Fort Worth physician’s assistant charged with healthcare fraud in pain management scheme [Fort Worth Star-Telegram]

A Fort Worth physician’s assistant has been charged with healthcare fraud, accused of injecting amniotic fluid into patients in a pain management scheme, U.S. Attorney for the Northern District of Texas Leigha Simonton said in a news release.

Ray Anthony Shoulders, a 36-year-old physician’s assistant at a Fort Worth pain management clinic, was indicted on one count of conspiracy to commit healthcare fraud and 11 counts of healthcare fraud.

He made his first court appearance Wednesday before U.S. Magistrate Judge Jeffrey Cureton.

“This defendant allegedly claimed that amniotic fluid — a product that has never been approved to treat pain — would alleviate his patients’ suffering... To add insult to injury, he allegedly scammed Medicare out of more than half a million dollars,” Simonton said in the news release. “Medical professionals cannot be allowed to bill insurers for unreliable, unapproved, unreimbursable treatments.”

Shoulders and others involved in the 17-month long scheme “improperly billed Medicare about $788,000,” according to the indictment. Shoulders and others received about $614,200 in reimbursements from Medicare for injecting amniotic fluid into patients to purportedly relieve joint pain, according to the news release.

“The conduct alleged in this indictment put patients at risk,” Jason Meadows, special agent in charge at the Department of Health and Human Services, Office of Inspector General, said in the release.

While certain amniotic products have been approved by the U.S. Food and Drug Administration for wound care, amniotic fluid — a liquid that surrounds a fetus during pregnancy — has not been approved for pain management or treating orthopedic conditions, Simonton said in the release.

Shoulders allegedly asked patients to pay more than $800 out of pocket per injection of amniotic fluid. “Cell Genuity,” the amniotic product that Shoulders used, is not covered or reimbursed by Medicare, according to the indictment.

“As a result of the high cost and the questionable efficacy, patients often refused such treatment,” Shoulders’ indictment said.

To get more patients to consent to the injections, he billed shots to Medicare under the code for another amniotic product, “Fluid Flow,” which the insurance covered for wound care, according to the news release.

From August to October 2020, the clinic Shoulders worked at submitted more than 100 bills for Fluid Flow to Medicare and received around $400,000 in reimbursements, Simonton said in the release. Shoulders then received a portion of the reimbursements.

The indictment says that Shoulders stopped the scheme in November 2020 to avoid detection, but then resumed in October 2021 through December 2021.

If convicted, Shoulders faces up to 120 years in federal prison — 10 years per count.

Shoulders’ attorney, Michael Heiskell, told the Star-Telegram in a statement that his indictment is “based upon the government’s misunderstanding of the operation of medical practices during the pandemic when many nuanced processes and procedures were put in place due to the prohibition of non-essential surgical procedures.”

“His described role in regard to the billing process during that time is erroneous. It is curious and questionable that the government chose to indict a physician assistant who, as his title reveals, is an assistant to the doctors in charge who employ him and who review and approve every aspect of his work,” Heiskell told the Star-Telegram.

His attorney further said that Shoulders is “absolutely and totally one hundred percent ‘Not Guilty’ and he looks forward to clearing his name in light of this overreach by the government.”

The Department of Health & Human Services’ Office of Inspector General conducted the investigation with assistance from the FBI’s Dallas Field Office.

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