After a two-year investigation by state officials, Dr. William "Duane" Harrington, a Sunnyside chiropractor, has been reprimanded by the Washington State Department of Health Chiropractic Quality Assurance Commission. He has been fined $40,000, half of which has been suspended, based upon Harrington's compliance with the terms of an agreed order signed by Harrington.
Harrington, who has an office on South Fourth Street, has had a license to practice chiropractic care in Washington state since August 1995. The charges against him are for improper or abusive billing practices.
Jeff Coopersmith of Coopersmith Health Law Group, attorney for Harrington, said "It's important to know this case was never about patient care and patient outcome. It's all about filling out the proper paperwork."
Serious allegations from the state, which included fraud, were dropped from the case because of lack of evidence, said Coopersmith.
Coopersmith, who formerly worked as the lead counsel for the Director of Enforcement at the office of the State Insurance Commissioner, said that cases such as the one against Harrington are all too common in Washington.
The state alleges that between 1997 and April 2003 Harrington required his employees to undergo chiropractic treatments by him on a regular basis. According to the state, Harrington's employees did not always have a diagnostic need for treatment before he provided services.
During a portion of the time that Harrington was "treating" his employees, he was providing health insurance for his employees that included chiropractic coverage. Harrington was charging his employees' insurance carrier for treatments, but waived the employees' and their family members' co-payments.
In March 2005, the state and Harrington came to an agreement on the facts of the case. Charging the insurance company for the treatments, Harrington said that he believed that coverage he purchased allowed him to bill for care and that he could waive the payments as an additional employee benefit.
Harrington was also found to have a dual fee schedule for massage treatments between August 1999 and April 2003. He was charging a higher rate for Labor and Industry and personal injury patients than for those with group insurance or who paid cash.
According to state records, Harrington maintains that he believed that he could keep a dual fee schedule for massage treatments and charge more for those with Labor and Industry and personal injury claims because the care provided for injured patients requires more time and is more complex than relaxation massages.
The state found that Harrington treated two separate patients a total of 230 times in three years without documenting findings, re-examination or diagnosis in the patients' records.
In both cases, Harrington alleges that he provided care at no charge and believed that since he did not charge the patients he did not need to fully document the care.
Other charges alleged by the state including improper billing practices and reporting.
Harrington allegedly told his employees to not tell his patients of their individual credit balances. As of July 2002, Harrington had retained credit balances totaling $19,177.67, according to the state Chiropractic Quality Assurance Commission.
The chiropractor also allegedly produced x-ray reports before reviewing x-rays and billed numerous re-examinations of patients without documenting any findings from the sessions with patients.
According to Tammy Benson, a case management manager for the Chiropractic Quality Assurance Commission, the additional charges were dropped due to lack of evidence as part of the settlement agreement.
She added that there is still a separate case pending against Harrington. Although Benson could not go into the specifics of the case, she did say it was billing related.
Also part of Harrington's reprimand, a three-year probation has been placed on his license. The probation does not restrict his license to practice chiropractic care in the state. As part of the action taken against Harrington, the chiropractor will be required to take 12 hours of continuing education ethics courses and at least 20 hours of training in proper billing techniques. During the probationary period, Washington Chiropractic Quality Assurance Commission investigators will have unannounced audits four times a year. Over the next six months Harrington is also required to pay back more than $27,700 in over billing to his employees' insurance company.
The action was signed by state officials March 23, 2005.
Harrington did not return phone calls, but forwarded inquiries to his attorney Coopersmith.
"These types of concerns could be raided at many private practices," he said. "If you look at any medical practice you will find violations of these rules are there."
He said smaller medical practices can't afford a compliance officer and the rules doctors abide by are very complicated.
Wanting to be the most compliant chiropractor in the state, Coopersmith said his client came up with his own compliance plan and added that the staff of Harrington's office has undergone additional training to help remedy the issue.
"It didn't affect patient care," said Coopersmith. "He wasn't trying to take advantage of the system to make more money than he should have."