WARWICK, RI – The homeowners and operators of a Warwick ache administration clinic have been indicted by a federal grand jury on well being care fraud prices for allegedly defrauding authorities and personal well being care insurers, Performing United States Attorney Sara Miron Bloom introduced.
Brandon Nowak, 32, and Jason Simmons, 33, each of Foster, RI, and officers and operators of Various Integrative Drugs, LLC, d/b/a Goal Well being, are charged with conspiracy to commit well being care fraud and fourteen counts of well being care fraud.
Well being care fraud sought cost for therapeutic massage remedy not coated by insurance coverage
The U.S. Legal professional alleges that starting October 2020, Nowak and Simmons conspired to and deliberately and repeatedly submitted fraudulent claims to Medicare and Medicare Benefit, Medicaid Managed Care, and 4 personal insurers as a way to accumulate funds for sure purportedly “medically mandatory” providers that weren’t truly offered to sufferers.
The indictment additionally alleges that sufferers had been routinely knowledgeable that therapeutic massage remedy was a service coated by their insurance coverage, when the truth is it was not. With a purpose to obtain insurance coverage cost for therapeutic massage remedy offered by a therapeutic massage therapist, the defendants allegedly billed insurers for coated providers equivalent to acupuncture, bodily remedy, and analysis and administration workplace visits, none of which the sufferers truly acquired.
Moreover, it’s alleged that the defendants submitted claims for providers equivalent to infrared remedy, cold and warm remedy, therapeutic exercise, and self-care/residence administration coaching that weren’t offered to the sufferers and for which AIM Well being didn’t make use of applicable suppliers.
The defendants are scheduled to be arraigned in U.S. District Court docket on April 11, 2025. A federal indictment is merely an accusation. A defendant is presumed harmless until and till confirmed responsible.
The case is being prosecuted by Assistant United States Legal professional Dulce Donovan, with the help of Assistant United States Legal professional John P. McAdams.
The matter was investigated by the U.S. Well being and Human Companies, Workplace of Inspector Common, the Federal Bureau of Investigations, Division of Protection Legal Investigative Service, and the U.S. Division of Veterans Affairs, Workplace of Inspector Common.
