A physical therapy practice in Erie County, Pennsylvania, and 20 people — 18 of them from northwestern Pennsylvania — have been indicted by a federal grand jury in Erie on charges of conspiracy to commit wire and healthcare fraud and healthcare fraud, Acting United States Attorney Stephen R. Kaufman announced today.
According to the Indictment presented to the court, the defendants conspired from January 2007 to October 2021 to commit wire fraud and healthcare fraud. The multi-faceted conspiracy had numerous components including:
- a) Hertel & Brown Physical & Aquatic Therapy utilized unlicensed technicians to provide physical therapy treatment, including aquatic therapy, and billed that treatment as if performed by a licensed physical therapist or physical therapy assistant.
- b) Unlicensed technicians at Hertel & Brown Physical & Aquatic Therapy were permitted and required to log into the treatment documentation system, WebPT, as a licensed physical therapist to facilitate documenting treatment as if performed by a licensed therapist.
- c) Hertel & Brown Physical & Aquatic Therapy and its licensed employees regularly recorded and billed for treatment time in excess of actual treatment time spent with patients.
- d) Hertel & Brown Physical & Aquatic Therapy and its licensed employees rarely if ever utilized group therapy codes when billing for treatment even when group billing codes were the only appropriate billing codes that could have been utilized.
- e) Hertel & Brown Physical & Aquatic Therapy regularly billed treatment time using the name and credentials of a physical therapist who was on vacation and not working on the day in question.
- f) Hertel & Brown Physical & Aquatic Therapy allowed physical therapy assistants and unlicensed personnel to treat patients with insurance that only reimbursed for treatment performed by a physical therapist. Then the practice and its employees covered up who actually treated the patient by removing the name of the actual person providing treatment from the treatment record.
- g) Hertel & Brown Physical & Aquatic Therapy and some of its employees also manually changed the patient schedule after the fact to conceal that Medicare patients were scheduled at the same time as other patients. This was done to conceal that Medicare patients did not have one on one treatment with a physical therapist as billed by the practice and required by Medicare.
