Federal prosecutors have charged 21 people — including six Twin Cities chiropractors — in connection with a series of parallel fraud schemes that allegedly bilked insurance companies out of more than $20 million over the past five years.

The chiropractors are accused of systematically paying recruiters, or “runners,” to identify victims of car accidents or people willing to claim that they were in a collision. They then submitted insurance claims and received reimbursements for services that were either not medically needed or were never rendered, according to the charges.

U.S. Attorney Andrew Luger, who announced the charges in Minneapolis Wednesday afternoon, said the alleged schemes were nearly identical, even though executed by different chiropractors.

Wednesday’s arrests and initial court appearances, he said, represented the first of several phases in taking down “many more” swindlers who seek to take advantage of Minnesota’s no-fault auto insurance law. The law guarantees at least $20,000 in medical coverage for policyholders regardless of fault in an accident.

“For the defendants charged in this scheme, what mattered was the ability to get that $20,000, not the patient’s need for medical services,” Luger said.

The charges were spread across four indictments and two felony information filings, and covered conspiracies that allegedly ran from 2010 to 2015.

The chiropractors charged are Preston E. Forthun, Angela A. Schulz, Huy Ngoc Nguyen, Adam J. Burke, Marlyn C. Comes and Darryl M. Hummeny. Comes and Hummeny were charged by felony information, which typically signals that a plea agreement will soon follow.

Minnesota is one of nine states that require auto insurance policies to include personal injury protection, which carries a minimum coverage amount of $20,000 to pay medical expenses required after automobile accidents, regardless of who was at fault.

Luger said the runners — 15 of whom were charged in the alleged conspiracies — received kickbacks of about $1,000 per patient. They would not be fully paid until the patients they recruited attended a “minimum threshold” of treatment sessions, according to the charges.

Some runners also staged phony accidents with patients to seek no-fault benefits, Luger said. Charging documents say the chiropractors worked to conceal kickbacks paid to runners: Forthun described the payments as “marketing” or “transportation” fees on check memo lines. Burke allegedly encouraged runners to create corporate entities to which he would send payments, the charges say.

Peter Wold, an attorney for Burke, said the charges resulted from “a dragnet of chiropractors and issues regarding no-fault insurance.” Wold described Burke, who is listed by the state board of chiropractic examiners as having an active license and practicing in Edina, as “a good doctor who does good work for his patients.”

“We are very interested to address these charges and have him vindicated,” Wold said Wednesday. “There’s nothing strange about insurance companies not happy about paying for services.”

Forthun’s attorney, Andrew Birrell, said agents raided his client’s Minneapolis clinic more than a year ago and that Wednesday’s charges were not a surprise.

“I expect the evidence to show that this is a legally and factually flawed prosecution,” Birrell said. “They’re painting with such a broad brush here.”

Undercover agents

The investigation was led by the FBI and the Minnesota Commerce Fraud Bureau, a law enforcement arm of the state Commerce Department. Undercover agents posing as patients helped crack open the alleged schemes, recording their interactions with runners and chiropractors.

FBI Special Agent in Charge Richard Thornton called the alleged scheme “relatively simple but widespread” and said it affected everyone who owns a vehicle or buys auto insurance.

“Every single person in Minnesota who owns a car is paying more for their car insurance because of this type of fraud,” Thornton said. “We are all victims of the crimes charged here today.”

Officials did not detail how the phony car accidents were staged, but Minnesota Commerce Commissioner Mike Rothman said such acts “threatened public safety.” He also said runners “often targeted vulnerable people to induce them to seek unnecessary care through fear and intimidation.”

Auto insurance fraud costs Minnesotans an estimated $100 million annually in higher premiums and other costs, according to Mark Kulda, a vice president at the Insurance Federation of Minnesota.

Under no-fault insurance, Kulda said, policyholders do not receive an explanation of benefits outlining services provided and their costs. He said there are few limits to billable services, which include aromatherapy, horseback riding and other services with limited evidence of effectiveness.

“You can see how lucrative that is and the providers know that,” Kulda said. “That’s why the fraudsters are here.”