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Phony D.C. Just Wanted to Work
Yellow Pages
Written by TAC Staff: Yellow Pages   
Sunday, 25 November 2012 22:12
aroundtheworld
PHILADELPHIA, PA-A Summerdale who posed as a chiropractor and a physical therapist and treated patients as part of an elaborate health-care fraud scheme was sentenced to six years in federal prison.

Tahib Smith Ali, 35, is to surrender to the Bureau of Prisons as soon as he gets a report date, U.S. District Judge Mitchell Goldberg said.

The judge also ordered Ali to make restitution of $287,972, which includes co-pays that Ali allegedly charged to 86 patients.

Ali, who was not licensed and had no medical training, purchased the Oasis Holistic Healing Village, on 17th Street near Spruce, in December 2008 from Dr. Paul Bodhise, a licensed chiropractor who was retiring and moving to California.

Ali told Goldberg that he tried to recruit a chiropractor from Delaware but he couldn't get licensed here.

"I should have stopped then, but I wanted to make the business work," he said. "I was afraid of failure."

After the business began to slow and patients stopped coming, Ali started submitting claims for chiropractic treatments to Independence Blue Cross and other insurers using Bodhise's name and medical provider number.

"It was the dumbest thing I ever did," said Ali, who pleaded guilty in June to health-care fraud and aggravated identity theft.

Between January 2009 and April 2010, prosecutors said, Ali submitted bogus claims for $1.4 million and actually received payments of more than $280,000 from IBC and other insurers.

Defense attorney Christopher Hall said Ali was a "good man, a caring man" who had "started with good intentions" but "whose judgment was clouded by a desire to run a business."

Assistant U.S. Attorney Mary Beth Leahy painted a far darker portrait of Ali, who allegedly wore scrubs and white lab coats when he met with and examined patients.

She said Ali's "deceit had no bounds" and he had acted "without concern for [patients'] dignity, privacy and health."

The prosecutor said Ali had even performed muscle-stretching on a 10-year-old girl with cerebral palsy who was wheelchair-bound and unable to speak.
 
Soure: Philadelphia Daily News
 
Ohio D.C. Pleads Guilty to Medicare Fraud
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Yellow Pages
Written by TAC Staff: Yellow Pages   
Sunday, 25 November 2012 22:09
aroundtheworld
AKRON,OH — A Medina chiropractor has pleaded guilty to defrauding Medicare and insurance companies of more than $1.8 million.

Dr. John N. Heary, 38, was accused of submitting fraudulent bills to Medicare, Anthem Blue Cross and Blue Shield, Medical Mutual of Ohio and the Ohio Bureau of Worker’s Compensation, according to the U.S. Attorney’s Office, Northern District of Ohio.

Heary pleaded guilty Friday to seven counts of health care fraud. District Judge David D. Dowd Jr. allowed Heary to remain free on bond until his sentencing, scheduled for April 22.

He could receive a maximum of 10 years in prison, and he likely will lose his medical license, said U.S. Attorney’s Office spokesman Mike Tobin.

Heary was charged with 38 counts of health care fraud, nine counts of mail fraud and eight counts of paying illegal kickbacks. Tobin said 31 counts of health care fraud and all other counts were dropped as part of a plea bargain.

The attorney’s office accused Heary of providing patients with medical treatments that were unnecessary to their health or were more expensive than required.

Medicare and insurance companies reimbursed Heary more than $800,000, which he was ordered to repay, according to the U.S. Attorney’s Office.

Heary operated out of his office at 433 W. Liberty St. He last resided in Westfield Township
 
Source:  The Medina County Gazzette
 
 
Chiropractors Under State Scrutiny in W.Va.
Yellow Pages
Written by TAC Staff: Yellow Pages   
Tuesday, 23 October 2012 22:09
aroundtheworldCHARLESTON, WV.  A new report says West Virginia needs to regulate chiropractors, but questions the performance of the agency assigned that task.
 
Lawmakers were told Tuesday that the Board of Chiropractic has failed to notify licensees about complaints pending against them. The people who file complaints have been left in the dark as well.
 
The report to House-Senate interim committees also said the board failed to discipline one chiropractor found to have violated professional standards.
 
The legislative auditors raise specific concerns about the board's handling of two recent cases. In one, it renewed the license of a chiropractor indicted on federal health care fraud charges.
 
The other involved a chiropractor who obtained 31 pain pill prescriptions from four different providers. The board contacted federal authorities, but took no internal actions. 

 
N.J. Chiropractor Steals from the Blues
Yellow Pages
Written by TAC Staff: Yellow Pages   
Tuesday, 23 October 2012 22:04
aroundtheworldA Matawan, N.J., chiropractor was indicted for allegedly stealing more than $13,000 by submitting numerous fraudulent claims to Horizon Blue Cross Blue Shield.
 
Charles Boas, 64, was charged with 60 counts of second-degree health care claims fraud and one count of third-degree theft by deception, according to the New Jersey Attorney General’s Office.
 
Between Oct. 9, 2006 and Aug. 13, 2009, Boas, who worked as a chiropractor in Bayonne, N.J., alleged submitted 60 fraudulent claims to Horizon Blue Cross Blue Shield for chiropractic services that he did not perform.
 
An investigation by the New Jersey Office of the Insurance Fraud Prosecutor determined that Boas allegedly made false statements and submitted false claims and that he allegedly requested that his patients identify family members and then he submitted fraudulent claims for purportedly treating those family members.
 
He allegedly received $13,626 from Horizon Blue Cross Blue Shield to which he was not entitled.
 
 
 
Office Manager of Bloomington Chiropractic Practice Arrested
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Yellow Pages
Written by TAC Staff: Yellow Pages   
Tuesday, 23 October 2012 21:59
aroundtheworldBLOOMINGTON, IN - 51-year-old Dennis Faulkner, the office manager at Faulkner Chiropractic and Acupuncture in Bloomington was arrested after police say he was wiring money from erroneous credit cards lines made in clients’ names.  According to Bloomington Detective Christopher, Faulkner turned himself into police last week.  According to police the business has a policy in place where a client may establish a line of credit where sessions could be charged. The activity never shows on the client's statements and no interest would accumulate as long as clients made the minimum payment.  Police say Faulkner allegedly would create the fake accounts, rake in the cash and make the minimum payment. Police say Faulkner established a total of 48 credit lines, accumulating to $210,800 and made $43,000 in payments. At the time of the arrest, he had an outstanding balance of more than $167,000.
 
When questioned by police, Faulkner said his wife, the chiropractor of the practice, had no knowledge of the operation  He also said the reason he began the operation was to supplement the cash flow of the business because of personal and financial difficulties.  An anonymous caller tipped off the investigation back in early April after the credit company Care Credit contacted Bloomington police.
 
Source: WBIW.com
 
 
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