STATE OF FLORIDA 00. DEPARTMENT OF HEALTH SEP it ay Ihe) DEPARTMENT OF HEALTH, Petitioner, Vs. CASE NO. 97-11856 ROBERT JON MICCICHE, D.C. Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, Department of Health, and files this Administrative Complaint before the Board of Chiropractic Medicine against the Respondent, ROBERT JON MICCICHE, D.C., and in support thereof would state: A i 1. Petitioner is the state agency charged with regulating the practice of _ chiropractic medicine pursuant to Section 20.43, Florida Statutes; Chapter 455, Florida Statutes; and Chapter 460, Florida Statutes. | 2. Pursuant to the authority of Section 20.43(3)(g), Florida Statutes, the Petitioner has contracted with the Agency for Health Care Administration, hereinafter referred to as the "Agency," to provide consumer complaint, investigative, and prosecutorial services required by the Division of Medical Quality Assurance, councils or board, as appropriate, including the issuance of emergency orders of suspension or restriction. 3. Respondent has been at all times pertinent hereto a duly licensed chiropractic physician pursuant to Chapter 460, Florida Statutes, having been issued license number CH 0005356. Respondent's license is on a probationary status at this time. 4. Respondent's last known address is 3801 West Lake Mary Boulevard, #111, Lake Mary, Florida 32746. 5. On September 11, 1996 the Respondent examined a patient who will be referred to as "A" herein, and rendered a diagnosis of post-laminectomy syndrome [ICDA 722.81]. In point of fact the patient had never had a laminectomy, and the diagnosis is incorrect, misleading and deceptive. 6. The Respondent treated patient "A" on fifty-five occasions from September 9, 1996 through January 15, 1997, for injuries allegedly received in a minor traffic accident ‘on May 23, 1996. As the patient reached Maximum Medical Improvement [MMI] on or about November 15, 1996, those treatments rendered by the Respondent from that date foreword, including physical therapy, was unwarranted and medically unnecessary. In addition, the patient progress notes supplied to the Petitioner during the course of the investigation of this matter do not establish;the medical necessity for the frequency or duration of these treatments. ; 7. On November 1, 1996 the Respondent prescribed a tens unit for this patient which was paid for by the insurance carrier. The progress notes in the medical records and charts provided as a result of the investigation undertaken by the Petitioner do not establish or document the medical necessity for this device. 8. On January 3, 1997 the Respondent ordered and obtained spinal ultra-sound and para spinal 4 / extremity EMG diagnostic studies on patient "A", billed, and was paid $ 600.00 from the insurance carrier. The medical progress notes from Respondent's office do not establish or document the medical necessity for these studies, nor would they be reasonable calculated to assist Respondent in determining a diagnosis or course of treatment for the patient. 9. Petitioner is informed and believes, and based upon said information and belief alleges that the EMG study was in fact a surface muscle scan, and not the 4 / extremity and related spinal region by needle test that the Respondent billed and was compensated for. 10. On December 18, 1996 the Respondent subjected patient "A" to an X-ray study. These tests were run one day before a scheduled independent medical examination of the patient by another Chiropractor, and after the patient had reached MMI. None of the patient progress notes submitted by the Respondent document the medical necessity for these tests, especially under these conditions and considering that the Respondent had run these same tests on this patient on September 11, 1996 and November 15, 1996. 11. Also, the medical records supplied to Petitioner revealed that the Respondent had personally treated patient "A" on twenty-nine (29) separate instances between September 11, 1996 and November 15, 1996, administering ultrasound, electrical stimulation, hot packs, interferential therapy, and hydrotherapy, none of which is documented as being reasonable medically necessary owing to the minor injuries sustained by the patient in the automobile accident in question. 12. The mis-diagnosis reached by the Respondent is contrary to Section 460.413(1)(K), Florida Statutes in that it was false, untrue, misleading and deceptive, and does not conform to generally prevailing standards of care in the chiropractic community. 7] 13. The excessive manipulative treatments provided by the Respondent to this patient: the prescribing of the tens unit without documented medical necessity; having the actually performed, or, in the alternative, billing for the wrong test, is contrary to the . patient submit to repetitive X-rays and other tests; and billing out a test that was never provisions contained in Sections 460.413(1)(n), (1)(v), and (1)(x) Florida Statutes, and Rule 64B2-17.005, Florida Administrative Code. WHEREFORE, Petitioner respectfully requests the Board of Chiropractic Medicine enter an Order imposing one or more of the penalties proscribed by law, . together with any other and further relief deemed just under the circumstances. SIGNED 06 Whey nt _ COUNSEL FOR AGENCY: Lawrence F. Kranert, Jr. Senior Attorney Florida Bar No. 0171063 Agency for Health Care Administration General Counsel's Office - MQA Allied Health P.O. Box 14229 . Tallahassee, Florida 32317-4229 (850) 487-2225 Pe: yleka ol Rit av oO Robert G. Brooks, M.D. BrL Secretary, Department of Health 32= $9 SALLY 40 Zi siThY 11 43 00 qa By: Nancy M. Snurkowski Chief Attorney On Behalf of the Agency for FILED DEPARTMENT OF HEALTH EPUTY CLERK cuencptiphanae 0. Quw DATE DUR-G9

Docket for Case No: 00-003780PL