVE COMPLAINT COMES NOW Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Chiropractic Medicine against Respondent, Lawrence Eric Schechtman, D.C., and in support thereof Petitioner alleges: 1. Petitioner is the state department Charged with regulating the Practice of Chiropractic Medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 460, Florida Statutes, 2. At all times material to this Complaint, Respondent was licensed to Practice chiropractic medicine in the State of Florida, having been issued license number CH 8037 on or about July 20, 2000. 3. Respondent's address of record is 11915 N.w. 7g" Place, Parkland, i JAPSU\Allied Health\Van winkle\Chiro\AC's‘Schechtman, Lawrence 2008-27285 (CE) failure to supervise CCPA, 456- ££,460 i, ff£m,x.doc ini i ings d February 21, 2012 2:24 PM Division of Administrative Hearing: File ir , Florida, 33076. 4. On or about March, 2005, Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valie-Cespedes, C.C.P.A., applied to the Board of Chiropractic Medicine to be supervised as a C.C.P.A. by Respondent. 2. On or about March 24, 2005, Respondent signed the Application Affidavit for Rodolfo Valle, C.C. P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A, to supervise him as a C.C.P.A. 6. Respondent was a supervising chiropractic physician of record for Rodolfo Valle, C.CP.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., from at least July 8, 2005, through September 6, 2005, and at all other relevant times before and thereafter, 7. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Respondent was employed as the Medical Director of Community Medical Group, Inc., as defined in Section 400.9905, Florida Statutes (2005), who's principle address was 4765 West gi Avenue, Suite 300A, Hialeah, Florida, 33012. 8. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Community Medical Group, Inc., was a health Care Clinic as defined in Section 400.9905, Florida Statutes (2005). 2 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 @(ED failure to supervise CCPA, 456- ££,460 i, ff,m,x.doc 9. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valie- Cespedes, C.C.P.A., was employed as a C.C.P.A. at Community Medical Group, inc. 10. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Enrique Puga, L.M.T +» Was employed as a message therapist at Community Medical Group, Inc. 11. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Mario L. Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., was employed as an L.M.T. at Community Medical Group, Inc. 12. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle- Cespedes, C.C.P.A., was under the direct and/or indirect supervision of the Respondent as the medical director of Community Medical Group, Inc. 13. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Enrique Puga, L.M.T., was under the direct and/or indirect supervision of the Respondent as the medical director of Community Medical Group, Inc. 3 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 G)(£D failure to supervise CCPA, 456- £8,460 i, f&m,x.doc 14. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Mario L. Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., was under the direct and/or indirect supervision of the Respondent as the medical director of Community Medical Group, Inc. 15. On or about June 2, 2005, H.C., owned and operated a 1996 Acura, on Lake Patricia Drive in Miami-Dade County, Miami Lakes, Florida, in which C.R. and O.Y. were passengers, when H.C. intentionally struck a tree. 16. On or about June 3, 2005, H.C., C.R., and O.Y. all presented to Community Medical Group, Inc., 4765 West 8th Avenue, Suite 300A, Hialeah, Florida, 33012, for medical care and/or treatment but were not injured. 17, At some time after June 3, 2005, Respondent, and/or other Community Medical Group, Inc. personnel, under Respondent's direct or indirect supervision, had patient H.C. sign multiple copies of blank treatment notes/ Papers at the Community Medical Group, Inc., and billed H.C’s insurance carrier, GEICO, $15,930.00. 18. At some time after June 3, 2005, Respondent, and/or other Community Medical Group, Inc. personnel, under Respondent's direct or indirect supervision, had patient C.R. sign multiple copies of blank treatment notes/ 4 . F\PSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (i)(fF) failure to supervise CCPA, 456- ££,460 i, f£m,x.doc Papers at the Community Medical Group, Inc., and billed H.C’s insurance carrier, GEICO, $7,975.00. 19. At some time after June 3, 2005, Respondent, and/or other Community Medical Group, Inc. personnel, under Respondent's direct or indirect supervision, had patient O.Y, sign multiple copies of blank treatment notes/ Papers at the Community Medical Group, Inc., and billed H.C’s insurance carrier, GEICO, $3,010.00 20. Patient H.C. did not receive any medical care or treatment from Respondent, and/or other Community Medical Group, Inc. personnel, under Respondent's direct or indirect supervision at the Community Medical Group, Inc. 21. Patient CR. only received medical care and/or treatment from Respondent, and/or other Community Medical Group, Inc. personnel, under Respondent's direct or indirect Supervision at the Community Medical Group, Inc., on less than five (5) occasions. 22. Patient O.Y. only received medical care and/or treatment from Respondent, and/or other Community Medical Group, Inc. personnel, under Respondent’s direct or indirect supervision at the Community Medical Group, Inc., on less than ten (10) occasions. 5 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (i)(ff) failure to supervise CCPA, 456- f£,460 i, ffim,x.doc 23. Between July 8, 2005, and September 6, 2005, Community Medical Group, Inc., created and submitted false medical records and false Health Insurance Claims Forms, CMS-1500, to GEICO Insurance Company, signed by Respondent for patient H.C, C.R., and/or OY. indicating that treatment was provided to patients H.C., C.R., and/or O.Y. when it in fact it was not. 24. Between July 8, 2005, and September 6, 2005, Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., created and submitted false medical records and false Health Insurance Claims Forms, CMS-1500, to GEICO Insurance Company, signed by Respondent for patient H.C., C.R., and/or O.Y. indicating that treatment was provided to patients H.C., C.R., and/or O.Y. when it in fact it was not. 25. Between July 8, 2005, and September 6, 2005,and at all other relevant times, Enrique Puga, L.M.T., created and submitted false medical records and false Health Insurance Claims Forms, CMS-1500, to GEICO Insurance Company, signed by Respondent for patient H.C., C.R., and/or O.Y. indicating that treatment was provided to patients H.C., C.R., and/or O.Y. when it in fact it was not. 26. Between July 8, 2005, and September 6, 2005, Mario L. Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., created and submitted false medical records 6 JAPSU\Allied Health\Van winkle\Chiro\AC’s\Schechtman, Lawrence 2008-27285 (i)(ff) failure to supervise CCPA, 456- £8,460 i, ffm,x.doc and false Health Insurance Claims Forms, CMS-1500, to GEICO Insurance Company, signed by Respondent for patient H.C., C.R., and/or O.Y. indicating that treatment was provided to patients H.C., C.R., and/or O0.Y. when in fact it was not. 27. Between July 8, 2005, and September 6, 2005, Respondent caused to be submitted multiple false medical records and false Health Insurance Claims Forms, CMS-1500, to GEICO Insurance Company, signed by Respondent for patient H.C., C.R., and/or 0.Y. indicating that treatment was Provided to patients H.C., C.R., and/or 0.Y. when in fact it Was not, 28. Between July 8, 2005, and September 6, 2005, and at all relevant times Respondent failed to serve as Community Medical Group, Inc.'s records Owner as defined in s. 456.057. 29. Between July 8, 2005, and September 6, 2005, and at all relevant times Respondent failed to ensure Community Medical Group, Inc.'s compliance with the recordkeeping, office Surgery, and adverse incident reporting requirements of chapter 456, the respective practice acts, and rules adopted under this part. 30. Between July 8, 2005, and September 6, 2005, and at all relevant times Respondent failed conduct a systematic review of all clinic billings to 7 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (Cf failure to supervise CCPA, 456- f£460 i, f£m,x.doc ensure that the billings are not fraudulent or unlawful; and upon discovery of any unlawful charge, failed to take immediate corrective action. 31. On or about December 15, 2006, the Department of Financial Services, Division of Insurance Fraud, received information indicating that Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., was involved in a conspiracy with Community Medical Group, Inc., to submit fraudulent insurance claims for patients H.C, CR. and/or 0.Y. involved in staged accidents. Specifically, it was discovered that Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valie- Cespedes, C.C.P.A., created false medical records indicating that treatment was provided to patients H.C., C.R., and/or O.Y. when in fact it was not. 32. On or about December 15, 2006, the Department of Financial Services, Division of Insurance Fraud, received information indicating that Enrique Puga, L.M.T., was involved in a conspiracy to submit fraudulent insurance claims for patients involved in staged accidents, Specifically, it was discovered that Enrique Puga, L.M.T., created false medical records indicating that treatment was provided to patients H.C., C.R., and/or O.Y. when in fact it was not. 33. On or about December 15, 2006, the Department of Financial Services, Division of Insurance Fraud, received information indicating that Mario 8 JAPSU\Allied Heaith\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (i)(ff) failure to supervise CCPA, 456- ££,460 i, f&m,x.doc L. Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., was involved in a conspiracy to submit fraudulent insurance claims for patients involved in staged accidents, Specifically, it was discovered that Mario L. Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., created false medical records indicating that treatment was Provided to patients H.C., C.R., and/or O0.Y. when it in fact it was not. 34. Based on the above-described actions, the State Attorney for the Eleventh Judicial Circuit in and for Miami-Dade County, Florida, criminally charged Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., on or about February 26, 2007. Specifically, the information filed against Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., charged him with, among other things, Committing three (3) counts of grand theft as follows: Count 4: . . . [Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A.] on or between June 3, 2005, and September 6, 2005, in the County and State aforesaid, did knowingly, unlawfully and feloniously obtain or use or did endeavor to obtain or use U.S. coin or Currency, valued at twenty thousand dollars ($20,000.00) or more but less than one hundred thousand dollars ($100,000.00), the Property of CHIRSTY POWELL and/or GEICO INSURANCE COMPANY, as the owner or custodian, with the intent to temporarily or permanently deprive GEICO INSURANCE COMPANY of a right to the property or the benefit there from or to appropriate the Property to said defendant's own use or to the use of a person not entitled thereof, in violation of s. 812.014(1) & (2)(b) and s. 777.011, Fla. Stat., contrary to the form of the Statute in such cases made and provided, and against the Peace and dignity of the State of Florida. 9 JAPSU\Allied Health\Van winkle\Chiro\AC’s\Schechtman, Lawrence 2008-27285 GCE failure to supervise CCPA, 456- £6,460 i, ffm,x.doc Count 5:. . . [Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A.] on or between June 3, 2005 and September 06, 2005, in the County and State aforesaid, did knowingly, unlawfully and feloniously obtain or use or did endeavor to obtain or use U.S. coin or Currency, valued at twenty thousand dollars ($20,000.00) or more but less than one hundred thousand dollars ($100,000.00), the property of CHIRSTY POWELL and/or GEICO INSURANCE COMPANY, as the owner or custodian, with the intent to temporarily or permanently deprive GEICO INSURANCE COMPANY of a right to the property or the benefit there from or to appropriate the property to said defendant’s own use or to the use of a person not entitled thereof, in violation of s, 812.014(1) & (2)(b) and s. 777.011, Fla. Stat., contrary to the form of the Statute in such cases made and provided, and against the peace and dignity of the State of Florida. Count 6:. . . [Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A.] on or between June 3, 2005 and September 06, 2005, in the County and State aforesaid, did knowingly, unlawfully and feloniously obtain or use or did endeavor to obtain or use U.S. coin or Currency, valued at twenty thousand dollars ($20,000.00) or more but less than one hundred thousand dollars ($100,000.00), the property of CHIRSTY POWELL and/or GEICO INSURANCE COMPANY, as the owner or custodian, with the intent to temporarily or permanently deprive GEICO INSURANCE COMPANY of a right to the Property or the benefit there from or to appropriate the property to said defendant’s own use or to the use of a person not entitled thereof, in violation of s, 812.014(1) & (2)(b) and s. 777.011, Fla. Stat., contrary to the form of the Statute in such cases made and provided, and against the peace and dignity of the State of Florida. 35. On or before June 5, 2007, Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., entered a plea of guilty to the above- mention charges. 10 JAPSU Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (OE) failure to supervise CCPA, 456- f£,460 i, ffm,x.doc 36. On or about June 5, 2007, the Court found Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., guilty of the above-mentioned three (3) Counts of grand theft but withheld adjudication. 37. The crimes to which Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle- Cespedes, C.C.P.A., was found guilty are all felonies, 38. The crimes for which Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle- Cespedes, C.C.P.A., was found guilty are crimes that directly relate to the practice of chiropractic medicine or the ability to practice chiropractic medicine. 39. Based on the above-described actions, the State Attorney for the Eleventh Judicial Circuit in and for Miami-Dade County, Florida, criminally charged Mario L. Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., on or about February 26, 2007. Specifically, the information filed against Mario L Horta L.M.T., a/k/a Mario L. Horta Vento, L.M.T., charged him with, among other things, insurance fraud under Section 817.234, Florida Statutes (2005), and grand theft under Section 812.014, Florida Statutes (2005), 40. Based on the above-described actions, the State Attorney for the Eleventh Judicial Circuit in and for Miami-Dade County, Florida, criminally charged Enrique Puga, L.M.T., on or about February 26, 2007. Specifically, the information filed against Enrique Puga, L.M.T.,charged him with, among other li JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (i)(ff) failure to supervise CCPA, 456- ££,460 i, f£m,x.doc things, insurance fraud under Section 817.234, Florida Statutes (2005), and grand theft under Section 812.014, Florida Statutes (2005). COUNT I -VIOLATION OF HEALTH CARE CLINIC REQUIREMENTS 41. Petitioner re-asserts and re-alleges paragraphs one (1) through forty (40) as if set forth fully at length herein. 42. Section 460.413(1)(ff), Florida Statutes (2005), provides that violating any provision of Chapter 460 or Chapter 456, or any rules adopted pursuant thereto, constitutes grounds for discipline by the Board of Chiropractic Medicine. 43. Section 460.413(1)(i), Florida Statutes (2005), provides that failing to perform any statutory or legal obligation placed upon a licensed chiropractic physician constitutes grounds for discipline by the Board of Chiropractic Medicine. 44. Section 400.9935(1), Florida Statutes (2005), requires that, among other things, the medical director of a clinic defined under Section 400.9905, Florida Statutes (2005), accept, in writing, legal responsibility for the following: (e) Serve as the clinic records owner as defined in s. 456.057; (f) Ensure compliance with the recordkeeping, office surgery, and adverse incident reporting requirements of chapter 456, the respective practice acts, and rules adopted under this part; and 12 JAPSU\Allied Health\Van winkle\Chiro\A C's\Schechtman, Lawrence 2008-27285 (i)(ff) failure to supervise CCPA, 456- #f,460 i, f£m,x.doc (g) Conduct systematic reviews of Clinic billings to ensure that the billings are not fraudulent or unlawful. Upon discovery of an unlawful charge, the medical director or clinic director shail take immediate corrective action. .. 45. On or about July 8, 2005, through September 6, 2005, and at all relevant times before and after, Respondent, while employed as the medical director of Community Medical Group, Inc., was required under Section 400.9935(1), Florida Statutes (2005), to among other things: (e) Serve as the clinic records owner as defined in s. 456.057; (f) Ensure compliance with the recordkeeping, office surgery, and adverse incident reporting requirements of chapter 456, the respective practice acts, and rules adopted under this part; and (g) Conduct systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful. Upon discovery of an unlawful charge, the medical director or clinic director shall take immediate corrective action. . . 46. Based on the foregoing, Respondent has violated Section 460.413(1)(ff), and Section 460.413(1)(i), Florida Statutes (2005), by failing to comply with the requirements of Section 400.9935(1), Florida Statutes (2005), by, among other things, failing to: (1) Serve as the clinic records owner as defined in s. 456.057; (2) Ensure compliance with the recordkeeping, office surgery, and adverse incident reporting requirements of chapter 456, the respective practice acts, and rules adopted under this Part; and/or 13 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (DUD failure to supervise CCPA, 456- £8,460 i, ff.m.x.doc (3) Conduct systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful. Upon discovery of an unlawful charge, the medical director or clinic director shall take immediate corrective action. . . COUNT II — FAILURE TO SUPERVISE C.C.P.A, 47. Petitioner re-asserts and re-alleges paragraphs one (1) through forty (40), and forty-two (42) through forty-six (46), as if set forth fully at length herein. 48. Section 460.413(1)(ff), Florida Statutes (2005), provides that Violating any provision of Chapter 460 or Chapter 456, or any rules adopted pursuant thereto, constitutes grounds for discipline by the Board of Chiropractic Medicine. 49. Section 460.413(1)(i), Florida Statutes (2005), provides that failing to perform any statutory or legal obligation placed upon a licensed chiropractic physician constitutes grounds for discipline by the Board of Chiropractic Medicine. 50. Section 460.403(3), Florida Statutes (2005), in pertinent part, provides: The “Certified chiropractic physician's assistant”, is a person who is a graduate of an approved Program or its equivalent and is approved by the department to perform chiropractic services under the indirect supervision of a chiropractic physician or group of physicians certified by the board to Supervise such assistant. An approved chiropractic i4 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (i)(A) failure to supervise CCPA, 456- f£,460 i, ff,m,x.doc physician or group of physicians May indirectly supervise more than one certified chiropractic physician’s assistant. 51. Section 460.403(7), Florida Statutes (2005), in pertinent part, provides that: assistant or a chiropractic student enrolied in a community-based shall require the physical presence of the licensed chiropractic physician for consultation and direction of the actions of the registered chiropractic assistant or a chiropractic student enrolled in a Community-based intern program. 52. Section 460.403(8), Florida Statutes (2005), provides that “Indirect supervision” requires the following: - . .[R]esponsible supervision and control, with the licensed chiropractic physician assuming legal liability for the services 53. Section 460.403(11), Florida Statutes (2005), provides that each chiropractic physician or group of chiropractic physicians utilizing certified chiropractic physician's assistants shall be liable for any act or omission of any physician’s assistant acting under his, her or its Supervision and control. 54. Section 460.4165(2), Florida Statutes (2005), provides: 1s JAPSU\A lied Health\Van winkle\Chiro\AC's\Schechtman. Lawrence 2008-27285 () failure to supervise CCPA, 456- ££,460 i, ffm,x.doc PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S ASSISTANT.—Notwithstanding any other provision of law, a certified chiropractic physician's assistant may perform Chiropractic services in the specialty area or areas for which the certified chiropractic physician's assistant is trained or experienced when such services are rendered under the supervision of a licensed chiropractic physician or group of chiropractic physicians certified by the board. Any certified chiropractic physician's assistant certified under this section to perform services may perform those services only: (a) In the office of the chiropractic physician to whom the certified chiropractic physicians assistant has been assigned, in which office such physician maintains her or his primary practice; (b) Under indirect supervision if the indirect supervision occurs at the address of record or place of practice required by S. 456.035, other than at a clinic licensed under part X of chapter 400, of the chiropractic physician to whom she or he is assigned as defined by rule of the board; 55. Florida Administrative Code Rule 64B2-20.001(4), in pertinent part, provided that a, “supervising physician,” is: -any licensed chiropractic physician or group of physicians who is approved and certified by the Board to provide supervision for the certified Chiropractic physician’s assistant and/or registered chiropractic assistant, and who assumes legal liability for the services rendered by such assistants. An approved chiropractic physician or group of physicians may Supervise more than one certified chiropractic physician's assistant at a ratio no greater than 2 certified chiropractic physician's assistants to one chiropractic physician. 16 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (Cf) failure to supervise CCPA, 456- ££,460 i, ff.m,.x.doc 56. Florida Administrative Code Rule 64B2-20.001(7), provided that, “responsible supervision”, means the following: in pertinent part, supervising physician, (g) the necessity for immediate attention, and (h) the number of other persons that the 57. Florida Administrative Code Rule 64B2-20.001(9), Provided that, “Indirect supervision” means the following; in pertinent part, - fesponsible supervision and control by the supervising Physician only in a Practice that is exempt from licensure under Part x, Chapter 400, F.S., and wholly owned by one or more chiropractic physicians or by a chiropractic physician and the spouse, parent, child, or sibling of that chiropractic physician. Indirect Supervision shall require the “easy availability” or physical presence of the licensed chiropractic physician for consultation and direction of the actions of the certified chiropractic physician’s assistant. “Easy availability” means the supervising physician must be in a location to enable him to be physically present with the certified chiropractic physician’s assistant within at least thirty minutes and must be available to the certified chiropractic physician’s assistant when needed for consultation and advice either in person or by communication devices, such 17 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (CfA) failure to supervise CCPA, 456. ff,460 i, f£m,x.doc as telephone, two-way radio, medical beeper or other electronic means. 58. Florida Administrative Code Rule 64B2-18.007(2), in pertinent part, provides that: The assistant must generally function in reasonable Proximity to the supervising physician. If he or she is to perform away from the supervising physician, these duties must be clearly specified in the supervising physician’s application to the Board. 59. Based on the forgoing, the Respondent has violated Section 460.413(1)(i) and (ff), Section 460.403(3),(7),(8), and (11), Section 460.4165(2), Florida Statutes (2005), and Florida Administrative Code Rules 64B2-20.001(4),(7),(9) and 64B2-18.007, by failing to provide responsible, direct and/or indirect Supervision, to Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle- Cespedes, C.CP.A., at all relevant times from July 8, 2005, through September 6, 2005, and at all relevant times before and after those dates, while Rodolfo Valle, C.C.P.A., a/k/a Rodolfo Valle-Cespedes, C.C.P.A., was participating in insurance billing grand theft while at Community Medical Group, Inc., in violation of Sections 812.014(1) & (2)(b) and Section 777.011, Florida Statutes (2005). 18 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (Cf) failure to supervise CCPA, 456- £6,460 i, ffi.m,x.doc COUNT ITI- RECORD KEEPING 60. Petitioner re-asserts and re-alleges paragraphs one (1) through forty (40), forty-two (42) through forty-six (46), and forty-eight through fifty-nine (59) and as if set forth fully at length herein, 61. — Section 460.413(1)(m), Florida Statutes (2005), provides that failing to keep legibly written chiropractic medical records that identify Clearly by name and credentials the licensed chiropractic physician rendering, ordering, supervising, or billing for each examination or treatment procedure and that justify the course of treatment of the patient, including, but not limited to, patient histories, examination results, X-rays, and diagnosis of a disease, condition, or injury is grounds for disciplinary action by the Board of Chiropractic Medicine. 62. Section 460.413(1)(ff), Florida Statutes (2005), provides that violating any provision of chapter 456 or chapter 460, or any rules adopted pursuant thereto, is grounds for disciplinary action by the Board of Chiropractic Medicine. 63. Fla. Admin. Code Rule 64B2-17.0065 sets forth the minimal recordkeeping standards as set forth below in pertinent part: a) Fla. Admin. Code Rule 64B2-17.0065(3) states that the medical record shall be legibly maintained and shal] 9 1 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (C)(ff) failure to supervise CCPA, 456. f£460 i, f£m,.x.doc contain sufficient information to identify the patient, support the diagnosis, justify the treatment and document the course and results of treatment accurately, by including, at a minimum, patient histories; examination results; test results: records of drugs dispensed or administered; reports of consultations and hospitalizations; and copies of records or reports or other documentation obtained from other health care Practitioners at the request of the physician and relied upon by the physician in determining the appropriate treatment of the patient. Initial and follow-up services (daily records) shall consist of documentation to justify care, b) Fla. Admin, Code Rule 64B2-17.0065(4) states that all patient records shall include a patient history; symptomatology and/or wellness Care; examination finding(s), including X-rays when medically or Clinically indicated; a diagnosis; a Prognosis; assessment(s); a treatment plan; and, treatments provided, C) Fla. Admin. Code Rule 64B2-17.0065(5) states all entries made into the medical records shall be accurately dated. The treating physician must be readily identifiable either by signature, initials, or Printed name on the record. Late entries are Permitted, but must be clearly and accurately noted as late entries and dated accurately when they are entered into the record. d) Fla. Admin. Code Rule 64B2-17.0065(6) States that once a treatment plan is established, daily records shall include: (a) Subjective complaint(s); (b) Objective finding(s); (c) Assessment(s); (d) Treatment(s) provided, and (e) Periodic reassessments as indicated. 64. Based on the forgoing, Respondent has Violated Section 460.413(1)(m), Florida Statutes (2005), and/or Fla. Admin. Code Rule 64B2- 17.0065 in one or more of the following ways: 20 J:\PSU\Allied Health\Van winkle\Chiro\AC’s\Schechtman, Lawrence 2008-27285 (OE) failure to supervise CCPA, 456- ££,460 i, f£m,x.doc a) By failing to record or maintain accurate and adequate medical records for the initial examination and/ or history for Patients H.C., C.R., and O.Y. when he first presented for chiropractic care and treatment; b) By failing to record or maintain accurate, complete and consistent daily treatment notes for Patient E.J. in SOAP format; c) By failing to record or maintain accurate, complete and consistent daily treatment notes showing who provided the care to Patients H.C., C.R., and O.Y.; d) By failing to record or maintain sufficient records that justify the necessity of the number, type, and frequency of the various therapy procedures billed on behalf of Patients H.C., C.R., and 0.Y, 65. Based on the foregoing, Respondent violated Section 460.413(1)(m), Florida Statutes (2005), and/or Fla. Admin. Code Rule 64B2-17.0065 by failing to keep accurate and adequate medical records. COUNT IV- SUBMITTING CLAIMS FOR SERVICES NOT PERFORMED 66. Petitioner re-asserts and re-alleges Paragraphs one (1) through forty (40), forty-two (42) through forty-six (46), forty-eight through fifty-nine (59), and sixty-one (61) through sixty-five (65), as if set forth fully at length herein. 21 JAPSU\Allied Health\Van winkle\Chiro\AC’s\Schechtman, Lawrence 2008-27285 (CD failure to supervise CCPA, 456- ££,460 i, ff&m,x.doc 67. Respondent's medical records for patients H.C,, C.R., and O.Y. do not provide documentation for all the chiropractic and other medical services and treatments billed to patient H.C.’s insurance company by Respondent, 68. Respondent submitted claims to Patient H.C.’s insurance company for chiropractic services and treatments that were not actually provided to patients H.C., C.R., and O.Y. 69. Section 460.413(1)(x), Florida Statutes (2005), provides that submitting claims to any third-party payor for a service or treatment which was not actually provided to a patient constitutes grounds for discipline by the Board of Chiropractic Medicine. 70. Based on the foregoing, Respondent has violated Section 460.413(1)(x), Florida Statutes (2005), by submitting claims to Patient H.C.'s insurance company for chiropractic services and/or other medical care and treatments which were not actually performed or Provided to patients H.C., CR, and O.Y, COUNT V- INTENTIONALLY SUBMITTING CLAIMS FOR PIP BENEFITS FOR SERVICES NOT RENDERED 71. Petitioner re-asserts and re-alleges paragraphs one (1) through forty (40), forty-two (42) through forty-six (46), forty-eight through fifty-nine (59), 22 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (CP) failure to supervise CCPA, 456- ££,460 i, ff,m.x.doc sixty-one (61) through sixty-five (65), and sixty-seven (67) through seventy (70) as if set forth fully at length herein. 72, Respondent intentionally submitted claims to patient H.C.’s personal injury protection (PIP) insurance company for chiropractic and other medical services and treatments that were not actually provided to patients H.C., C.R., and OY. 73. Section 456.072(1)(ff), Florida Statutes (2005), provides that intentionally submitting a claim, statement, or bill for the Payment of services that were not rendered under a patient's personal injury protection insurance coverage, as required by Section 627.736, Florida Statutes (2005), constitutes grounds for discipline by the Board of Chiropractic Medicine. 74. Section 460.413(1)(ff), Florida Statutes (2005), provides that Violating any provision of chapter 460 or chapter 456, or any rules adopted Pursuant thereto, constitutes grounds for discipline by the Board of Chiropractic Medicine. 75. Based on the forgoing, Respondent has violated Section 456.072(1)(ff), Florida Statutes (2005), by intentionally submitted claims to Patient H.C.’s personal injury protection (PIP) insurance company for chiropractic 23 JAPSU\Allied Health\Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (Cf) failure to supervise CCPA, 456- f£,460 i, ff£.m,x.doc care and other medical services and treatments that were not actually provided to patients H.C., C.R., and O.Y. 76. Based on the forgoing, Respondent has violated Section 460.413(1)(ff), Florida Statutes (2005), by violating provisions of chapter 460 or chapter 456, and/or any rules adopted pursuant thereto. WHEREFORE, the Petitioner respectfully requests that the Board of Chiropractic Medicine enter an order imposing one or more of the following penalties: permanent revocation Or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. TA SIGNED this_3)+/“" day of VALI 2011. H. Frank armer, Jr., M.D., Ph.D, State Surgeon General Florida Department of Health a ZED Kae > hen): “hts, FILED Tari Rossitto-Van Winkle, R.N., 3.0. DEPARTMENT OF HEALTH 4082 sence purse c ress Way, Bin C-65 bate JURE ° a piees Tallahassee, FL 32309" Florida Bar # 0542131 PCP Date: 5/24/2011 (850) 245-4640 ext. 8139 Panel Members: (850) 245-4684 FAX tari_rossitto-vanwinkle doh. state.fl.us 24 JAPSU\Allied Health Van winkle\Chiro\AC's\Schechtman, Lawrence 2008-27285 (i(f) failure to supervise CCPA, 456- ££,460 i, ff,m,x.doc NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to. have subpoena and subpoena duces tecum issued on his or her behalf NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and Prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. 25 JAPSU\Allied Health\Van winkle\Chiro\AC's'Schechtman. Lawrence 2008-27285 (D(ff) failure to supervise CCPA, 456- ££,460 i, ff,m,x.doc

Docket for Case No: 12-000708PL