Wednesday, February 4, 2015

YOU LIE, YOU LOSE: A ROCHESTER, MASS. MAN AND HIS EMPLOYER WERE SENTENCED ON THURSDAY FOR DEFRAUDING INSURANCE COMPANIES REGARDING PHYSICAL THERAPY SERVICES THEY SAID WERE PROVIDED TO PATIENTS INJURED IN CAR ACCIDENTS.



YOU LIE, YOU LOSE:  A ROCHESTER, MASS. MAN AND HIS EMPLOYER WERE SENTENCED ON THURSDAY FOR DEFRAUDING INSURANCE COMPANIES REGARDING PHYSICAL THERAPY SERVICES THEY SAID WERE PROVIDED TO PATIENTS INJURED IN CAR ACCIDENTS.


Boston, Mass — A Rochester, Mass. man and his employer were sentenced on Thursday for defrauding insurance companies regarding physical therapy services they said were provided to patients injured in car accidents.

U.S. District Judge Richard Stearns sentenced Walkyrie Massie, 39, and 65-year-old Edward Rossi of Rochester to prison for 30 months and 18 months, respectively, and two years of supervised release. The judge also ordered them to pay $174,597 in restitution to the defrauded insurance companies.

According to the U.S. Attorney’s office, Massie and her employees submitted fraudulent medical reports to the insurance companies for services provided at her business, Westgate Physical Therapy in Brockton.

“The scam perpetrated by Massie and her employees defrauded insurance companies and deprived injured patients proper care,” said U.S. Attorney Carmen Ortiz. “Patients desire quality care and need honest caregivers. This kind of fraud is corrosive to our healthcare system.”

Rossi, a licensed physical therapy assistant, was supposed to offer therapy to patients several times a week. After that, a physical therapist was to evaluate the patient, and then Westgate would bill the insurance company following treatment.

According to officials, Rossi filed “cookie-cutter” treatment notes for patients who either didn’t show, were in the clinic for minutes or were not seen by Rossi at all because he was absent.

From 2009 to 2011, Westgate billed insurance companies more than $400,000 and received more than $174,000 based on the fraudulent treatments.

During the investigation, federal officers used a cooperating witness, who feigned having been in a car accident and went to Westgate for treatment. From March 2011 to June 2011, the patient recorded visits to Westgate and taped Massie boasting about forging the witness’s name on sign-in sheets that made it appear he had received treatment, prosecutors said.

“Westgate Physical Therapy was solely motivated by profit rather than patient care when it forged patient records,” said Vincent Lisi, special agent in charge of the FBI’s Boston Field Division. “The FBI is dedicated to aggressively investigating this type of criminal activity because it has a great impact not only on private insurance companies but on the economy as a whole.”

The Massachusetts Insurance Fraud Bureau also assisted in the investigation. Assistant U.S. Attorney Shelby Wright prosecuted the case.