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Patrick Springer, Published March 26 2012

Chiropractor's license revoked after pattern of fraudulent billing

FARGO – Chiropractor Todd Fiebiger’s license was revoked effective today because of an “alarming” number of billing irregularities that examiners concluded were fraudulent.

The North Dakota Board of Chiropractic Examiners took the action, concluding more than seven years of investigations and disciplinary proceedings involving irregular billings dating back to 2004 – including allegations that he charged insurers for services he didn’t perform.

Fiebiger, of Fargo, must pay a civil penalty of up to $10,000 or reimburse the board for the cost of its investigation, whichever is less. He cannot reapply for a license for five years.

Fiebiger declined comment, referring questions to his lawyer, Jacqueline Anderson, who did not return a call from The Forum seeking comment.

“We are heartbroken and bewildered on the course of action handed down onto our clinic to provide chiropractic treatment in this great state of North Dakota,” the Fiebiger Chiropractic Clinic announced in an advertisement Sunday in The Forum addressed to patients.

“This is certainly not how Dr. Todd wanted to ‘retire’ from the profession he was trained in, was dedicated to, and loves so much,” the ad continued after thanking patients.

An administrative law judge found four types of violations by Fiebiger involving patient billing and recordkeeping practices that violated professional standards or ethical codes.

Problems included insufficient documentation; billing for services he did not perform; billing for services under the names of other chiropractors; and billing for a higher level of services than provided.

“… Fiebiger’s documentation irregularities are not clerical errors or billing errors,” Allen Hoberg, an administrative law judge, wrote in his opinion. “Rather, they are irregularities in Fiebiger’s notes.”

The judge added: “Simply put, Fiebiger’s notes falsely reflect the evaluation or treatment of the patients.”

Examiners found no problems, however, with the treatment Fiebiger provided patients since the clinic opened in 1996.

“During the entire time the Clinic has been in operation, there has never been a complaint filed by a patient alleging improper conduct or care or treatment,” Hoberg wrote. “It appears that with regard to treating patients, Fiebiger is an excellent chiropractor, giving quality patient care to the satisfaction of the patients he treats.”

In a related disciplinary case, Dr. Tanya Fiebiger, Todd Fiebiger’s wife and partner in the Fiebiger Chiropractic Clinic, recently was placed on probation for one year by the chiropractic board.

Tanya Fiebiger, who was primarily responsible for the clinic’s billings, was found to have committed “unprofessional billing practices,” including billing for higher services, billing for services with improper provider identification numbers and inadequate documentation.

Her probation, which began Jan. 2, came in an agreement reached in December that requires monitors to review randomly selected patient files, with half a dozen reviews conducted every two months.

The first of the scheduled reviews is not yet completed, said Edward Erickson, an assistant attorney general. He added, though, that the board doesn’t have any reason to believe there are any problems.

The billing irregularities addressed in Todd Fiebiger’s license revocation also were the subject of an earlier disciplinary case against him by the chiropractic board.

His license was revoked in 2006. The board initially suspended his license for four months while it investigated his billing practices. Examiners later found that he was treating patients during his suspension.

Todd Fiebiger regained his license in 2007 but was barred from reimbursement by Blue Cross Blue Shield of North Dakota starting in 2008. He was barred from payment and members have been barred from reimbursement “except in very rare circumstances,” said Najla Amundson, a spokeswoman for the health insurer.

Todd Fiebiger’s repeated billing irregularities continued despite his previous disciplinary actions and “extensive” corrective actions by Blue Cross Blue Shield, Hoberg said.

Reviewers also found numerous billing irregularities involving patients covered by Medica, the examiners found.

Fiebiger tried to deflect some of the blame by implicating an “unreliable employee,” but the review panel found no evidence to support that defense.

“Keying errors may occur,” Hoberg wrote. “However, there is a significant difference between a keying error, such as mistyping a date, and submitting bills when a patient was never treated.”

Erickson, an assistant attorney general, said the findings of the chiropractic board weren’t forwarded to any agencies for possible criminal investigation.

The Fiebiger Chiropractic Clinic is in the process of “transitioning” the clinic to the “trusted hands” of a colleague, according to the newspaper ad. The ad did not identify the colleague.

Meanwhile, the clinic was scheduled to remain open until 11:59 p.m. – the final moments his chiropractor’s license remained in effect.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522

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