Man Poses as Chiropractor, Pleads Guilty to 101 CountsInsurance Fraud, s — By Trace America on June 27, 2012 at 2:46 PM
In all meanings of the word “normal”, the Oasis Holistic Healing Village looked as normal as a chiropractor’s office in a former mansion could. On the inside however, it was a house of lies.
Behind the extravagant stone facade, the man inside wearing the scrubs was not a chiropractor at all, let alone a licensed medical professional.
According to federal prosecutors and philly.com, Tahib Smith Ali had no license or medical certification when he bought the business from an actual chiropractor back in December of 2008. Court documents note that that didn’t seem to stop him from examining patients and performing treatments on them, including “muscle stretching and spinal manipulation.”
If that’s not creepy enough, one source –who asked not to be identified, stated that after Ali hired a part-timer, he would examine the attractive female patients and pawn the others off on his employee, who is a licensed chiropractor.
Ali then filed over $1.4 million in bogus claims from January 2009 to April 2010. During that time, Independence Blue Cross (IBC) paid out more than $280,000.
Several female patients were set to testify about Ali’s interaction with them, but they never got the chance. Right before jury selection was to begin on June 26th, Ali pleaded guilty to 50 counts of health-care fraud, 50 counts of making false statements and one count of aggravated identity theft.
A sentencing date has not yet been set.
Ali, 35, could face up to five years in a federal prison, including a mandatory minimum of two years for stealing the identity of Paul Bodhise, the chiropractor from whom he bought the business.
Assistant U.S. Attorney Mary Beth Leahy said in a court filing that Ali had “submitted more than $1.4 million in fraudulent claims for chiropractic services to Independence Blue Cross under Bodhise’s name and medical provider number even though he had moved out of state and no longer treated patients at Oasis.”
And in case you were wondering, this isn’t Ali’s first time getting in trouble for insurance fraud relating to chiropractors. At the time that he bought Oasis, he was on probation for a state conviction in Montgomery County from July of 2007, for his role in an insurance-fraud scheme in which a Philadelphia-area chiropractor submitted millions of dollars in fraudulent claims to insurance providers for services that were never rendered.
Leahy said in court papers that Ali worked for the chiropractor and met patients to have them sign phony “treatment sheets indicating they had been treated by the chiropractor when they had not received any treatment at all.” The court filing said Ali was paid $49,000 for his role in the scheme. He was sentenced to two years’ probation.
While at Oasis, Ali operated without a chiropractor on staff from January to late August of 2009, when he hired licensed chiropractor Valda Dawson to work about eight hours a week. In a court document, Leahy stated, “Dawson saw four patients at most, but usually less, on days she worked, and was paid $40 for each patient she treated.”
Had the case gone to trial, Dawson was expected to testify for the government, to which she did not submit any claims for her services while working for Ali.
Prosecutors said Ali submitted claims for Dawson’s patients, while also using Dr. Bodhise’s identity. He included several procedures that Dawson didn’t even perform.
Leahy noted that IBC investigators were tipped off to Ali when the number of claims that were submitted under Bodhise’s provider information “spiked dramatically to $1.4 million for 2009 compared to approximately $316,000 for 2008.”
Court papers stated that, in 2009, claims submitted for Bodhise were among the highest for all IBC participating chiropractors nationwide.
By late 2009, IBC began to investigate complaints from insured patients who reported that claims were submitted from Oasis on their behalf for visits that never occurred and services that were never performed.
Ali, who was released on $50,000 bond after his arrest in back July of 2011, remains free pending sentencing.
This post is authored by Trace America.