Published: 2009-10-23 21:12:05
Author: Atlanta Business Chronicle | October 9, 2009
Two Mariettans were arraigned Friday on felony charges for allegedly defrauded Blue Cross Blue Shield and other insurers out of $11 million.
Andrew L. Sokol, 41, and Julie B. Weisberg, 35, were charged with fraudulently submitting millions of dollars of insurance claims to Blue Cross Blue Shield and other private insurers for physical therapy services that were not actually provided.
WellnessOneallegedly offered massage, personal training, and chiropractic services to its patients, but the indictment alleges the services were fraudulently billed to insurance companies as physical therapy.
Sokol and Weisberg allegedly targeted MBNA and Bank of America Corp. employees because the Blue Cross Blue Shield policies covering those employees provided generous chiropractic and physical therapy insurance benefits.
To attract patients to WellnessOne clinics, Sokol and Weisberg designed and implemented frequent promotions, giving bank employees who came in for a massage or chiropractic adjustment gifts cards in the amount of $50, $25, or $10, and restaurant and free gasoline cards; raffle tickets offering the chance to win BMW and Hummer leases or $5,000; frozen turkeys and pies at Thanksgiving and Christmas; gift bags containing supplements, vitamins, lumbar and cervical pillows, and weight loss patches; and free catered lunches in the clinics.
Sokol and Weisberg also waived patients’ co-payments and deductibles, resulting in the patients being compensated with gift cards and other items of value while paying nothing for the massages and chiropractic adjustments they got at WellnessOne.
From January 2005 through September 2007, Sokol and Weisberg allegedly employed licensed medical doctors and physical therapists in order to bill massage as physical therapy, even though these licensed providers never saw the majority of patients and massage therapists were actually giving the massages. Several medical providers quit when they realized WellnessOne was billing insurers under their names for services they did not perform.