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.