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McMechen physician, pain clinic operator charged with health fraud

By LINDA HARRIS

The State Journal

CHARLESTON, W.Va. — The McMechen osteopathic physician being sued by former patients who allege they contracted serious diseases after receiving injections from him in unsterile conditions has now been indicted by a federal grand jury for fraud.

Dr. Roland Chalifoux Jr. allegedly submitted claims for insurance reimbursement claiming he’d spent 15 to 25 minutes or more with patients in his office when he ” did not see the patient at all,” the indictment stated.

The indictment listed 26 occasions, all but one in 2012, when Chalifoux allegedly billed insurance providers for bogus office visits. The insurance paid out nearly $1,500 for those 26 non-visits, the indictment alleged.

Chalifoux has been charged with health care fraud, mail fraud and wire fraud, all felonies. The government also is seeking forfeiture of property valued at more than $290,000.

Chalifoux, who at one time practiced in Wheeling, had operated Valley Pain Management in McMechen, which closed for several months in 2014 over alleged health violations.

State health officials reported a number of health violations, including Chalifoux’s alleged reuse of single dose dispensers, syringes and bags of saline, after one of his patients was diagnosed with bacterial meningitis after receiving an epidural. The report also claimed Chalifoux failed to wear a face mask during epidural procedures or wash his hands before giving patients injections, and that he failed to properly sanitize injection areas or clean examination rooms between patients.

State health officials said they advised Chalifoux his patients should be tested for Hepatitis B, Hepatitis C and HIV, but after he balked at providing them with a complete list of patients his medical license was suspended and his clinic closed.

Chalifoux has sued, claiming the Bureau of Health claims were false and that his practice and reputation had been destroyed. He won reinstatement of his medical license in 2016 after a circuit judge in Kanawha County ruled the West Virginia Board of Osteopathic Medicine had failed to prove Chalifoux reused needles.

But at least four class-action lawsuits have been filed, and Chalifoux’s current malpractice carrier, National Fire and Marine Insurance Co., recently asked a federal judge in Wheeling to issue a declaratory order that it shouldn’t be liable for those claims. National Fire claims Chalifoux lied or downplayed the scope of the class actions, telling them he faced just four claims when, in fact, several hundred former patients are involved in the litigation. On the application, National Fire said Chalifoux had stated he had followed accepted treatment protocols.

National claims that, under the terms of its policy, the alleged violations should be the responsibility of the doctor’s previous insurers, Catlin Specialty Insurance Co. and Capson Physicians Insurance Co. and its responsibility, if any, should be in excess of the coverage promised by the other two companies.

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