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Local News Pitt chiropractor Cohen set for sentencing today A local chiropractor is scheduled to be sentenced today on charges relating to health care fraud. Steven I. Cohen, a licensed chiropractor who has practiced at variously named clinics at 3100 S. Memorial Drive, appeared in court Wednesday for the first part of his sentencing hearing. Cohen was indicted in 2004 on 527 counts of health care fraud, 21 counts of mail fraud, two counts of obstruction and one count each of conspiracy to commit health care fraud and money laundering. In July, he entered guilty pleas to two counts of mail fraud and one count of conspiracy to commit health care fraud as part of a plea agreement. The mail fraud charges stem from claims submitted to Blue Cross/Blue Shield for patient treatments not actually rendered. Cohen also conspired with another chiropractor to use provider numbers, some not belonging to them, to submit claims to insurance companies for procedures that were not performed, assistant United States Attorney Yvonne Watford-McKinney said. Both Watford-McKinney and Cohen's attorney called witnesses throughout the day Wednesday. While prosecutors argued Cohen was the leader in a scheme designed to defraud insurance companies, Cohen's attorney focused on the disorganization of the billing and recordkeeping at Cohen's office. The final witness to testify for the defense was Keith Conners, a psychologist who said Cohen suffers from a severe case of attention deficit hyperactivity disorder. While the disorder would not keep Cohen from knowing right from wrong, it made him impulsive and made it difficult for him to focus, Conners said. The inaccuracies from which the charges stem could have been a result of bad record-keeping, confusing billing and a high turnover of staff at the office between 1999 and 2002, Cohen's attorney, Larry Economos, suggested. A chiropractor who worked with Cohen between 1998 and 2004 told a different story. The fraud was intentional and planned, Andrew Gratzmiller said. Gratzmiller has pleaded guilty to false declarations before a grand jury in connection with previous testimony given during a grand jury investigation of fraud at the chiropractic office. Among other things, Gratzmiller told a grand jury he had not been asked to move medical records. Wednesday, Gratzmiller testified he, Cohen and another man at the clinic did move records after an investigator with Blue Cross/Blue Shield began asking for them. Gratzmiller also testified Cohen asked that services not provided be billed to insurance companies that would pay for them and that provider numbers of medical doctors were used rather than those of chiropractors because insurance coverage would be better. Gratzmiller is also expected to be sentenced today on the perjury charge. The manager of special investigations for Blue Cross/Blue Shield also testified. She said Cohen provided her with 32 files after she had asked for many more. After going through those files, she found 79 percent of the claims in the files were fraudulent, she said. The initial charges against Cohen alleged false claims were submitted to a number of insurance companies, including Nationwide, State Employees Health Plan, Aetna and State Farm. Judge Malcolm Howard will still consider several issues today before sentencing Cohen. One is whether Cohen is entitled to a reduction in his sentence for accepting responsibility. The U.S. assistant attorney does not believe Cohen should be given the reduction because, she says, he has not accepted responsibility. Cohen's attorney is arguing for the reduction. Watford-McKinney, instead, believes Cohen's sentence should be enhanced for obstructing justice in suggesting others give false testimony during grand jury proceedings. Another issue is the amount of loss. An initial probation office calculation estimated more than $1 million had been paid in fraudulent claims, but Cohen's attorney argues that amount should be lower. |