Liberty Mutual accuses back clinic Marque Medicos of workers comp insurance fraud, demands $17 million

By Jonathan Bilyk | Aug 19, 2016

Liberty Mutual Insurance has brought a $17 million fraud lawsuit against a Chicago-based medical practice specializing in neck and back injuries, saying the practice billed for procedures and therapy they did not perform on worker’s comp patients and billed at inflated rates.  

On Aug. 17, Liberty Mutual filed a complaint in Cook County Circuit Court against Marque Medicos, a practice which provides care to patients at several locations in Chicago and west suburban Aurora. According to published reports about the practice, Marque Medicos specializes in neck and back injuries generally payable under workers compensation claims. The practice also was described in at least one report as catering particularly to Hispanic patients.

The Aug. 17 lawsuit also named as defendants Derrick Wallery, listed in the complaint as owner of Marque Medicos, as well as all of Marque Medicos’ various other associated corporate entities.

Liberty Mutual was joined in the lawsuit by 17 other affiliate insurance companies.

According to the lawsuit, Liberty Mutual, which provides workers’ compensation insurance to many businesses in Illinois, has paid claims to Marque Medicos for “treatment allegedly rendered to workers’ compensation claimants who were employed by companies insured by Liberty Mutual.”

However, from 2008-2014, Liberty Mutual said it received bills from Marque Medicos “for additional medical bills and charges … which were denied and/or not paid.”

Those charges prompted Liberty Mutual to launch an investigation into Marque Medicos’ claims, the lawsuit said, which “revealed … fraudulent billing practices.”

Liberty Mutual alleged its investigation showed Marque Medicos had billed at higher rates for such procedures as “attended electrical stimulation when unattended electrical stimulation was actually performed” and billing for “multiple units per visit of direct one-on-one” physical therapy, when they actually allegedly performed “single-unit-per-visit group therapy.” The lawsuit alleged the practice also billed for “hands-on therapy” when it was never actually performed.

In all, Liberty Mutual alleged it had paid more than $2.5 million to Marque Medicos to satisfy those bills, and had received approximately $5.1 million in additional bills from the practice.

The insurer alleged counts of insurance fraud and common law fraud against Marque Medicos.

The lawsuit asked the court to award Liberty Mutual and its affiliates three times the $2.5 million already paid, and two times the $5.1 million “wrongfully attempted to be obtained through the use of fraud.”

In all, Liberty Mutual has asked the court to order Marque Medicos to pay out more than $17.7 million in damages, plus attorney fees.

Liberty Mutual is represented in the action by attorneys John F. Boyle and Michael D. Spinazzola, of the Law Offices of Meachum, Starck, Boyle & Trafman, of Chicago.




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