The owners and operators of a Rhode Island pain management clinic have been indicted by a federal grand jury on healthcare fraud charges for allegedly defrauding government and private healthcare insurers. Brandon Nowak, 32, and Jason Simmons, 33, both of Foster, RI, and officers and operators of Alternative Integrative Medicine, LLC, d/b/a Aim Health, are charged with conspiracy to commit healthcare fraud and fourteen counts of healthcare fraud. It is alleged that beginning in October 2020, Nowak and Simmons conspired to and did intentionally and repeatedly submit fraudulent claims to Medicare and Medicare Advantage, Medicaid Managed Care, and four private insurers in order to collect payments for certain purportedly “medically necessary” services that were not actually provided to patients.
The indictment also alleges that patients were routinely informed that massage therapy was a service covered by their insurance, when in fact it was not. In order to receive insurance payment for massage therapy provided by a massage therapist, the defendants allegedly billed insurers for covered services such as acupuncture, physical therapy, and evaluation and management office visits, none of which the patients actually received. Additionally, it is alleged that the defendants submitted claims for services such as infrared therapy, hot and cold therapy, therapeutic activity, and self-care/home management training that were not provided to the patients and for which AIM Health did not employ appropriate providers.
