Therapist faces insurance fraud charges

BY ART BUKOWSKI
abukowski@record-eagle.com

June 30, 2009 07:10 am

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KALKASKA -- A physical therapist whose license was suspended after allegations of sexual misconduct now faces criminal insurance fraud charges.

Michigan State Police recently arrested Mark R. Melton, who operated out of offices in Gaylord and Kalkaska. He was arraigned last week on seven felony counts of health care fraud.

Police early last year investigated allegations of inappropriate contact made by an employee and two patients. Criminal charges weren't authorized after those complaints, though state health officials suspended Melton's license.

Investigators uncovered the alleged insurance fraud while looking into the sexual misconduct claims, state police Detective Lt. Rick Simpson said. Police contacted Blue Cross Blue Shield of Michigan, and the insurance company assigned its own investigators to help police examine Melton's billing records.

Investigators allege Melton billed Blue Cross for patient visits that never occurred. In other instances, he billed for services insurance officials deemed "medically unnecessary," Simpson said.

The alleged incidents date to October 2005 and involve three patients at the Kalkaska office, Simpson said.

Melton, 39, deferred comment to his attorney, who could not be reached for comment. His license remains suspended, health officials said.

Melton was accused of a sexual relationship with a patient over a number of months in 2005 at his Kalkaska office, as well as requiring an employee to engage in sex acts to keep her job.

He allegedly showed the patient a gun and threatened to shoot her husband if his suspicions caused a confrontation, according to documents from a state investigation, though he did not physically compel her into an affair.

Melton also allegedly required an employee to have sex to keep her job. The employee did not stop Melton's alleged advances because of promises of a raise and a promotion to business partner, documents show.

A second patient also alleged inappropriate contact after police began their investigation into the first two complaints.

State and local authorities determined Melton's alleged conduct with the three individuals didn't merit criminal charges, Simpson said.