A chiropractor accused of bilking Iowa Medicaid out of $75,000 is suing the state for more than $280,000 in legal fees, claiming he is the victim of a long-running campaign of harassment and intimidation.
The case involving Dr. Mark Den Hartog, 56, began quietly enough at 7:45 a.m. on May 27, 2015, when Jody Jones, an investigator with Iowa Medicaid’s Program Integrity Unit, pulled into the parking lot of The Chiropractic Hut in Pleasantville, Iowa. She was there to examine patient-care records, according to Jones’ written notes of the visit.
Nine years earlier, Den Hartog had been forced to repay Medicaid $7,000 when investigators determined he had no records to support some of the claims for payment he had submitted to Medicaid. Then, in 2014 and 2015, Den Hartog allegedly failed to respond to written demands for more recent patient records. As a result, Jones was sent, unannounced, to the Chiropractic Hut to obtain patient records for examination at the Iowa Medicaid offices.
At 8 a.m., just after the doors to the clinic were unlocked, Jones walked inside the clinic with its Tiki-themed décor and faux thatched roof over the receptionist’s desk. Jones showed Den Hartog her badge and handed him a spreadsheet listing 24 patients whose files she wanted him to copy and turn over. She told him he had nine hours to comply and explained that she’d sit a few feet away in his waiting room while he copied the files.
According to Jones’ report, Den Hartog was unable to immediately produce any of the records, telling her he knew he was going to have to pay back all of the money associated with the patients’ care, allegedly adding, “I’m probably going to put a gun to my head and kill myself after all this is over.” He then laughed and, according to Jones, said the audit of his patient files was going to end his career in chiropractic.
Over the next four hours, Den Hartog allegedly produced only two patient files. Jones later reported that she approached Den Hartog at his computer and pointed to a patient’s name on the screen and asked him to print out the accompanying file showing the services he had provided the woman. According to Jones, Den Hartog stared at the screen and repeatedly said he didn’t understand what she wanted or what she was asking him to do. When Jones asked him whether he had created, on the spot, the two files she had already been given, Den Hartog allegedly said yes and acknowledged he had no patient files that he could produce for her.
According to Jones, the tenor of the conversation then changed, with Den Hartog challenging her authority, then staring at her without responding to questions. Jones reported that she walked out of the clinic and drove off, telephoning a colleague to say she felt very uncomfortable and didn’t want to go back into the clinic alone.
Den Hartog sold the Pleasantville clinic a short time later, and in January 2016 he was criminally charged with tampering with records. His attorney, Mike Sellers, says Den Hartog was “hauled off to jail at 5 a.m. in front of his entire crying, hysterical family — during Christmas break — after the two cops searched the house with their flashlights.” Sellers successfully fought to have the criminal charge dismissed in July 2017, but Medicaid banned Den Hartog from the program and insisted he reimburse taxpayers for $35,000 in billings for undocumented services.
Now, more than five years after Jones’ unannounced visit to the Chiropractic Hut, Den Hartog is suing the state, with his attorney alleging in court filings that Iowa’s attempts to recover money paid to “a small-town chiropractor” is based on harassment, intimidation and the fabrication of facts, all in an attempt to put Den Hartog out of business.
In fact, Den Hartog has three separate lawsuits pending against the state and is demanding the state pay the more than $280,000 in expenses associated with that litigation and with the criminal case.
The first case was filed in January 2019, when Den Hartog asked for judicial review of the state’s determination that by failing to keep patient records, he had violated Medicaid regulations.
In August 2019, a second lawsuit was filed, this one seeking judicial review of the state’s decision to demand repayment of the $35,000.
Ten weeks ago, a third lawsuit was filed, this one alleging intentional infliction of emotional distress. In that case, Den Hartog argues the state should have dropped its pursuit of the claims against him once the Marion County Attorney’s Office opted to dismiss the criminal charge of tampering with records.
Assistant County Attorney Jared Harmon, who handled that case, did not respond when asked why he agreed to drop the criminal charge. In his legal filings, Sellers says the case was dismissed after he expressed to Harmon “threats of our list of planned actions if there is a conviction.” Asked about the nature of those threats, Sellers says he simply informed Harmon of his plans to sue the state, which he is now doing.
Court records indicate the county prosecutor agreed to dismiss the charge in return for Den Hartog’s promise to pay $989 in restitution to the state’s Medicaid Fraud Control Unit. But after the deal was made and the charge dismissed, Sellers sought to have the order for restitution vacated, noting that the state was using the restitution agreement to support its efforts keep his client banned from Medicaid. A judge refused to vacate the order.
In court filings, the state says that despite the dismissal of the criminal charge, Den Hartog’s “actions have demonstrated an intentional attempt to defraud Medicaid,” and it argues that the taxpayer-funded program suffered a loss of more than $75,000 as a result.
The state also claims the most recent lawsuit should be dismissed, in part because it is based on actions already being litigated in the other two cases.
As for Den Hartog, he moved to Olympia, Washington, three years ago, where he can practice chiropractic in the one state where a Medicaid ban has no practical effect. As Sellers phrased it in court filings, Den Hartog was forced “to flee from Iowa, where he and his family were born and raised, to the state of Washington — which was one of the few states that do not pay Medicaid for chiropractic treatments — so that he could find work.”
The Iowa Board of Chiropractic took no action against Den Hartog’s license in response to Iowa Medicaid’s allegations. The Washington Chiropractic Commission says Den Hartog’s license is in good standing there, with no public record of complaints or disciplinary action.
In his court filings, Sellers says the State of Iowa should pay his for legal work on behalf of Den Hartog so that state agencies’ “unrestrained assaults on innocent victims” will stop. He argues that unless agencies are penalized in this fashion, “they lose nothing and simply move on to the next target.”
The Iowa Attorney General’s Office says payment of attorneys’ fees in cases of this kind are not warranted.