Phony chiropractor gets 6 years [The Philadelphia Inquirer] - Insurance News | InsuranceNewsNet

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October 19, 2012 Newswires
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Phony chiropractor gets 6 years [The Philadelphia Inquirer]

John P. Martin, The Philadelphia Inquirer
By John P. Martin, The Philadelphia Inquirer
McClatchy-Tribune Information Services

Oct. 19--A federal judge on Thursday sentenced a Philadelphia man to six years in prison for posing as a chiropractor and trying to bilk $1.4 million from the insurer Independence Blue Cross.

Tahib Smith Ali, 35, was a smooth-talking con artist whose offense wasn't just about money, prosecutors said. Scores of patients went to his Center City practice in search of pain relief, and left thinking they had been treated by a trained professional.

One was a 9-year-old severely disabled girl who couldn't speak or walk, and whose legs Ali massaged. Others included women who shared their personal medical histories, stripped down to a medical gown, and let the man they thought was a licensed doctor put his hands on them.

"I trusted him as a healing professional," patient Mary J. Gentile testified during the two-day sentencing hearing.

U.S. District Judge Mitchell S. Goldberg said the examinations were never sexual in nature but still amounted to a very personal breach of trust.

"I don't think you understand the violations that occurred," the judge told Ali. "Very serious, very humiliating."

Ali was on probation for a misdemeanor conviction in another insurance fraud when he agreed in late 2008 to buy the Oasis Holistic Healing Village on 17th Street from its retiring owner, Dr. Paul Bodhise.

Ali told Bodhise he planned to hire a licensed professional chiropractor to continue offering services, court filings show. Instead, he donned the scrubs himself, examined patients, even scrawled notes on their charts.

Using Bodhise's medical provider number, Ali also submitted claims for insurance repayment. Lots of them.

In 2009, Independence Blue Cross received invoices for more than $1.4 million from the office. The amount was more than four times what Bodhise had billed the insurer the previous year -- and more than it had received from any single chiropractor nationwide, prosecutors said.

The insurer paid Ali $285,000 -- fueling a lavish lifestyle that included vacations to Aruba and Napa Valley and a $20,000 motorcycle -- before its investigators began to get suspicious.

Besides recognizing the inflated billings, the company had started fielding complaints from patients about the practice, court records show. One patient told investigators he or she never visited the office, even though Ali had billed the insurer for treating the patient 50 times.

FBI agents confronted Ali in the spring of 2011, and he admitted billing with Bodhise's medical provider number. A grand jury later indicted him on more than 100 counts of health-care-related fraud.

On the day his trial was to begin in June, Ali pleaded guilty to fraud and identity theft, a crime that alone carried a mandatory minimum two-year term.

In a courtroom packed with his friends and supporters on Thursday, Ali told the judge that he bought the practice with the intention of serving as the manager and hiring a chiropractor. But when he couldn't find a professional to come on board, his ambition clouded his judgment, he said.

"Lots of false pride; I told everyone I owned a business," he said. "I was really afraid of failure."

Assistant U.S. Attorney Mary Beth Leahy suggested his remarks were just an extension of the fraud.

"What's in his DNA, your honor, is deceit," she said. "He's a very good con man."

Dr. Daniel Bowerman, a physical therapy and chiropractic treatment expert enlisted by prosecutors to review the patients' statements and medical histories, said Ali could have unknowingly inflicted serious, or even fatal, injuries.

Ali's lawyer, Christopher Hall, argued that such a conclusion was hyperbolic speculation. He also repeatedly tried to suggest that Bodhise had a role in the fraud and knew Ali was using his medical license number, an allegation prosecutors called a fabrication.

Hall described his client as a "good man" who had made a huge mistake but was eager to serve his time, repay his debt, and return to his family.

The judge cited that strong family support as one reason he gave Ali slightly less than the nearly seven-year term prosecutors had sought.

Goldberg also said he was skeptical that Ali was routinely exposing patients to life-threatening risks. But the judge was troubled that Ali gave no thought to how unqualified he was to make judgments about someone's health.

"He not only wasn't a chiropractor, he had no training at all," the judge said.

Contact John P. Martin

at 215-854-4774, jmartin@phillynews.com, or follow @JPMartinInky on Twitter.

___

(c)2012 The Philadelphia Inquirer

Visit The Philadelphia Inquirer at www.philly.com

Distributed by MCT Information Services

Wordcount:  744

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