The co-owners of a Warwick-based holistic health care center are accused of defrauding federal and private health care insurance providers of nearly $1.9 million.
Brandon Nowak, 32, of Providence, and Jason Simmons, 32, of Foster, were charged in federal court with health care fraud conspiracy, health care fraud, and filing false claims. They are accused of submitting fraudulent claims for reimbursement for services that were not provided to patients at their business, AIM Health Care Centers LLC, which has satellite offices in Pawtucket, North Kingstown, and East Providence.
Nowak is the president and CEO of the company. Simmons is the vice president, chief financial officer, and compliance officer.
AIM Health Care Centers is accused of electronically submitting claims for services that did not happen, including infrared and hot/cold therapy, therapeutic activity, and self-care/home management training. They are also accused of submitting claims for acupuncture and evaluation and management office visits when the actual services provided were massages given by licensed massage therapists, which is not a covered service.
The company is also accused of billing for high complexity office visits that were not provided, modifying codes on reimbursement forms to avoid automatic denials for payment for services that were either not provided nor medically necessary, and billing for services that were provided by uncredentialed providers under the provider numbers of credentialed providers.
AIM Health Care Centers is alleged to have fraudulently received $1,872,330 in payments from government and private insurers.
Generative artificial intelligence (AI) assisted a What’sUpNewp journalist with the reporting included in this story.
Gateway says there something wrong with collecting clipped toenails an they just can’t mind there own business