The co-owners of a Warwick-based holistic healthcare center have been charged in federal court with allegedly defrauding federal and private healthcare insurance providers out of nearly $1.9 million dollars by submitting fraudulent claims for reimbursement for services that were not provided. Brandon Nowak, 32, of Providence, and Jason Simmons, 32, of Foster, co-owners of Alternative Integrated Medicine, LLC (doing business as AIM Health), made initial appearances on Tuesday before a US Magistrate Judge on charges of healthcare fraud conspiracy, healthcare fraud, and filing false claims. It is alleged in charging documents that, at Nowak’s direction, and with Simmons’ knowledge, AIM Health electronically submitted for payment claims for services that did not occur or were not covered, including such treatment as infrared therapy, hot and cold therapy, therapeutic activity, and self-care/home management training.
Additionally, it is alleged that AIM Health submitted reimbursement claims for acupuncture and evaluation and management office visits when the actual services provided were massages given by licensed massage therapists (a non-covered service); that the company billed for high complexity office visits without providing that level of service; that AIM modified codes on reimbursement forms to avoid triggering automatic denials for payment for services that were either not provided nor medically necessary; and that AIM billed for covered and non-covered services rendered by uncredentialed providers under the provider numbers of credentialed providers. As a result of this conduct, it is alleged that AIM Health fraudulently obtained $1,872,330 in payments from government and private insurers to which AIM was not entitled to receive.
